Covid-19 vaccines: Safety is top priority, but what is safety?

It is a matter of weighing benefits and risks and finding a right balance after doing due diligence

By Lim Poh Lian, Published The Straits Times, 28 Nov 2020

Would you take the Covid-19 vaccine, if it's available?

With the announcements of three Covid-19 vaccines achieving excellent rates of effectiveness, that is the question everyone is asking themselves.

The United States' Food & Drug Administration (FDA) will meet on Dec 10 to discuss the emergency use authorisation (EUA) of Pfizer's Covid-19 vaccine. If approved, Covid-19 vaccination for the highest risk groups could start in the US before Christmas.

Whether a vaccine should be used depends on several critical factors. Vaccine effectiveness is the obvious first step. However, it must be considered together with vaccine safety.

Vaccine safety is absolutely essential when considering vaccinating millions of people. So, what should we know about Covid-19 vaccine safety, and how should we think about it?

It is useful to first ask: "What is safety?" We could start with a dictionary definition: "The condition of being protected from danger, risk, or injury."

I suggest a pragmatic definition: Safety is finding an acceptable balance between risks and benefits, after doing due diligence.

This approach allows us to move forward, rather than getting stuck in analysis paralysis. After all, we make risk-benefit decisions every time we get in a car, board a plane, or cross the road. We manage the risks by putting in place systems to ensure road and air travel is as safe as possible.

We accept the risks when we get on an airplane, because the alternative would be a very long journey by road or sea, or not going anywhere at all.

We make similar risk-benefit judgments in medical practice. Vaccine safety is no different. Can we give an absolute guarantee that no one will ever experience any side effects or be harmed by a vaccine? Obviously not. Vaccines are medications, and all medications have risks and side effects, as well as situations when they should not be used.

The issue of side effects

So, what side effects should we look for when considering whether to use a vaccine?

There are two categories: danger and discomfort. Most of us who have had influenza vaccines are familiar with the discomfort; a sore arm for one to two days, a "fluey" feeling of fatigue, achiness and headaches.

Do vaccines cause fever? It depends on age group and the vaccine. For the influenza vaccine, fever can occur in 12 per cent of children aged one to five, in 5 per cent of those six to 15 years old while in adults, no difference was observed compared with placebo, or dummy.

Very rarely, more serious events with long-term consequences, even death, can occur after vaccinations. This is known and accepted in medical and public health practice because the alternative is the disability and death caused by the actual infectious disease itself in much larger numbers and scale.

The problem for vaccine programmes is that their very success breeds complacency, and a loss of urgency for the vaccine when the disease is no longer seen.

Among serious adverse events from vaccines, yellow fever vaccination can cause liver or brain inflammation for three out of a million persons vaccinated. The people who get the yellow fever vaccine nowadays are travellers to South America and sub-Saharan Africa, and populations in those endemic countries.

Yellow fever sounds like an exotic disease, and we may hesitate to vaccinate travellers at higher risk for vaccine complications. But what is rarely appreciated is that yellow fever used to be far more widespread and devastating; the last yellow fever outbreak in the US occurred in 1905 in New Orleans, and Philadelphia lost 10 per cent of its entire population to yellow fever in the 1793 outbreak.

Yellow fever is spread by Aedes aegypti mosquitoes, familiar to us as the vector for dengue fever. However, unlike dengue which has a fatality rate of 1 in 1,000, yellow fever still carries a fatality rate of 20 per cent to 60 per cent among those severely ill.

So, the safety considerations for vaccination must take into account the other side of the equation: What happens without vaccination, not just for the individual, but also for entire cities and countries?

Polio, which caused epidemics leaving children and adults permanently paralysed, was stopped only by vaccination. The Sabin oral polio vaccine contains a live, weakened virus, which rarely causes vaccine-associated paralytic polio, at four in a million. Vaccine-associated polio happens to 400-500 persons per year worldwide, but when compared with the 350,000 polio cases in 1988 at the start of polio eradication efforts, the risk-benefit clearly favours vaccination.

If a serious event occurs after someone gets vaccinated, another challenge is to determine whether the event is caused by the vaccination, or whether it is a coincidental occurrence.

We have had influenza vaccines for over seven decades, giving over 150 million doses per year.

Yet when media reports surfaced of deaths following flu vaccination in South Korea, vaccination was paused until autopsies on 46 of the cases provided evidence that the deaths, mostly among people in their 70s and 80s, were likely to have been caused by existing medical conditions, and not the vaccine.

