Can Singapore handle Zika?

Photo: coniferconifer/CC BY 2.0

Further outbreaks of the Zika virus have prompted Singapore into more fumigation and calls for a regional approach to tackling the mosquito-bourne disease. However, the systems needed to do that need a lot of work to be effective. 

Singapore’s Prime Minister Lee Hsien Loong is urging ASEAN partner countries to unite in what may be an extended fight against the worrying Zika virus.

Speaking at the 28th ASEAN Summit, Lee said ASEAN needs to get ready for a persistent fight against Zika, asking his counterparts to join hands and tackle it as one so the economy and regional trade does not suffer. Cases have recently been reported in the Philippines, Indonesia, Vietnam, Malaysia and Thailand leading to calls from citizens for governments to actively fight the disease. We need more information about the risks, say many. 

But as reports come in of new clusters, concerns are being raised over the size and concentration of the Singapore outbreak. Many observers wonder whether the most advanced nation in Southeast Asia is susceptible to large-scale infection, and the efficiency of its public health measures.

Spreading fast

Medical professionals believe the portion of the Singaporean population that is naturally immune to the Zika virus is low, and this increases the chances of a wider outbreak. However, Singapore’s Ministry of Health said an investigation of two cases recently found had likely evolved from a strain of Zika that was already circulating in Southeast Asia

Because the spread of this disease depends on how well countries can control the mosquito, PM Lee has urgently stepped up fumigation measures. But it is not an easy thing to manage, Singapore’s urban density and flows of migrant labour from across the region intensify its exposure to outbreaks of infection. Currently, the number of locally transmitted cases stands at around 258. 

An official from the emerging infectious diseases programme at Duke-NUS medical school, Eng Eong Ooi explained, “the only way not to have Zika in Singapore is to have no mosquitoes, and that is impossible. It was never a question of whether we could prevent it, however when it would come, and what we will do when it gets here.” 

Officials are now under pressured to increase the surveillance of possible disease outbreaks in the region. It is no longer enough to look at the internal safety of a nation; this needs a collaborative outlook. These observation measures need to be supported by strong legislation; the threat of punishment will encourage agencies to complete safety procedures. For example, tackling mosquito breeding grounds.

But looking back through recent history we see that preventing Zika’s spread will need a lot of work. If the latest epidemic is compared to dengue, another mosquito-borne disease that’s endemic to ASEAN, it becomes obvious that for all of Singapore’s efficiency and its small size, the city-state has been unable to eliminate the risk. So what can we learn?

The need for good neighbours

Health experts say as infectious diseases know no boundaries, it is vital that countries work together to curtail the spread of mosquito-borne conditions. And this awareness seems to be dawning as the region confronts the reality of increases in Zika cases. Thailand has recorded 100 cases.  Malaysia confirmed its first case of Zika infection in a 58-year-old woman who had visited her daughter in Singapore only last week.  Indonesia’s foreign minister said that the country would “strengthen alertness” to prevent the spread of the virus.

This kind of cooperation between neighbours seems to fit neatly within the hopes of the ASEAN community but is difficult to administrate across borders. The ASEAN Emergency Operation Centre connects countries on a monthly basis to discuss the latest threats and provides alert states about imminent outbreaks, but wider regional collaborations are limited because countries usually only fund their internal research. Therefore, if scientists from Singapore, Malaysia, and Vietnam all want to work on a project, they may need to acquire three separate grants.

To tackle this problem, Southeast Asian governments need to ensure that they learn from previous outbreaks.  A regional approach to controlling the current outbreak of Zika is needed where Singapore, Malaysia and Indonesia cooperate – though it is probably necessary to involve all of ASEAN. Every nation in the bloc could eventually become hosts to regional bursts of mosquito-borne diseases; now is an excellent time to learn to tackle them together.