DPM Heng Swee Keat at the Bioethics Advisory Committee 20th Anniversary Virtual Public Conference

Mr Richard Magnus, 
Chair of the Bioethics Advisory Committee,

Ladies and Gentlemen, I am delighted to join you in commemorating the 20th anniversary of the Bioethics Advisory Committee and be part of this virtual public conference, to speak about the role and future of bioethics in Singapore. 

Historical Context

The 1990s saw a boom in the field of biomedical sciences. The advent of high throughput DNA sequencing opened up new frontiers. The Human Genome Project officially began in 1990, as an international scientific effort to map and sequence the entire human genome. The first therapeutic use of gene transfer, as well as the first direct insertion of human DNA into the nuclear genome in a clinical trial, took place in the same year, to treat a patient with severe immune system deficiency. The birth of Dolly the Sheep in 1996 – the first mammal to be cloned – heralded a new era in genetics.  Science was pushing new frontiers, which raises new moral and ethical issues. Many countries and the scientific community were quick to draw the line on human reproductive cloning and human germline editing, and there was growing recognition of the need to avoid a “wild west” developing. 

There was a growing appreciation that the progress of science and ethics had to proceed hand in hand. We must continue to invest in science and encourage discovery, to crack the many challenges that we are facing, but we must always do these in a way that is in line with our values.  

Growth of Biomedical Sciences in Singapore 

Singapore was quick to join the fast growing biomedical sciences space. The late Dr Sydney Brenner spurred the establishment of the Institute of Molecular and Cell Biology in 1985, which marked the beginning of our biomedical sciences journey. At the turn of the millennium, we restructured the National Science and Technology Board into A*STAR, and launched the Biomedical Sciences Initiative. Under the leadership of Mr Phillip Yeo, A*STAR recruited world-renowned scientists, built up our talent pool through national science scholarships, and developed Biopolis to bring together the biomedical research ecosystem. And when the science of genomics was still in its nascent stages, we set up the Genome Institute of Singapore, in anticipation that the Human Genome Project would transform biology and medicine. In 2006, we established the National Research Foundation. We invested more in research as part of our Research, Innovation and Enterprise or RIE plans.  In the same year, we formally incorporated clinical research as part of the Ministry of Health’s mandate – to facilitate the translation of scientific discoveries from bench to bedside and from bench to industries.  Through the National Medical Research Council, MOH launched several programmes to build up translational and clinical research capabilities in our healthcare institutions.

Today, the biomedical sciences sector generates more than 33 billion dollars in manufacturing output and employs over 24,000 workers. Singapore has more than 50 pharmaceutical manufacturing facilities, including plants from eight of the world’s ten biggest pharmaceutical firms. The number and quality of medical technology and biotech start-ups have grown significantly. When the unexpected struck, the value of our research investments became even more visible. We mobilised these capabilities to fight COVID-19, including the developments of diagnostic tests, such as The Fortitude 2.0 PCR test kit, which is now used by more than 45 countries, cPass, the first serological test for neutralising antibodies to be authorised for emergency use by the US FDA, and Breathonix and TracieX, breath analysers that are designed to detect the presence of COVID-19 within minutes. The biomedical sector continues to attract new investments during the pandemic. These include the BioNTech manufacturing facility – to produce a range of different mRNA vaccines and therapeutics, and a vaccine production centre by Sanofi Pasteur to simultaneously manufacture multiple types of vaccines in Singapore. 

Bioethics Advisory Committee

As biomedical sciences advance, bioethics became even more important. We anticipated this. Some 20 years ago – the same year that we gave greater momentum to the biomedical sciences sector, we also set up the Bioethics Advisory Committee or BAC, under the chairmanship of Professor Lim Pin. The BAC’s first order of business was to develop guidelines for human stem cell research. It has been an extremely busy two decades since. For example, the BAC’s recommendations – on human stem cell research, reproductive and therapeutic cloning – were incorporated into the Human Cloning and Other Prohibited Practices Act in 2004. BAC’s recommendations on the Institutional Review Boards also laid the foundations for the Human Biomedical Research Act in 2015. 

We have since formalised the role of the Institutional Review Boards, to ensure that they continue to protect the rights, safety and welfare of clinical trial participants, and adhere to international standards and best practices. 

