DPM Heng Swee Keat at the Singapore Clinical Research Institute (SCRI) Clinical Trials Symposium 2024

Professor Tan Chorh Chuan and Professor Kenneth Mak,
Professor John Lim, Chairman, Consortium for Clinical Research and Innovation, Singapore
Associate Professor Danny Soon, CEO of CRIS and Executive Director, Singapore Clinical Research Institute,

Ladies and gentlemen,

Good morning. I am delighted to join you today at this Clinical Trials Symposium to discuss an important topic.

Let me first congratulate Danny and his team at SCRI for convening an inaugural symposium at this scale. Over the next 2 days, more than 500 clinicians, researchers, academics, healthcare sector leaders and industry experts will come together to exchange ideas on how clinical trials can transform healthcare outcomes. 

Such wide-ranging participation reflects a recognition of the value of clinical trials in shaping a healthier future. It also underscores how clinical trials are fundamentally a collaborative endeavour. Through clinical trials, hospitals, clinicians, pharmaceutical companies and patients work with one another to advance impactful research. So it is very useful that the experts will hear directly from patients and clinical trial participants during this symposium. 

I am also very encouraged that many of the collaborations extend across borders. So let me warmly welcome our speakers and participants from across Asia, Australia, the US and Europe. Many of you have had very productive collaborations with SCRI and our ecosystem over the years. I trust that these linkages will grow even stronger going forward.

Clinical trials are a critical element in the broad spectrum of healthcare and biomedical capabilities. Through clinical trials, patients can access new treatment methods, offering them renewed hope. Trials enable healthcare providers and professionals to explore novel therapies and solutions, benefitting patients who do not respond to existing modes of treatment. This helps to improve accessibility.

Importantly, clinical trials also help to facilitate safe and credible innovations in healthcare. They provide a rigorous framework for the testing of new health products and solutions. This ensures that they meet safety, efficacy and regulatory standards before widespread adoption. Through well-designed clinical trials, innovators can validate their technologies, gather robust data, and refine their products and solutions based on real-world feedback. Taken together, the increased accessibility and enhanced safety arising from clinical trials helps to strengthen public trust in healthcare systems.

Moving forward, these dimensions that I just mentioned – accessibility, innovation and trust – will become even more important to healthcare systems around the world. Our experience with the COVID pandemic taught us how healthcare systems must be prepared to respond to sudden and disruptive shocks in a globalised, hyperconnected world. To save precious lives and preserve public trust, our healthcare systems must innovate with speed and scale, and make these innovations widely available. I am glad that later this morning, you will hear from the World Health Organisation’s Chief Scientist, Sir Jeremy Farrar, on how clinical trials underpinned our global response to the pandemic.

And with populations ageing globally, and the growing impact of climate change including through more protracted weather extremes, healthcare demands around the world will rise in the decades ahead. Transforming our healthcare systems to be more innovative and accessible will be crucial. So the theme of this symposium, “The Promise of Clinical Trials: Transforming Tomorrow’s Health” is most timely.

Here in Singapore, we started building our clinical research capabilities early, in tandem with wider investments into the biomedical sector. Recognising the value of strong biomedical capabilities, we started to develop our research infrastructure, capabilities and talent from the early 2000s. John earlier brought us through the history and evolution of SCRI, starting with the Clinical Trials and Epidemiology Research Unit in the 1990s. I commend SCRI for your good work over the years, including in developing clinical research talent, building industry and cross-border partnerships, and in patient advocacy engagement.
Today, we have more than 100 clinical trials approved each year. SCRI oversees close to 60 clinical research projects at any given time, including national-level clinical trials. Danny will speak at length later about the value proposition that clinical trials bring to Singapore. Let me briefly mention two examples.

The first is the Adaptive COVID-19 Treatment Trial, that SCRI facilitated during the pandemic. This involved a multi-centre effort trialling investigational therapeutics in hospitalised COVID patients – those who needed acute care. Through SCRI’s facilitation, including in grant applications and regulatory submissions, the study kicked off within just a month. The Adaptive COVID-19 Treatment Trial network was later expanded from one hospital in March 2020 to six hospitals by 2021 and helped to save precious lives. 

A second example is an ongoing collaboration between the National University Cancer Institute, Singapore, and the Cancer Science Institute of Singapore. Under this trial, 43 patients with advanced metastatic breast cancer were treated with a combination drug therapy between 2015 and 2021 to achieve better control of their disease. The results showed that half of these patients, many of whom had failed prior treatment methods, experienced good disease control outcomes. And the next phase of this research is currently ongoing. 

In these cases, clinical trials enabled life-saving therapies to reach vulnerable patients sooner.

As we look to proactively address the health challenges of tomorrow, the key question we must ask ourselves is how can we make better use of clinical trials to build a future of longer lifespans and healthspans for our societies? Drawing from Singapore’s experience, let me briefly suggest three ways.

The first is to design clinical trials around upstream prevention and detection, in addition to downstream therapy and treatment. We can all agree that early detection and intervention can improve treatment outcomes. So even as we trial new drugs and therapies, we must also focus on new diagnostics that can detect the onset of disease early. 

