Speech by Minister for Defence Chan Chun Sing at the 20th Public Health and Occupational Medicine Conference on 12 August 2026 at Temasek Club

A very good morning to all of you.

Introduction

I was just reflecting on your choice of theme for today’s conference – “From Prevention to Preparedness”. I thought it was rather apt, and had a deep meaning to it. It reminds me of what Donald Rumsfeld said some time back, that in a world, there are known knowns, there are known unknowns, and there are unknown unknowns. For a very long time, most of us, including in the military and in medicine, would like to think that we are dealing with prevention, which actually deals with what I call the “known knowns”. You know something is going to happen, you know what to do; and you prepare and try to prevent something from happening. And in yesterday’s world, that is an easy task. But we all know that preventing something from happening, dealing with the known knowns, is necessary but not sufficient. On the other hand, it is much more challenging to deal with the known unknowns and the unknown unknowns. What are some possible known unknowns? Well, disease outbreak is certainly one of them. We often know that such things will happen; it is not if, but when it will happen. That seems quite simple. That requires a bit more than just prevention and it shifts us a bit to preparedness, but the greatest challenge is dealing with the unknown unknowns in today’s world – from geopolitics to even medicine and public health messages.

COVID-19 was also one example of us having to deal with the unknown unknowns. We knew neither the nature of the virus nor the public health crisis that we had to deal with. Neither did we know the time of the outbreak nor when we had to get ready. So increasingly, every one of us, from defence to public health, will have to deal with the unknown unknowns besides the known unknowns. That is why I thought today’s theme, “From Prevention to Preparedness” is so apt and should send us thinking about how we should prepare ourselves, our teams, and our systems against such unknown unknowns.

So now let me share three thoughts.

Public health begins upstream

First, we all know that public health begins upstream. We are not in the business of “just-in-time”, but more importantly, we are in the business of “just-in-case”. For us to really deal with things upstream, we have to start thinking way ahead. “Just-in-time” systems are lean and efficient; they deploy resources only when they are needed. But in defence and public health, there are vulnerabilities with “just-in-time” thinking, which is simply not good enough. When crisis hit, there is little time for us to build capability from scratch. We all know that in both medicine and defence, capabilities require years to build and to put in place.

Our Singapore Armed Forces (SAF) Medical System is built on this upstream, “just-in-case” philosophy. We do not begin when a serviceman reports sick. We begin early, from pre-enlistment medical examination, medical classification, cardiac fitness screening, and so forth. These are not administrative formalities. They are risk identification. They place servicemen in roles suited to their health profile, protect them from avoidable harm, and preserve our operational readiness.

This upstream approach continues throughout their service, from vaccination, disease surveillance, heat injury prevention, health promotion, follow-up of medical issues that could affect training and deployment. The objective is simply this: to keep our servicemen healthy, safe, deployable, and able to contribute to Singapore’s defence. This is a lifecycle approach that we adopt, from pre-enlistment, through full-time National Service, into Operationally Ready National Service, and back into civilian life. Our goal, as part of Singapore’s overall health care system, is to optimise health and performance at every stage of a person’s life. In Singapore, there is little distinction between civilian and operational servicemen, because all males and increasingly, many females, are both civilians and operational servicemen at the same time.

For a small state like Singapore, we must always use our resources judiciously – that is not in question. The real question is: which vulnerabilities carry strategic consequences if they fail? Those are the ones that demand a “just-in-case” approach. Our national stockpiles of masks and antivirals, together with the SAF’s operational medical stockpiles, were strategic investments that embodied this thinking. We learnt this through SARS and COVID-19. After SARS, we invested in the National Centre for Infectious Diseases, which opened in 2019 with dedicated isolation capacity and outbreak response capabilities. These prior investments gave us a stronger footing when COVID-19 arrived. That is the essence of “just-in-case” – investing ahead of time in capabilities that are not fully appreciated until the moment they are needed. Another very good example was during the 2004 SARS episode. Some of you might still remember that we had to find ways to do mass temperature screening in a very short time. There was no ready solution in the market at that point in time. The SAF, because of the capabilities built up over time – the scientists who were in Defence Science and Technology Agency and DSO National Laboratories were able to quickly reconfigure the MILAN Anti-Tank Guided Missile weapon system thermal sight to become a mass screening tool for the population. This is yet another example whereby capabilities built up ahead of time can be redesigned and redeployed quickly when we put your minds to it in a crisis. But neither the National Centre for Infectious Diseases nor the capabilities to convert heat thermal imagery into mass temperature screening can be done in a short time.