Events are top-line numbers, numerators. We need denominators to understand the true risk. The 50-90 deaths occurred on a denominator of 19 million Koreans vaccinated, so we must know the baseline rate of deaths to know if there are grounds for concern.

Singapore has scope to be a safe, secure meeting place for businesses amid Covid-19: Chan Chun Sing

Whoever ensures visitors' health security in a faster and better way will gain edge, he says

Singapore holds first physical trade show since February 2020

By Choo Yun Ting, The Straits Times, 26 Nov 2020

As a key travel and transit hub in the region, Singapore has scope to establish itself as a safe and secure meeting place for businesses amid Covid-19, Trade and Industry Minister Chan Chun Sing said yesterday.

"Whoever can ensure visitors' health security in a faster and better way will gain a competitive advantage. Singapore recognises this and has every intention to be amongst the leading lights in this area," he said. "If we are able to build and operationalise these capabilities, it will set us apart from many other competitors."

Speaking at the start of TravelRevive, a two-day travel event, at the Sands Expo and Convention Centre, he was outlining how Singapore wants to position itself as a leading MICE destination in a time when businesses may not be able to meet due to coronavirus-related travel restrictions between countries.

TravelRevive, organised by Messe Berlin (Singapore) and the Singapore Tourism Board (STB), is the first trade show here to pilot new safety measures under the newly developed hybrid event trade show prototype for safe business events, safe itineraries and digital enabler tools.

Yesterday, Mr Chan said Singapore is "not going to play defensive by just trying to get back to where we were" in the MICE space.

Beyond that, Singapore wants to break new ground and establish a new level of experiences that the country can provide.

He said that the Republic's lack of a large local population and its reliance on external visitors mean that it cannot shut itself off from the world, and needs to adopt a risk-management rather than a risk-elimination approach.

While Singapore had closed its borders and imposed travel restrictions in the early days of the pandemic for health and safety purposes, it now has the confidence to progressively resume travel and connect with the rest of the world, Mr Chan said, citing how Singapore has stronger and more varied testing options, as well as tighter contact tracing capabilities.

"However, beyond merely resuming travel in a safe and sustainable manner, Singapore is going to pioneer several things to lead the reinvention of global travel, especially in the MICE industry," he said.

The gradual resumption of MICE events is one of seven areas which industry-led coalition groups, convened by the Emerging Stronger Taskforce, are studying.

The Alliance for Action team that has been tasked with bringing back travellers aims to take steps to re-establish Singapore's lead as a MICE destination and maintain the country's position as one of the top 10 cities in the world by international visitor traffic.

The TravelRevive hybrid event, with its trials of MICE safety measures, is intended to pave the way for more international trade shows to be held here in the first quarter of 2021.

STB signed three memorandums of understanding with exhibition organisers Fiera Milano, Messe Munich and Informa Tech yesterday. The one-year MOU with Informa Tech and the Infocomm Media Development Authority will see Informa Tech - which organises the London Tech week - launch a new international technology event in Singapore.

The event is currently slated for the second half of 2021 and will bring together industry stakeholders to discuss topics related to innovation and digital transformation in the tech sector.

Emerging Stronger Taskforce: Singapore's new collaborative approach to reignite economic growth in a post-Covid-19 world

7 Singapore Together Alliances for Action (AfA) are working with the Government to act on key growth opportunities

Private, public sectors to work as partners to propel economy; medtech a new area of focus

By Tham Yuen-C, Senior Political Correspondent, The Straits Times, 20 Nov 2020

As Singapore resets its economy to navigate a post-pandemic world, it has decided to take a fresh approach to growth and initiated several projects that could hold the key to the future.

These range from the safe and gradual resumption of large-scale conferences to a trial of autonomous shuttles, revealed the Emerging Stronger Taskforce (EST), six months after it started exploring new ideas to reignite the economy.

The EST is also adding a new area of focus, medical technology, which will look into developing diagnostics for diseases like Covid-19 and cancer. It is also looking at tie-ups with South-east Asian partners.

Giving an update on the work of the task force yesterday, Deputy Prime Minister Heng Swee Keat noted that it has taken a new approach to collaboration under which industry-led groups dubbed Singapore Together Alliances for Action are given leeway - much like start-ups - to prototype new ideas.

"This is in keeping with the spirit of Singapore Together, where we work in partnership to achieve more than the sum of our parts," said Mr Heng, referring to the movement he and his fourth-generation colleagues started to give citizens more say in policymaking.