GASTROClear, a novel cancer test developed by researchers at A*STAR, the National University Hospital, Tan Tock Seng Hospital and the National University of Singapore is a good example of this. Developed and validated through large-scale clinical studies involving 5,000 people in Singapore and Korea, GASTROClear has helped doctors achieve higher treatment rates through early diagnosis and has advanced blood-based early cancer detection.

Second, beyond early diagnostics and therapeutics, we should also step up clinical trials of new health-tech innovations. The digital revolution unfolding around us, especially artificial intelligence, has gathered momentum in recent years, impacting every sector including healthcare. For example, the Singapore Eye Lesion Analyser or SELENA+, is an AI system that can detect abnormal fundus images within minutes. SELENA+ has transformed the management of diabetic retinopathy screening in Singapore. Several polyclinics here are using this as an assistive device to speed up the detection of diabetic eye conditions.
 
uSINE, the world’s first AI-powered, ultrasound-guided, automated spinal landmark identification system, is another example. This was developed by a clinical team from KK Women’s and Children’s Hospital to better deliver spinal anaesthesia at precise locations to women in labour. Now spun off into a start-up, this innovation has helped to enhance patient safety during childbirth and has been integrated into clinical practice at KK Hospital.

I mentioned earlier that clinical trials can deliver new discoveries and insights to help us better manage the rising demands on healthcare globally. This brings me to my third point – to amplify impact, we must also tap on clinical trials to make healthcare more sustainable. As healthcare demands rise, the rising cost of treatment and therapy is a natural concern for many. Even as we deliver excellent and effective healthcare for our people, we must also do our best to make sure that costs remain affordable and sustainable. Clinical trials, such as those evaluating drug dosage efficacy, are one way of optimising treatment costs. Indeed, some trials have shown that lower dosages could yield the same clinical benefits. This could potentially lower treatment costs and improve the long-run sustainability of healthcare.

The common thread binding the three points I have made – and the examples I mentioned – is that collaboration is key in achieving impact and building a healthier future. As I said earlier, clinical trials are a collaborative enterprise involving several stakeholders – patients, caregivers, clinical investigators, researchers, government and other public and private entities. And everyone has a role to play in strengthening and deepening our clinical research capabilities, including those who are healthy. Healthy cohorts now form part of the clinical research landscape, providing important insights into how ageing, lifestyle and environmental factors affect health.

To promote closer collaboration and to make clinical trials more accessible for people, I am happy to announce the launch of ClinicalTrials.SG, or CTSG, today. CTSG, an initiative by SCRI, is a comprehensive centralised clinical trials portal that aims to drive clinical research excellence in Singapore by meeting the diverse needs of the clinical research community.

CTSG aims to educate patients and caregivers about clinical trials so that they can better understand their crucial role in advancing medical science, benefiting both current and future patients. Currently, such information on clinical trials in Singapore is tailored primarily to clinical research professionals and principal investigators. Healthy volunteers can also participate in early phase drug trials that help us investigate the tolerability of new therapeutics.

For clinical research professionals, CTSG will enable greater collaboration by connecting professionals with a diverse network of clinical researchers, academic institutions, and industry partners. Trial sponsors, such as pharmaceutical companies can identify potential collaborators by searching for clinical investigators in Singapore who align with their research goals and expertise. This platform is also designed to advance research efforts by offering detailed insights into regulatory and ethical requirements to conduct clinical trials in Singapore. Additionally, CTSG features a biorepository catalogue drawn from existing cardiovascular and oncology imaging databases to enable clinician investigators to search for relevant samples that will aid their research.

Just as we foster collaborations within our ecosystem, we can also do more across borders to advance the impact of clinical trials in the rest of Asia, and globally. Indeed, Singapore aspires to be a Global-Asia node of technology, innovation and enterprise, working with like-minded partners to harness the power of science in impactful and beneficial ways. Keeping our societies healthy, in the face of demographic and environmental changes, is a shared global challenge.

It is encouraging to hear John earlier mention that SCRI has established clinical research networks with countries in the region to advance research, particularly in gynaecologic cancer studies and pre-hospital emergency care. These help to gather clinical evidence from across countries. This, in turn, raises the level of quality research and impactful applications – not only for patients in Singapore but also those in the wider region. So I also invite our partners from around the world who are here with us today to further your collaborations with SCRI and our wider biomedical ecosystem to enhance the efficacy and impact of clinical trials.

In conclusion, we must seize the opportunities we have today to advance clinical research as we strive to create a healthier tomorrow.  In particular, we must invest more in trials centred on upstream prevention, leverage new health-tech innovations, and tap on clinical trials to advance more sustainable healthcare systems. By bringing different stakeholders together with a common cause and by working across borders, we can achieve lasting impact and improved health outcomes for Singapore, Asia and the world. 

I congratulate John, Danny and the team at SCRI once again for convening this symposium, and I wish all of you two fruitful days of discussions and exchanges ahead. 

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