YESTERDAY, the prime minister said the government has agreed to set up a Covid-19 health and scientific advisory group which will advise the government on matters related to the pandemic as a response to an open letter sent on January 7 from a group of health experts, including Dr Abu Bakar Suleiman (former director-general of health) and Prof Dr Adeeba Kamarulzaman (professor of medicine, Universiti Malaya) and G25 member, offering several recommendations, including the formation of a Covid-19 task force.Muhyiddin Yassin welcomed the nomination of representatives from the signatories of the open letter to meet with the health minister, the prime minister’s special adviser on public health and himself, together with the relevant senior officials.Muhyiddin further assured that he would be open to listen to the group’s advice and ideas so that they can all collectively contribute to reducing the number of infections and the subsequent impact on the lives of the rakyat.It was particularly encouraging to observe that instead of a health-focused advisory group, the government recognised the fundamental importance of science and the application of science-based evidence to support its decision-making and response to the Covid-19 pandemic, and thus is supporting the formation of a health and scientific advisory group.In view of the critical importance of the role, function and membership of this august group, Malaysia could consider the United Kingdom’s response in engaging scientific, health and other experts to advise the government in times of emergencies and crisis.UK government’s chief scientific adviser (GCSA) Recognising the fundamental importance of science and its impact on society, industry and the economy, the United Kingdom appointed a government chief scientific adviser (GCSA), who serves as adviser on science and technology-related activities and policies to the prime minister and the cabinet and is the head of the government office for science. The adviser also usually serves as chair of the UK’s scientific advisory group for emergencies (SAGE).UK’s chief scientific advisers (CSA)GOV.UK highted that most government departments in the United Kingdom have a chief scientific adviser (CSA) to provide scientific advice. Departmental CSAs work together under the leadership of the GCSA to support each other and to resolve cross departmental problems, primarily through the CSA network.The network advises the GCSA on all aspects of policy on science and technology. In particular, they* provide advice to ministers, through the cabinet committee system* discuss and facilitate implementation of policy on science, technology, engineering and mathematics (STEM)* identify and share good practice in STEM-related areas, including the use of scientific advice in policy making* facilitate communication on particular high-profile STEM-related issues and those posing new challenges for government.SAGEGOV.UK dovetailed that effective emergency management and informed decision-making relies upon ministers having access to the best available advice in a timely fashion.To ensure the full range of issues are considered, advice needs to stem from a range of disciplines, including the scientific, technical, economic and legal.In view of the strategic importance of applying scientific-based evidence in responding, in particular to and during emergencies and crises, the UK established a scientific advisory group for emergencies (SAGE) responsible for coordinating and peer reviewing, as far as possible, scientific and technical advice to inform decision-making. SAGE provides scientific and technical advice to support government decision-makers during emergencies and is responsible for ensuring that timely and coordinated scientific advice is made available to decision makers to support UK cross-government decisions in the cabinet office briefing room (COBR).The advice provided by SAGE does not represent official government policy. SAGE meets in advance of COBR and the GCSA subsequently represents SAGE at COBR. SAGE provides COBR with science advice at the UK level.Membership and tenureThe membership of SAGE depends on the nature of the emergency but it typically includes leading experts from within government and leading specialists from the fields of academia and industry.They do not operate under government instruction and expert participation changes for each meeting, based on the expertise needed to address the crisis the country is faced withSAGE is chaired by the GCSA, Patrick Vallance and in health emergencies, such as Covid-19 co-chaired where appropriate by the chief medical oficer, Professor Chris Whitty.It includes participation from public health England, medical director for NHS England, Office for National Statistics, NHS, Food Standards Agency, health and safety executive, and chief scientific advisers of government departments relevant to specific meetings or their own scientific expertise.Frequency and nature of emergenciesSAGE has been activated eight times since 2009.SAGE was last activated in response to the potential breach of Toddbrook reservoir in Whaley Bridge in August 2019.A precautionary SAGE (known as pre-SAGE) was activated to advise on the Zika virus outbreak in 2016. In 2015, SAGE was activated to advise on the Nepal earthquake and in 2014, it was called in response to the Ebola outbreak in west Africa. It was also activated during the nerve-agent poisonings in Salisbury.SAGE also advised on winter flooding in the UK in 2013, the Japan nuclear incident in 2011, the volcanic ash emergency in 2010 and the H1N1 (swine flu) pandemic in 2009.And just recently, SAGE was activated to support the government in response to the Covid-19 pandemic.Expert groups in relation to Covid-19In relation to Covid-19, SAGE brings together expertise from across the scientific spectrum, including