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Only 11 experts for infectious diseases (The Straits Times [Singapore])
15 Nov, 2004

More specialists, resources needed to handle growing problem: CDC director

SINGAPORE has only 11 practising infectious disease specialists who tackle everything from dengue, cholera and melioidosis to Aids, Sars and bird flu, and that is not enough, say doctors at the front line.

There is an urgent need for more money, research and expertise to build up defences against the threats not just from Aids but also other infectious diseases that are becoming rampant, said Dr Leo Yee Sin, clinical director of the Communicable Disease Centre (CDC).

Responding to Senior Minister of State for Health Balaji Sadasivan's call for the CDC to do more in Aids prevention and tackle an 'alarming Aids epidemic' here, Dr Leo said yesterday that the CDC did not have the expertise to do the job right now, as its focus had always been treatment rather than prevention.

The number of new HIV cases has been increasing and is set to cross the 300 mark this year, Dr Balaji warned on Wednesday night. If this continues unchecked, he said, Singapore might have 15,000 people with HIV by 2010.

Dr Leo told The Straits Times: 'Ever since the CDC was set up, treatment has been our forte. What we've been trained for is patient care and that will remain our focus.'

However, if the CDC had to expand its role to include prevention, it would need more money and trained manpower to draw up and implement strategies. 'We need to relook not just Aids, but all other infectious diseases, including new ones like Sars and avian flu,' she said.

To do this, research was critical. In the case of Aids, for example, it was not clear why, as Dr Balaji pointed out, there was a sharp rise in new Aids infections among homosexuals, from 54 cases last year to 77 in the first 10 months of this year.

Said Dr Leo: 'Is this rise in Aids cases because of a change in sexual behaviour, a change in demographic patterns or a change in social responsibility? We do not know.'

Not much is known about other infectious diseases either, noted Associate Professor Peter Preiser, an expert in the field at Nanyang Technological University. 'In many infectious diseases that are on the rise, such as dengue, there are still no vaccines, and treatment options are still quite limited.'

Training more physicians was also imperative, the experts asserted. At present, the 11 practising infectious disease specialists, five of whom work at the CDC, handle all infectious diseases, not just Aids.

Although the Health Ministry website lists 15 infectious diseases specialists, Dr Leo said only 11 were practising. 'We certainly need many more,' she said, adding that public health in infectious diseases had been a 'neglected field' for many years now.

Expertise alone would not do the job when it came to disease prevention, said Dr Chong Weng Chiew, deputy chair of the Government Parliamentary Committee for Health. All sections of society, including government and non-governmental organisations, businesses and the community must be involved in infectious disease education and prevention programmes, he said.

Offering to do his part was the chief executive of gay portal Fridae.com, Dr Stuart Koe, who suggested that the Health Ministry engage the gay community directly in dialogues on the issue.

Dr Balaji, who said the 'promiscuous and unsafe lifestyle advocated and practised by some gays' was responsible for the recent explosion in cases, had singled out an article in Fridae.com for criticism.

Dr Koe said the portal backed the Government's stand on safe sex, but like other publications, it had a mix of serious, fact-based articles as well as light-hearted, entertainment pieces.

Preaching abstinence or faithfulness to your spouse was not going to work with the gay community, added Dr Koe, who offered the ministry Fridae.com's 'significant resources' to target Aids prevention messages at homosexuals.

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