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​The well-being of Singapore's population is not only based on its economic progress. Rather, it is also dependent on its ability to defend against public health threats, such as the spread of infectious diseases that can undermine social stability. However, Singaporeans can rest assured that combating health threats is aided by legislation that were implemented not to penalise them, but crafted with the well-being of Singaporeans in mind.

What sort of legislation exists?

The Infectious Diseases Act (IDA), enacted by Parliament in 1976 and implemented on 1 August 1977, is a piece of legislation that deals with the prevention and control of infectious diseases in Singapore.

Although the legislation is jointly administered by the Ministry of Health (MOH) and the National Environment Agency (NEA), it can only be made effective through the collaborative effort of healthcare professionals and staff treating cases on the ground. As these medical practitioners are able to directly attend to cases of infectious diseases, they are in a position to alert the relevant authorities if they spot situations that might indicate a significant public health threat. The list of notifiable diseases is constantly under review and communicated to all medical practitioners and relevant laboratories. This form of notification, which is vital during outbreaks, is one of the measures provided for by the IDA.

Legislation as a tool

Even though it might seem harsh to implement legislation to deal with the threat of infectious diseases, the IDA is necessary in preventing and controlling public health threats. Legislation can be considered as a tool against infectious diseases in two wide-ranging ways.

Controlling infectious diseases

Firstly, besides providing for the notification of infectious diseases, the IDA authorises the Director of Medical Services to order a medical examination and treatment of anyone, who is, or suspected to be a carrier or contact, of an infectious disease. The Director is also authorised to order a post-mortem examination of any person, who has died while being, or suspected of being, a carrier or contact of an infectious disease.

The Director is also empowered to order treatment or even closure of premises such as food establishments, if it is suspected to be the source of transmission of infectious diseases. Furthermore, the Director can prohibit meetings and public entertainment gatherings because the close proximity of human contact can increase the spread of any infectious disease. These types of measures are likely to be taken to reduce the risk of an outbreak and to assist in the investigation and control of the source of infectious diseases.

Preventing infectious diseases

Secondly, under the IDA, authority is given to the Minister to declare any area within or outside of Singapore as an infected area. This measure can occur when there is reason to believe that an infectious disease may be introduced into Singapore from that area. Going beyond identifying infected areas, other possible measures stipulated to prevent the importation of infectious diseases at any ports of entry might also be taken. These steps are implemented to try to keep infectious diseases at bay.

Compulsory immunisation as preventive measure

The IDA has also made immunisation of young children​ against vaccine-preventable diseases compulsory in Singapore. This is so as the young are especially prone to being infected by infectious diseases. As such, the IDA has also contributed in establishing the National Childhood Immunisation Programme, which comprises MOH senior officials and experts in communicable diseases. This is the governing body that oversees the immunisation programme in Singapore.

Moreover, according to regulations under the IDA, it is an offence not to vaccinate children against certain diseases. For example, it is compulsory for children to be vaccinated against diseases such as diphtheria within 12 months of their birth, while vaccination against measles should be carried out between one year and two years of age. Under the Infectious Diseases Act and the Infectious Diseases (Diphtheria and Measles Vaccination) Regulations, it is compulsory for parents and guardians to have their child vaccinated against diphtheria and measles. The penalty for non-compliance is a fine of up to $500 for the first offence and up to $1,000 for the second or subsequent offence.

Infectious diseases guidelines

Although Singapore is free from most vaccine-preventable diseases due to the effective vaccination programme as a result of regulations under the IDA, various guidelines on managing different infectious diseases have still been prescribed over the years. The purpose of these guidelines is to maintain vigilance and to respond to various incidents of infectious diseases that have come and gone over the last few years. The information provided in the guidelines is accessible to the public, and also useful for medical practitioners in Singapore.

A higher chance of staying in the pink of health is possible with tough legislation in place. This acts as the foundation for carrying out measures to reduce and control outbreaks, and to establish a healthy and functioning society.