"This new approach to economic growth will propel our economy through Covid into a new normal post-pandemic," he added.

Members of the task force said at a press conference that this has allowed the private and public sectors to work alongside each other as partners - rather than as regulators and the regulated.

PSA International group chief executive officer Tan Chong Meng, an EST co-chair, described it as "crossing the stream while feeling the stones", rather than feeling all the stones and mapping out the way before crossing the stream.

This has borne fruit. A project by the meetings, incentive travel, conventions and exhibitions alliance, to pilot rapid testing at mass events, saw all visitors to last month's Singapore International Energy Week tested on the spot before being allowed into the venue.

The alliance on robotics has initiated a project which will see early versions of autonomous vehicles deployed by the end of the year.

And the alliance on supply chains has brought together 50 organisations to create a set of data standards that will allow different segments of the supply chain ecosystem to work together.

The other four alliances are looking at sustainability, digitalising the built environment, smart commerce and education technology.

In all, the seven alliances have collectively engaged over 600 people and over 330 businesses, trade associations and chambers, and public agencies, among others.

Minister for National Development Desmond Lee, the other EST co-chair, said this agile approach to collaboration can be a competitive advantage for Singapore and may soon become the norm.

He added that it is key to be nimble as the task force has identified six shifts in the global economy from which opportunities will emerge: A changing global order; a rebalance between efficiency and resilience in supply chains and production; digital transformation and innovation; changes in consumer preferences; greater focus on sustainability; and accelerating industry consolidation and churn.

In navigating these shifts, the task force is guided by two themes, Mr Lee said, that must underpin the future economy: A Singapore that is connected to the world, and one that is sustainable for the environment and inclusive for its people.

He called on people to share their ideas through the EST's new website emergingstronger.sg, saying: "The EST needs both the support and the ideas and creativity of Singaporeans to build a Singapore that enables virtually unlimited possibilities."

PM Lee Hsien Loong at the APEC CEO Dialogues 2020

PM Lee urges businesses to take care of their workers even as they adapt to new normal

He also paints sobering picture of Covid-19's lasting impact on daily life, work and travel

By Grace Ho, Senior Political Correspondent, The Straits Times, 20 Nov 2020

The world will take several years to recover from the Covid-19 pandemic and even then, some things will change in the new normal, Prime Minister Lee Hsien Loong said yesterday.

He does not see Singapore, in the short term, escaping overnight from the precautions and risks that exist right now. "It is not possible."

Even if there is a vaccine by the beginning of next year, it will probably be 2022 by the time it gets rolled out to a significant proportion of the population and have an impact on slowing down the spread of the disease, he added during a virtual event associated with the Asia-Pacific Economic Cooperation (Apec) grouping.

PM Lee also does not foresee international travel returning to normal next year: "Maybe in two years' time, it would be possible to extend in a bigger way. But that is down the road."

He said there will be lasting impacts, even after Covid-19 is gone, as people would have become used to working remotely, doing business online and travelling less.

PM Lee gave this sobering picture at the Apec CEO Dialogues for political and business leaders in the Apec Business Advisory Council, which meets four times a year to advise leaders in the region on the priorities and concerns of companies in the region.

Other speakers at the annual event, which is organised by Malaysia this year and ends today, include Chinese President Xi Jinping, New Zealand Prime Minister Jacinda Ardern and Facebook chief operating officer Sheryl Sandberg.

When asked by moderator and Singapore Business Federation (SBF) chief executive Ho Meng Kit what advice he has for business leaders facing an uncertain future, PM Lee said: "I am not a businessman, I hesitate to preach, but in this situation, you have to look forward - not back to what (it) was... Make an objective assessment of what it means for your business and how you can best advance it."

He added that whether these businesses choose to pivot, transform or right-size, it is important that they take good care of their workers, who are also stakeholders and an important resource.

"Look after them during this difficult period. Do not just make a short, quick decision - 'I am saving cost and I must drop so many headcounts' - but take care of them, retrain them if possible, redeploy them if possible, and they (will) repay that to you and to your company.

"In the process, we will strengthen our cohesion and one day, we will prosper again."

He noted that the Government had stepped up in a major way to preserve jobs and make sure businesses survive as far as possible.

It has unleashed unprecedented fiscal firepower this year to the tune of around $100 billion in Covid-19 support measures, and is looking to draw up to $52 billion from past reserves.

Pointing to those hit hardest, PM Lee said that many are self-employed, such as tour guides and freelance coaches.

