It takes 27 hours from the time I leave home until I reach
my hotel room in Singapore, half a world away. I last
made the trip in October to sign a new five-year collaboration
with Singapore’s government that enlarges Hopkins
Medicine’s research and educational presence in
|By Edward D. Miller,
What does this small island nation
offer Hopkins that is so enticing? Why is the School
of Medicine’s first-ever division outside Baltimore
situated in this faraway, tropical setting? Singapore
is a beautiful, modern city-state of 4.6 million highly
educated people. A former British colony just south
of Malaysia, it is a young, entrepreneurial country
with an international flavor. English is an official
language and an integral part of the nation’s
booming free-market economy.
In the 1990s, Singapore’s government set out
to develop a life sciences presence second to none in
that part of the world. Because of Hopkins Medicine’s
preeminence at the bench and at the bedside, we were
approached about building a hospital and running it.
We declined but said we’d be interested in education
and research programs based on Hopkins’ groundbreaking
clinical scientific training model, which was quite
different from the existing approach to medicine in
Singapore. What evolved, starting in 1999, was a two-pronged
effort, a research arm underwritten by the government
and a high-end oncology clinical unit—a hospital
within a hospital—in partnership with the National
Along the way, we had a few stumbles in adapting to
the country’s culture, its social nuances and
our role as a “change agent.” Private physicians
feared we would take oncology patients from them. Medical
research, meanwhile, had never been given the status
it enjoys in our country.
When it was time to renew the agreement last summer,
University President Bill Brody and I met with government
leaders. We felt Johns Hopkins Singapore had not reached
its full potential. Bill laid it on the table: “Why
should Hopkins be here?” he asked. “If you
don’t think it’s working, tell us.”
He didn’t get an answer that day, but Bill’s
forthright approach proved crucial in negotiating a
The new five-year agreement gives Hopkins expanded
research space in the ultra-modern Biopolis biotech
park where we can pursue studies in genetic immunotherapy,
tissue engineering and cell therapy, tumor virology
and cancer biology. On the clinical side, Singapore
officials want us to do more than just oncology. Our
medical director, Alex Chang, already is regarded as
the man to see for cancer treatment.
Now, we’re expanding educational efforts with
a full-time faculty of 12, a rotation of Hopkins medical
students, Singapore medical students spending time on
the East Baltimore campus, and more seminars and forums.
Singapore lacks internists who are super diagnosticians,
and we’d like to add to that side of their training.
There’s also a need to train more oncology nurses
to international standards of care. We want to encourage
them to play the role of patient advocate, something
that’s not regarded as part of their role at present.
The breadth of what we seek to accomplish, with significant
help from the local government, represents a unique
opportunity that brings value to our institution and
to Singapore. It does not, though, offer a template
for Hopkins endeavors abroad.
In other countries, Hopkins acts as consultant, strategic
planner or medical partner. We’re flooded with
offers from foreign governments and medical institutions,
and I say no to 90 percent of them. The ones we act
on must make financial sense, and they must be consistent
with Hopkins’ core mission and objectives.
Singapore’s offer was exceptional because of
the government’s eagerness to underwrite our effort.
I’ve made it clear to them I won’t take
money from East Baltimore to support Singapore’s
programs. I could not in good conscience tell a faculty
member, I’m sorry, I can’t fund your project
because I put the money in Singapore. That wouldn’t
be central to our mission.
Here’s what I hope the Johns Hopkins Medicine
Division of Biomedical Science in Singapore achieves
over the next five years.
- A nucleus of world-class researchers zeroing in
on early detection of cancers, immunology, early biomarkers
and very special tumors.
- Spin-off business activities from this research.
- Extension of Hopkins’ clinical presence to
other internal medicine specialties.
- Sustained and growing clinical scientific training
for the region’s health care providers.
None of this will come easily. Singapore’s location,
far from our home base in Baltimore, makes recruitment
a special challenge. But Singapore is focused on becoming
the leading Asian center for biomedical research and
development. Hopkins is well-positioned to help shape
and participate in that nation’s exciting biomedical