The nature of ethics is complex and multi-faceted. Bioethics in Singapore has to reflect the values that we hold as a society, which is why BAC is composed of members from diverse backgrounds. To address the complex ethical, legal and social issues arising from biomedical science research, the Committee comprises lawyers, doctors, biomedical and social scientists, philosophers, as well as representatives from religious groups and the media. Under the leadership of Mr Richard Magnus, the BAC has grown in standing, both locally and internationally. Richard was the first Singaporean appointed to the UNESCO's International Bioethics Committee in 2012.  He was also elected as its Vice-Chair from 2016 to 2019. Richard’s appointment shows the value and relevance of BAC’s work internationally. I am glad that we are making a contribution. 

Into the Future

At the heart of what we do is to ensure that science and technology benefit our people, and is congruent with what we stand for as a society. The importance of taking a more human-centric approach to research and innovation is also reflected in our priorities for RIE2025, where we focused the Biomedical Sciences domain on Human Health and Potential. This reflects our emphasis on using science in a way that will improve lives, and bring out the best in each and everyone of us. 

One key priority under the Human Health and Potential domain is to understand how we learn, function and perform, especially from a young age, and at different stages of life so that we can grow to our full potential. 

Another key priority for this domain is to better harness data safely and securely to support healthcare and digital health innovation. For example, by expanding our National Precision Medicine research programme, and developing our data infrastructure and capabilities, we aim to use large-scale genomic, phenotypic, lifestyle and clinical data, to predict disease risk upstream, better diagnose medical conditions, and develop targeted treatments with reduced clinical complications and costs. As part of the National Artificial Intelligence Strategy, which I launched in 2019, we are using AI and Big Data in a bigger way to enhance healthcare and other sectors. We launched the AI in Health Grand Challenge in 2018, to encourage the development of innovative AI approaches, to tackle common chronic conditions. This has led to earlier disease detection at the pre-chronic stage, better risk stratification of patients with diabetes, and more optimal treatment of those with hypertension. An AI programme, known as SELENA+, has also been put to practical use, by helping healthcare professionals quickly analyse eye images for diabetes related disease. This will be deployed to all polyclinics by early next year.  

These rapid developments in human health and potential will open up new ethical frontiers. One scenario is that the use of AI in biotechnology may one day enable scientists to influence human thought, emotion and behaviour. We must therefore proactively address such concerns at the outset. In Singapore, we take care to ensure that data confidentiality, privacy and security are maintained, as we explore the frontiers of innovations. The BAC is also studying the need for additional safeguards in the use of digital solutions in biomedical sciences. For instance, precision medicine can generate large volumes of medical, genetic, and behavioural data. This information can help us to develop targeted treatments with greater effectiveness and fewer complications.However, we also need to consider how we can better protect participants’ privacy, obtain informed consent, and address third party access and system governance. 

The BAC’s work complements our ongoing efforts to build biomedical ethics capacity and capability in Singapore. The BAC collaborates with local partners such as the NUS Centre for Biomedical Ethics, to develop clear and effective guidance for the responsible implementation of digital solutions. The BAC also supports MOH’s efforts in building up a team of Institutional Review Board members, as well as to upskill staff and researchers through a suite of training programmes, including research ethics in Big Data and AI. 

Today’s Conference is yet another example of how the BAC builds greater awareness and deeper knowledge on bioethics in Singapore, not only with academics and healthcare professionals, but also with the general public, including our students.

Conclusion

Congratulations to the BAC once again on your 20th anniversary. I thank all the past and present members of the BAC, as well as the BAC’s local and international advisors for bringing BAC so far in this journey. Biomedical sciences will be even more exciting in the future as our knowledge of life advances, and as we focus our RIE efforts to improve health and human potential.  This also means that the BAC will confront a wider range of issues. But with your continued commitment to maintain high ethical standards, I am confident that Singapore will not only be a thriving global node for biomedical sciences, we will be one that realises the full benefit of science and technology for the benefit of humankind. 

I wish BAC a happy 20th anniversary – it has been a fulfilling journey. I also wish everyone an inspiring learning experience in this conference. Thank you.