"They all desperately needed help. The first thing to do was to keep body and soul together... I think it has prevented a lot of hardship and kept the economy at least nose above water, afloat."

But now that the situation is stabilising, "this large infusion of government resources cannot go on indefinitely, and we have to gradually tail this off and get things onto a sustainable footing", he said.

"We have to adapt ourselves for what is to come, rather than freeze a position which reflected what was pre-Covid-19. Otherwise, we will end up with zombie companies and an unproductive economy, and I think that will lead to more trouble for us later on."

Acknowledging that entertainment and tourism businesses are not out of the woods yet, unlike the manufacturing and technology sectors which are doing well, he said the authorities are experimenting with how entertainment outlets can be opened up safely.

"But it is very challenging because the whole point of entertainment is that you go to let your hair down, whereas here, we are trying to keep our guard up.

"Even if you have rules, when you want to relax and have a drink and then sing some songs, or dance in an entertainment lounge, karaoke, it is a completely different mindset altogether."

Under a pilot programme, selected nightlife venues can reopen by next month or January under strict safe management measures, such as wearing masks on the dance floor and showing proof of negative Covid-19 tests before being allowed in.

In his remarks following the Dialogues, SBF's Mr Ho said the resumption of safe and seamless travel is crucial to generate market demand and revive business and other activities that will enable the global economy to recover.

"The Apec Summit is hopefully an opportunity for leaders to progress work on a possible regional travel bubble to facilitate movement of people across borders."

Tripartite Advisory on Mental Well-being at Workplaces

MOM, NTUC and Singapore National Employers Federation issue new advisory to tackle mental health needs of workers

Firms asked to address workers' mental health amid Covid-19 pandemic

Advisory calls on them to train managers to spot signs of distress, give staff adequate rest

By Calvin Yang, The Straits Times, 18 Nov 2020

With lines between the workplace and home getting blurred during the Covid-19 pandemic, employers have been advised to address the mental health needs of their workers who are under more stress and facing a higher risk of burnout.

An advisory issued yesterday called on companies to recognise the need for their staff to have adequate rest outside work hours.

This can be done by establishing a work-life harmony policy to offer clarity on after-hours work communication, said the advisory, which was jointly released by the tripartite partners: the Ministry of Manpower, National Trades Union Congress (NTUC) and Singapore National Employers Federation.

The recommendations come a month after Prime Minister Lee Hsien Loong announced that an inter-agency task force has been convened to tackle the mental health needs of Singaporeans. He said the coronavirus pandemic has brought about more stresses, pressures and disruptions.

The outbreak has led many workplaces to adopt work-from-home arrangements as the norm, leading to employees feeling more stressed and putting them at a higher risk of burnout, the tripartite partners said.

They encouraged employers to organise talks and workshops on the issue, and train managers to spot signs of distress, and offer help to their colleagues.

It was important to set boundaries, they noted. For example, firms should set out a clear position that employees were not expected to respond to work-related messages sent after work hours - unless they were marked urgent or critical.

Companies were advised to extend employees' flexible benefits to cover mental health-related consultations and treatments, or offer workers access to counselling services such as employee-assistance programmes.

But workers and self-employed persons can also reach out for help if they feel overwhelmed.

Manpower Minister Josephine Teo, who introduced the advisory at the start of the Singapore Workplace Safety and Health Conference 2020, said the pandemic will be a long-drawn battle and urged employers and workers to adopt the recommendations.

"While the future remains uncertain as the world continues to battle Covid-19, let us not lose sight of our goals," she added. "It is timely for the Government, unions, businesses and workers to come together and collectively chart a future where everyone can bounce back."

It is the first time the biennial conference is being held online.

NTUC assistant secretary-general Melvin Yong said that workers were facing greater stress from juggling work and personal commitments during this period of prolonged telecommuting work arrangements. He said the advisory will "help to reassure workers that safeguards are in place to support their mental well-being".

Workplace Safety and Health Council chairman John Ng added that the advisory will help employers to take proactive steps to look after their workers' mental health, "so that they are able to stay focused at work, work safely and stay healthy".

"In turn, employers will benefit from a healthy and productive workforce which can contribute to better business performance," he added.

Singapore needs top tech talent to build world-class teams, says PM Lee Hsien Loong at the Singapore Tech Forum 2020

As foreign professionals enter, Singaporeans also have to feel assured of fair treatment, he says

By Hariz Baharudin, The Straits Times, 18 Nov 2020

Even as the local tech talent pool grows, Singapore has to bring in foreign professionals at mid-to senior levels to build world-class teams, grow the industry and tackle urgent problems, said Prime Minister Lee Hsien Loong yesterday.

