Singapore, April 7, 2021 – Precision medicine is part of Singapore’s Strategic Research, Innovation and Enterprise (RIE) 2025 goal to transform and protect the health of every Singaporean. Precision medicine has been identified as a priority by the Ministry of Health, and aims to understand how genomic, phenotypic, lifestyle and clinical factors contribute to the health of Singaporeans. It also supports the responsible use of health data in clinical applications with the long-term goal of addressing Singapore’s healthcare challenges in a clinically sustainable and effective manner.
Singapore’s National Precision Medicine Strategy (NPM) is a 10-year plan to advance and accelerate Singapore’s biomedical research, health outcomes and economic growth. The NPM is an all-government effort to create the frameworks and infrastructure necessary to achieve precision medicine on a national scale, to ultimately improve public health, to promote disease prevention and to identify appropriate treatments for appropriate individuals and groups.
The second phase of the NPM strategy will begin in Singapore in April 2021 with a horizon of four years and aims to:
1. Further research insights into the Asian phenotype by analyzing the genetic makeup of 100,000 healthy Singaporeans and up to 50,000 patients with specific diseases;
2. Improving patient outcomes through the experience of applying precision medicine in clinical practice; And
3. Creating new economic opportunities for the healthcare sector and biomedical technology in Singapore by attracting and establishing foreign companies while providing new opportunities for local companies.
To achieve this, Precision Health Research, Singapore (PRECISE), was established as a central entity to drive the NPM.
Increasing research insights into the Asian genome
Precision medicine is a rapidly growing medical approach that takes into account individual patient variables including genetics, lifestyle, as well as other environmental factors. A more comprehensive understanding of disease-causing agents provides early, faster and more accurate diagnoses, improves treatments by prescribing the right drug at the right time, informs the development of new drugs and treatments, and promotes disease prevention.
Governments around the world – including the United States, the United Kingdom, Denmark, Finland and Japan – have begun national genomics programs to harness the benefits of precision medicine. However, most of the current programs focus largely on Caucasian populations or lack genetic diversity. Many conditions, such as cancer and heart disease that can have different symptoms among Asians, remain underrepresented.
With its multi-ethnic population accounting for 80 percent of Asia’s genetic diversity, Singapore is well positioned to address knowledge gaps in Asia-specific precision medicine and complement the global effort.
The NPM strategy was launched in 2017, with the support of the RIE 2020 plan in Singapore. Phase I of NPM has culminated in the world’s largest genetic data bank for multiracial Asian populations. The NPM Phase 1 data bank, completed in October 2019, includes complete genetic data for 10,000 healthy Singaporeans, serves as a reference for Asian genetic normality and supports the subsequent development of precision medicine for Singaporeans and patients across Asia.
In the second phase of the NPM, PRECISE will collaborate with research partners and clinicians from the Singapore ecosystem, including the Agency for Science, Technology and Research (A * STAR), Lee Kong Qian College of Medicine, National Healthcare Group, National University Health System, and the National University of Singapore, And SingHealth Duke-NUS Academic Medical Center to study the genetic makeup of 100,000 healthy Singaporeans and up to 50,000 people with specific diseases. The genetic data will be combined with detailed lifestyle data, environmental and clinical data to provide rich insights into the factors that contribute to Asian diseases and conditions.
A study with this degree of population genetic diversity, combined with this level of phenotyping, is unparalleled. This is a powerful approach to identifying factors that determine why some Singaporeans, but not others, develop specific diseases. By taking insight into these pathogens, researchers and clinicians can develop new approaches that will not only benefit patients in the short term but for decades to come. Additionally, as this will require analyzing big data to generate insights, we have also intensified our efforts to ensure a secure and trustworthy data environment by actively working with various government agencies to build a robust infrastructure with safeguards in place to maintain data security and privacy, said Professor John Chambers, Senior Scientific Officers of PRECISE and one of the principal investigators supervising and coordinating the SG100K cohort study. The SG100K seeks to recruit 100,000 healthy participants for further research insights into the Asian genome and how it affects health and disease. Professor Chambers is also Professor of Cardiovascular Epidemiology and Chair of Cardiovascular Epidemiology at Li Kongqian School of Medicine at Nanyang Technological University.
Experimenting with the use of precision medicine in clinical practice
Singapore’s rapidly aging population and increasing prevalence of chronic diseases have fundamentally changed healthcare requirements. To ensure that healthcare delivery evolves to meet these demands and remains prepared for the future, precision medicine remains the primary focus of human health and potential area under the RIE2025 plan.