Preparedness as a whole-of-system effort

This brings me to my second thought, which has to do with preparedness being a whole-of-system effort. In fact, in Singapore, we like to use the word that we are building a system of systems, and never a sectoral one. In a real crisis, problems to not arrive neatly within organisational charts. In fact, we have a saying in the military that a plan is but a basis for change in operations. COVID-19 was not just a healthcare problem. It was also a manpower problem, a logistics problem, a communications problem, a border control problem, a social cohesion problem – all at once. A “just in time” mindset in any one part of the system creates a vulnerability for the entire system.

The SAF Medical System is a close partner of the national healthcare system. (A/P) Brian (See) would like to call us the fourth cluster. Our servicemen receive care from the national healthcare system before, during and after National Service. SAF medical services work with public healthcare institutions on specialist care, vaccinations, infectious disease management to provide continuum of care, from civilians to operational servicemen and beyond.

We are also moving towards deeper integration. The SAF’s adoption of the Ministry of Health’s (MOH) Next Generation Electronic Medical Record for the next iteration of our own system, PACES 4, will support better continuity of care between the SAF and the national healthcare system. This reflects the direction we must move in, connecting our systems, sharing our data, for better coordination across institutional boundaries. And in the process, we will also save resources because we don’t have to restart the medical examinations and records at different stages of a serviceman’s life.

The digital dimension matters because healthcare resilience today is not just about beds, medicine and manpower. It is also about data integrity, system uptime, cybersecurity, and continuity of operations. Preparedness must include secure data systems, interoperable systems and platforms, stronger cyber hygiene, regular stress-testing, and trusted coordination across agencies and sectors. If we neglect this, we are building resilience with a gap in foundation.

People as our decisive advantage

Finally, my third thought for this morning: there is an evergreen saying in the SAF and in Singapore that people will always remain our decisive advantage, and investing in people is the most important “just-in-case” investment of all. Because it is the ingenuity and the determination of our people that will make or break us in any crisis. Technology will continue to transform healthcare. Artificial intelligence can help us detect patterns faster, support diagnosis, improve planning and optimise resource allocation. These are all obvious to us.

But Artificial Intelligence (AI) cannot replace judgement entirely. AI certainly cannot replace responsibility. We cannot outsource our responsibility to algorithms and AI. It cannot replace the trust a patient places in a doctor, the reassurance a nurse gives to a worried family, or the leadership that teams need when circumstances become uncertain. There is much that AI can do for us, but there is still much that we need the individual to take responsibility, to give assurance and to build teams. In healthcare, the human dimension is central to safety, trust and performance. If people are our decisive advantage, then developing our people well and to the best of their potential must be a strategic imperative, and not an optional thing that we want to do.

In the SAF, this means bringing together medicine, psychology, social science and training science across a serviceman’s entire journey. Readiness is not achieved by medical care alone. It depends on mental resilience, social support, sleep, fatigue management, conditioning, heat resilience, nutrition, leadership and training design – all working together.

We see this in heat resilience, where medical knowledge must be combined with training safety, environmental monitoring, acclimatisation, leadership vigilance and individual behaviour. We also see it in the Republic of Singapore Air Force’s (RSAF) work on performance maximisation, where psychological readiness, fatigue management, physiological training and operational demands must be considered as an integrated whole. Hence, health, performance and readiness are not separate domains, but are connected. This is why we must train across disciplines, not within professional silos. Doctors, nurses, public health practitioners, psychologists, exercise scientists, commanders and data specialists each bring their expertise to the table. But we need to learn to operate as one team before the next crisis emerge.

Conclusion

Ladies and gentlemen, this is an annual conference, but I hope this conference will also spark your curiosity to think deeply about how we can work together as a team to help not just the SAF, but Singapore, to prepare for the unknown unknowns. To be able to deal with the known known is Level 101 basic competency, but for Singapore to continue to survive, to thrive, and defy the odds of history, we will have to go beyond Level 101 to seriously consider how we build our systems, how we build our teams, in order to deal with the many more unknown unknowns in this tumultuous world.

On that note, I wish you all the very best. I wish you a fruitful conference, and thank you very much for having us here.

Thank you.