He acknowledged the sense of competition and discomfort that can arise from large numbers of foreigners in the industry, and said Singaporeans have to feel assured that they are fairly treated.

They must see that tech companies are bringing in people with expertise and experience, whom Singaporeans can learn from, he said.

Speaking at the Singapore Tech Forum that is being held virtually, PM Lee said that while the country has a supportive environment for technology in terms of infrastructure, the key factor is talent.

"We need more tech talent to grow the industry, and to tackle the urgent problems that we have and that tech can help us to solve."

Local universities and polytechnics are producing more graduates who are in demand, but companies also need to bring in overseas professionals at higher levels who are in short supply here, he noted.

Such professionals help create a virtuous circle by expanding Singapore's talent pool, raising standards and strengthening the tech ecosystem here, said PM Lee.

But he also noted that social frictions can develop, especially if there are large concentrations from a single source and there is an economic downturn. Such tensions are not unique to Singapore, he said, adding that the Government will do its best to address them.

He said foreigners must make the effort to fit in here, and at the same time, Singaporeans have to feel that they are not discriminated against.

"They have got to see the tech companies as bringing in expertise and experience, (and) building up the industry and capabilities," said PM Lee. "So that our own people can learn from them, upgrade themselves and eventually build up our own talent pool."

Singapore has done so in the past with the petrochemical, biomedical and semiconductor industries, he added.

He also held up the Government's new Tech.Pass work pass, which will allow foreigners to start and operate a business, serve on the board of a Singapore-based company or be a shareholder or investor in companies here. They can also take up lecturing roles, serve as an adviser to companies here and conduct corporate training. Candidates must show they are high-level tech professionals.

"The Tech.Pass scheme is aimed at highly accomplished tech talent, the movers and shakers of the tech world - people who usually play different roles at once: founder, investor, employee, consultant, academic. People who can contribute to multiple parts of the ecosystem with their capital, their networks, their knowledge," said PM Lee.

He added that unlike the Employment Pass where an individual is tied to a particular job or employer, Tech.Pass will be personal to the holder and allow them to move between roles and employers - a flexibility meant to make Singapore more attractive to such talent.

At the dialogue that followed, PM Lee was asked about challenges Singapore faces in realising its Smart Nation ambitions. While the "will" to transform digitally is present, the lack of talent is an issue, he said.

He was also asked about Singapore's approach to lesbian, gay, bisexual, transgender and queer people, to which he said they are welcome here and their contributions are greatly appreciated, but that society is still conservative.

PM Lee Hsien Loong on Future of Trade at the Bloomberg New Economy Forum 2020

PM Lee hopes US President-elect Biden will build constructive ties with China

This means both countries may compete but ultimately do not want to collide, he says

By Linette Lai, Political Correspondent, The Straits Times, 18 Nov 2020

Asia - and especially China - is an important part of the world for America, said Prime Minister Lee Hsien Loong yesterday, expressing his hope that US President-elect Joe Biden will develop a framework for an overall constructive relationship with Beijing.

This means a relationship in which both powers remain in competition with issues to resolve, but ultimately do not want to collide and will work to develop areas of common interests while constraining the areas of disagreement, he said at the Bloomberg New Economy Forum, which is being held virtually.

Within this framework, topics such as trade, security, climate change, nuclear non-proliferation and the issue of North Korea can be dealt with, he added.

He also expressed the hope that the World Trade Organisation, under the Biden administration, will no longer be "deliberately pushed to one side" in the way it has been under the Trump administration.

Countries may quarrel over many things, but they should try to "insulate" trade because trade disputes hurt all parties involved, he said.

"The more countries avoid doing that, the more it will be credible when they say we believe in multilateral trade, and they believe in win-win development and cooperation with our neighbours."

PM Lee was speaking to Bloomberg News editor-in-chief John Micklethwait in a wide-ranging interview.

Asked if President Donald Trump has done "permanent damage" to the way the United States is viewed in the region, PM Lee said there will be some long-term impact on how America is viewed, as well as how it views itself. Although the shift in perspective did not start with Mr Trump, it has become more evident in the last four years, he added.

"When you talk about putting America first and making America great again, it is a more narrow definition of where America's interests lie than has hitherto been the way US administrations have seen things," PM Lee said.