Precision medicine has already seen success in treating rare genetic diseases in Singapore. For more than two decades, the Genetics Service at KK Women’s and Children’s Hospital (KKH) has been providing clinical care to pediatric patients with genetic disorders, making use of a precision medicine approach to treat diseases. Through BRIDGES (bringing research innovations to genetic disease diagnostics in Singapore), 412 families have been analyzed over the past six years by genome researchers at SingHealth, A * STAR and Duke-NUS. As a result, 160 children with rare and undiagnosed conditions were able to receive appropriate diagnoses that led to dedicated clinical management and improved health outcomes in at least one out of three families. At 39 percent, Bridges has demonstrated a diagnostic return of 25 to 40 percent in similar research programs worldwide. Precision medicine helped improve understanding of the causes of genetic disorders, and helped clinicians assess and set evidence-based treatment goals to develop accurate treatments for conditions.
“While the field of precision medicine has seen significant progress in recent years, there is still an urgent need to translate research results into standard clinical practice. In the second phase of the NPM, we will work with clinicians, healthcare institutions and the Ministry of Health to find ways to apply PM to improve Singaporeans’ health in an affordable way. Maximize the benefit for the patient, ”said Professor E Shyong, Chief Medical Officer at PRECISE. He is also a Senior Consultant in the Department of Endocrinology at National University Hospital and Professor at the Yong Loo Lin School of Medicine of the National University of Singapore, the Su Soi Hook School of Public Health and the Duke-NUS School of Medicine.
Creating new economic opportunities for the healthcare and biomedical technology sector in Singapore
Making precision medicine a reality in Singapore requires a long-term and concerted commitment from both government and industry. In addition to expanding research efforts and establishing national clinical workflows, the second phase of the NPM will continue to partner with the National Research Foundation of Singapore (NRF), A * STAR, the Economic Development Board and the Health Promotion Board to catalyze the next phase of growth for the healthcare industry and biomedical technology in Singapore by attracting and entrenching foreign companies in Singapore, and creating new opportunities for local companies.
PRECISE Executive Director Professor Patrick Tan said: “Pharmaceutical, biotechnology and data science companies are a key component of Singapore’s NPM strategy. They are moving our research from the bench to bed by developing and manufacturing new drugs and treatments for patients. PRECISE will look to develop meaningful partnership models between The public and private sectors to facilitate growth and drive innovation across the healthcare and biotechnology industry – creating higher value jobs, nurturing the next generation of scientists and clinicians, and strengthening Singapore’s position as a leading medical center in the region offering precision medicine-based therapies. ” Professor Tan is also the Executive Director of the Genomics Institute. In Singapore at A * STAR and Professor at Duke-NUS Medical College.
About Precision Health Research, Singapore (PRECISE)
Precision Health Research, Singapore (PRECISE) is the central entity created to coordinate entire government efforts to implement the second phase of the National Precision Medicine (NPM) in Singapore for a period of 10 years.
The second phase of NPM aims to transform healthcare in Singapore and improve patient outcomes through new insights into the Asian genome and data-driven healthcare solutions. The second phase of the NPM will also enhance the breadth and depth of the PM-related industry by attracting and anchoring foreign companies in Singapore, while providing new opportunities for local firms.
PRECISE is a business unit of the Clinical Research and Innovation Consortium of Singapore (CRIS), a subsidiary of the Holding Ministry of Health. NPM Phase II and PRECISE are supported by the National Research Foundation of Singapore and the National Council for Medical Research under the Singapore Ministry of Health.
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About the Consortium for Clinical Research and Innovation of Singapore (CRIS)
The Clinical Research and Innovation Consortium of Singapore (CRIS) was established in 2020 to foster synergies and issue clinical research strategies and translation programs nationwide under the Ministry of Health (MOH).
CRIS combines the following five research platforms and programs as business units under one management and governance structure:
Singapore Clinical Research Institute (SCRI)
Singapore National Health Innovation Center (NHIC)
Advanced Cell Therapy and Research Institute, Singapore (ACTRIS)
Precision Health Research, Singapore (accurate)
Singapore Transitional Cancer Consortium (STCC)
The business units cover a wide range of activities, in both research and corporate functions – from clinical trials, medical technology development, precision medicine, and cellular therapy manufacturing, to cancer translation.
CRIS aims to make a positive difference to patients and researchers in Singapore by ensuring that these clinical research platforms and programs are at the forefront of capacity development and innovation, by facilitating collaborations and lasting partnerships with entities and biomedical research and communities across the public sector and industry.
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