epidemiologists, clinicians, therapeutics and vaccine expertise, public health experts, virologists, environmental scientists, data scientists, mathematical modellers and statisticians, genomic experts, and behavioural and social scientists who feed analysis, research and data into SAGE.It first met formally to discuss specific science questions raised by Covid-19 on January 22, 2020 and has convened on a regular basis since then.When it comes to Covid-19, participants on SAGE and the expert groups come from more than 20 different institutions who in turn consider research and original work from many sources, including the Covid-19 Genomic UK Consortium, Imperial College London, London School of Hygiene & Tropical Medicine, Manchester epidemic group and many academic, clinical and other groups. However, not all participants are at every meeting.As Covid-19 is a highly complex crisis, a lot of work is done by sub-groups and de-facto sub-groups. These groups consider the scientific evidence and feed in their consensus conclusions to SAGE.SAGE relies on external science advice and on advice from these expert groups. During coronavirus, this includes the:* new and emerging respiratory virus threats advisory group (NERVTAG) (16 participants)* scientific pandemic influenza group on modelling (SPI-M) (Department for Health and Social Care – 40-45 participants)* independent scientific pandemic insights group on behaviours (SPI-B) (18 participants)* Covid-19 genomics UK (COG-UK)* health data research UK (HDR UK)In addition to the above groups, ad hoc subject specific groups have been and will be stood up as needed. Examples include groups on transmission in children, environmental considerations, care homes and nosocomial spread.Arising from the work of these experts, the government has published a number of the pieces of scientific evidence supporting the UK’s response to Covid-19 which are available online.Does the government have to listen to SAGE’s advice? The government is not beholden to what SAGE says and the evidence SAGE puts forward forms just one part of what the government considers before adopting new policies and interventions during an emergency. In this current pandemic, the government also has to consider other factors.Communications in relation to Covid-19For many emergencies, the coordination of advice from multiple providers and advisory groups will be required. Effective coordination relies upon, cooperation, integration and effective communication.In the case of the UK, Prime Minister Boris Johnson during his address and progress update to the British public is accompanied and supported by both Vallance and Whitty.I would like to offer the following recommendations for Malaysia.In view that the government is supporting the establishment of a health and scientific advisory group, I would to recommend for Malaysia to consider setting up SAGE with roles, functions and memberships similar to the UK experience, inviting relevant experts to offer their skills and experience depending on the type and nature of the emergency or crisis that the nation is confronted with.And this main group will be supported by necessary sub-groups. The group is not permanent but exists only when necessary to support government during an emergency and will disband once the particular emergency or crisis has been successfully addressed, contained or mitigated.When or if the country is confronted by, hopefully not if possible, another emergency of a different type or nature, SAGE can be reactivated but with new members with different set of skills and experience.As we are now being confronted by the Covid-19 pandemic but expect several other emergencies such as new pandemics, global warming and maybe nuclear incidents, the government could consider setting up SAGE with committees in several areas in addition to Covid-19, including1. panel on global warming2. panel on nuclear incidents 3. other panels as advised by key experts from time to time and depending on nature and types of new emergencies and crisisIn view of the fundamental importance of science for innovation and socio-economic development and with a number of ministries with portfolio involving science, innovation and economy, there is an urgent need for coordination of inter-agency efforts to develop and to implement sound science and technology policies and budgets.The science advisers, such as those appointed in the UK, United States and South Korea assume this critical role. Malaysia has introduced the post of a science advisor in the 1980s but removed this post during previous administration.As Malaysia strives to enhance its capacity in science and innovation for socioeconomic development and also presently as the country is striving to mitigate Covid-19, which requires in addition to experts in health but also in science, hence the appointment of Mercy Malaysia founder Dr Jemilah Mahmood as the prime minister’s special adviser on public health, it is imperative for the government to appoint a special adviser to the Prime Minister on science or a science adviser, similar to the US, UK and South Korea to lead inter-agency efforts to develop science, technology and innovation policies as well as to chair the SAGE.A highly respected Malaysian nationally and internationally in science, technology and innovation could be considered by the government for this important and august post. – January 18, 2021.* Note: Malaysia’s first science adviser was Dr Omar Abdul Rahman and this post was introduced after reviewing the post of the United Kingdom’s post of science adviser. * Sheriffah Noor Khamseah Al-Idid Syed Ahmad Idid is the former special officer to Malaysia’s science adviser. * This is the opinion of the writer or publication and does not necessarily represent the views of The Malaysian Insight.
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