Previous administrations took a broad interest in the region's stability and the well-being of the country's partners, he noted. It tended its alliances, fostering an orderly environment and subjecting itself to the same rules.

"It will take some time for America to come back to such a position, and for others to be convinced that it is taking such a position," PM Lee said. "It may never come back all the way, certainly in the short term and certainly in terms of its relationship with China."

But he also noted Mr Biden knows Chinese President Xi Jinping very well. "That personal engagement at the top is important," he said, when asked how Mr Biden might deal with China on issues like human rights.

Equally important is how each country sees the other and the intentions of the other, he added.

The Chinese, for their part, do not want a collision with America. But at the same time, PM Lee said, "I am not sure that they are prepared to give a lot of ground."

China is likely to hold the view that its growing affluence and power have resulted in a win-win situation for the world, he said. "Things have gotten better, yet many countries do feel that things do need to be adjusted. That adjustment will be very difficult to make."

On Mr Biden's pledge to convene a global summit of democracies in the first year of his presidency, PM Lee said most countries want to work with the US but few would be willing to join a coalition that excludes players like China.

All countries should be involved in working out adjustments to the world order, he said. In the process, alliances will form and cooperation will take place, he added. "But to try and make a line-up, Cold War-style, I do not think that is on the cards."

On whether the US will rejoin the Comprehensive and Progressive Agreement for Trans-Pacific Partnership trade agreement, PM Lee replied that this is not likely to happen any time soon.

"The stars are not aligned," he said. "I still think that it makes sense for the US, but it has to make domestic political sense as well. That will take time and a different alignment of the economic situation as well as the political configuration in the US."

As for whether Mr Biden could reach out to Asia when he becomes president, PM Lee said that it is a possibility, but Asia will be just one of the Biden administration's many priorities.

He also said the domestic forces represented by Mr Trump persist, and will have to be dealt with.

"I hope that it will be a new direction for America, but do not forget that Mr Trump collected more votes than Barack Obama," he said, referencing the former US president.

PM Lee added of Mr Trump: "He has not disappeared, nor the pressures which he represented - they have not disappeared from America's body politic either."

At the same time, China has come to realise that having an America that is "at sixes and sevens" is not much to their advantage, the Prime Minister said.

"It is better to have somebody there who may not fully agree with you, but understands his interest in a broad way and whom you can deal with," he said. "With Biden, maybe they will decide that they want a new try. I hope so. It is not easy to do this."

Universal basic income is regressive: Tharman at Bloomberg New Economy Forum 2020

By Grace Ho, Senior Political Correspondent, The Straits Times, 18 Nov 2020

A universal basic income (UBI) is regressive and means that large numbers of people have to be taxed more heavily, said Senior Minister Tharman Shanmugaratnam at the Bloomberg New Economy Forum on Monday.

Responding to moderator and Bloomberg Quicktake chief correspondent Jason Kelly's question on whether governments should institute a UBI, Mr Tharman called it a "bad idea" on two counts.

Firstly, it is regressive.

"The idea of giving everyone (the same) quantum of money is very different from giving the poor and the lower-middle-income group the support they need."

He added that while many UBI proponents say it is a way of flattening the system of benefits, he thinks countries need to stack the benefits in favour of the poor and the lower-middle-income group, not give them less.

"Secondly, to give the poor what they need through UBI, you've got to give everyone that same higher amount. In other words, you don't just flatten the curve but you've got to raise the curve. That needs much more taxes.

"And if we do the arithmetic, it can't just be taxes on the rich. You need much more taxes on the middle-income group in order to give everyone the amount of benefits that the poor actually need."

Another argument for UBI is that new forms of automation and artificial intelligence (AI) will displace humans from a much wider range of jobs, and a way must be found to distribute productivity gains from automation and AI to a population that may not be fully employed. "We might get to that situation, but we have no idea whether we will," he said. More importantly, what happens depends on the actions taken now, he added, and the last thing countries should do is to "give up hope" and go for purely redistributive, or passive, strategies.

"We do need redistribution. But what we should be doing now is investing in public goods, investing in public school systems, and I'm quite optimistic about that potential," Mr Tharman said.

He stressed that by investing in things that everyone can see opportunity in, for themselves and their families, people can be brought together because they have a feeling that governments are doing something for everyone.

"Let's talk about how we can do things to develop capabilities, develop hope and aspirations," he said. "If we lose the game in 20 or 30 years' time, we can start talking about UBI, but we first have to get started. We haven't gotten started in many countries."