Opening Remarks by Mr Lim Chuan Poh, A*STAR Chairman at GUSTO’s 10th Anniversary Celebration event

President Halimah Yacob-
Prof Chong Yap Seng- Executive Director- Singapore Institute for Clinical Sciences (SICS)-
Distinguished Guests-
Ladies and Gentlemen-

A very good morning to all of you and thank you for joining us to celebrate the 10th anniversary of Singapore’s largest and most comprehensive birth cohort study- GUSTO.

In particular- I want to thank President for honouring us with your presence today in spite of your very busy schedule- and this will certainly spur everyone involved in GUSTO to strive even harder going forward.

For the uninitiated- GUSTO stands for: Growing Up in Singapore Towards healthy Outcomes.

It is a major collaborative research effort involving the research institutes- academia and the clinical community across Singapore and other countries. It aims to enhance our understanding of how conditions in pregnancy and early childhood influence the health and development of women and children. Today- we have many of the children who have been part of the study for the past 10 years- here with us.

Let me begin by congratulating Yap Seng- lead investigator of the study at A*STAR’s SICS.

As such work requires extensive collaborations- GUSTO has connected public sector investigators and partners from Ministry of Health’s National Medical Research Council (NMRC)- KK Women's and Children's Hospital (KKH)- National University Hospital (NUH) and National University Health System (NUHS). Through this whole of Singapore- multi-institutional- multi-disciplinary and translational approach- the programme has resulted in many positive healthcare outcomes for Singapore. 

As a nation- we recognise that research and innovation is critical to Singapore’s economic development.

We did not reach where we are today by chance.

Instead- we take a sustained and steady approach to our R&D investments in order to derive healthcare and economic benefits for Singaporeans.

The Biomedical Sciences (BMS) Initiative was launched in the early 2000s and it focused on building basic research capabilities.
The focus then was to initiate the process to build a critical mass of upstream biomedical scientists.

The second phase- launched in 2006- was aimed at extending from basic BMS research into translational and clinical research- or TCR.

In the BMS space- it was clearly not enough to just do excellent research in the laboratory important as it is if we want to impact healthcare outcomes.

To achieve the latter- we needed to close the gap between bench and bedside and to bring challenging problems from bedside to work at the bench.

In the process- we are also likely to bring about economic benefits directly or indirectly.

In Sep 2008- SICS won its first large grant- the S$25 million TCR Flagship Programme to work on Developmental Pathways to Metabolic Disease.

Yap Seng will later fill us in on how he worked together with Prof Judith Swain and Peter Gluckman to forge a collaboration between SICS- NMRC- KKH together with the NUH and NUHS- to set up GUSTO.

Over the years- GUSTO was able to attract significant interest from many major nutrition companies such as Abbott- Danone and Nestle- which have since developed into enduring and productive collaborations. 

This study successfully contributed to the convergence between economic and social outcomes through the industrial collaborations and the engagement with the Ministry of Health’s national challenge: The War on Diabetes.

Diabetes Mellitus and related metabolic/endocrine disorders are some of the therapeutic areas of focus identified by the Ministry of Health (MOH) based on factors such as disease impact- scientific excellence in Singapore and national needs.

Mothers with gestational diabetes have a seven-fold risk of developing Type 2 Diabetes1 and higher fasting glucose levels can affect infant obesity and neural development.

Findings from GUSTO indicated that gestational diabetes mellitus or GDM affects about 1 in 5 women from the study- and that GDM in more than half of the mothers would have been missed if only high risk cases were screened.

In 2015- a white paper was presented by the GUSTO team (from NUHS- KKH- and A*STAR) to MOH and KK Women’s and Children’s Hospital piloted the universal GDM screening in January 2016.

MOH accepted the team’s recommendations and in February 2017- universal screening was first instituted at three public hospitals – KKH- SGH and NUH.

Subsequently in January 2018- Senior Minister of State for the Ministry of Health Dr Amy Khor- announced new GDM clinical guidelines for universal screening for GDM in all pregnant women across all public healthcare institutions- with far-reaching effects on the well-being of women and their children.

It is very heartening to see the translation of research into healthcare policy and practice- within 10 years of GUSTO’s launch.

We expect more such translatable health outcomes arising from GUSTO as the children taking part in the study enter the critical ages of school-going and puberty- and behavioural and metabolic indicators begin to manifest.

GUSTO collaborators are already partnering other government- healthcare- and social agencies to move into adjacencies to derive greater benefit for society.

I will let Yap Seng tell you more about the many meaningful milestones of the GUSTO journey thus far.
On this note- I would like to say that GUSTO as a program is growing up with healthy outcomes and let me wish you another ten years of healthy growth.

Thank you very much.

1Hartling L- Dryden DM- Guthrie A- Muise M- Vandermeer B- Donovan L. Benefits and harms of treating gestational diabetes mellitus: a systematic review and meta-analysis for the U.S. Preventive Services Task Force and the National Institutes of Health Office of Medical Applications of Research. Annals of internal medicine 2013;159:123-9.