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Chikungunya Virus and NDP52: a deadly association?

Chikungunya virus (CHIKV) is the causative agent of an arthropod (mosquito) transmitted disease which is characterised by a high fever, rash, joint pain, and arthritis which was reported in 1952 in Tanzania but has spread since to Europe, the Americas, Asia, and Australia and currently epidemic in the Americas.

Confirmed cases of Chikungunya Virus infections in the Caribbean and continental
US as August 22nd 2019

Being a member of the Alphaviridae genus of the family Togaviridaerelated to Ross River virus, O'nyong'nyong virus, and Semliki Forest Virus (SFV), CHIKV has a positive strand ssRNA genome of 11.6 kb in size which encodes for both the structural and non-structural (nsP) proteins. In accordance with other prototype members of the Alphaviridae, the 5’ two thirds encodes for the four viral nsP (nsP 1-4) whereas the structural proteins are encoded within a subgenomic m 26S RNA, which in turn derives from a precursor 42S RNA.


Alphavirus genome, particle, and proteins


Both in vitro and in vivo, CHIKV can infect a wide variety of cells, including primary fibroblast cells, macrophages, astrocytes as well as hepatic cells. Similar to other alphaviruses, CHIKV infection has the capacity to induce caspase dependent apoptosis especially late infection. This process is preceded by autophagy (as discussed below) which might not only favour viral replication but also prevent apoptosis. Viral replication itself takes place in perinuclear replication centers (RCs) derived from endosomal and lysosomal membranes containing the three nsP in addition to the viral RNA dependent RNA Polymerase, akin to to the RTC induced by the Nidovirales, although viral RCs have also been observed close to the plasma membrane. Similar to the coronaviral N protein, the nsP2 of SFV also localises to the nucleolus where it associates with the ribosomal protein S6 (RpS6), thus might contribute to the shut off of host cell translation.

                          Induction of ER stress and apoptosis
Following the infection of glioblastoma cells with CHIKV, apoptosis as evidenced by DNA fragmentation, cleavage of PARP, nuclear condensation, loss of mitochondrial membrane potential, and activation of caspases can be observed at 48 h p.i. . Akin to cells infected with Japanese Encephalitis Virus (JEV), apoptosis is induced by the ER stress response, which in the case of SFV is characterised by the induction of IRE1 and ATF6 (but not PERK) pathways, involving the splicing of XBP1 as well as ATF6 mediated phosphorylation of eIF2α (subsequently increasing the expression of CHOP) as well up regulation of proteins inducting the antiviral response such as proteins of the RIG-I like receptor (RLR) pathway as well pro-inflammatory cytokines namely CXCL9, IL-6, TNF-α, and IL-1β within 24 h p.i. Interestingly, in contrast to Sindbis Virus (SINV), in CHIKV infected cells, the viral RdRP, nsP4, inhibits the phosphorylation of eIF2α following treatment with tunicamycin not only in mosquito (Aedes albopictus) C6/36 cells,  but also in HEK293T,  MRC-5 and BHK-21 cells,  similar to vaccinia virus K3L or Hepatitis C Virus NS5A. In the context of viral replication, the data support a model in which CHIKV nsP4 delays the activation of PERK mediated phosphorylation of eIF2α by at least 21 h p.i. compared to cells infected with SINV, although it has been not demonstrated that a recombinant SINV expressing CHIKV nsP4 has delayed pattern of eIF2α  phosphorylation similar to CHIKV .

CHIKV and the ER stress response: inhibition of PERK by nsP4 and
BiP by preE1/E2

In general the ER stress response is triggered however not by the accumulation of non-structural proteins at the ER, but by the envelope glycoproteins, namely the E1 and E2 proteins in a process that depends on a cellular BiP. In the case of SINV both the precursor of E2, PE2, and E1 are co-translationally inserted into the ER membrane prior to their transport to the cell surface via the Golgi where they are inserted into the plasma membrane by palmitoylated residues. The insertion into the ER membrane therefore does not induce the formation of the replication complex but is only transient in nature. Both proteins however might induce the ER stress pathways by two mechanisms, either depletion of lipid due to the formation of vesicles and/or via BiP. BiP is a molecular chaperone, which not only associates with unfolded proteins within the ER and facilitates correct folding but is also involved in transporting proteins across the ER membrane. In the case of SINV E2 and E1 proteins, BiP associates with both E2 and E1 within the ER and is implicated in their transport across the ER membrane. More importantly however (at least in terms of the UPR), in SINV infected cells, BiP also induces the ATF6 and IRE1 induced ER stress response, problem by releasing BiP from its interaction with ATF6, IRE1, and Caspase-4/-12.  As discussed in prior posts, the induction of both the ATF6 and IRE1 dependent ER stress response not only induces apoptosis, but also autophagy. Indeed cells infected with SFV, CHKV, or SINV exhibit the induction of the autophagy pathway prior to the induction of apoptosis and autophagy has been shown to be required for productive infection and CHIKV induced autophagy has been shown to delay caspase induced apoptosis.
                                       CHIKV and autophagy
In the case of CHIKV, autophagy not only has a cytoprotective function but also enhances viral replication and the switch from autophagy to viral assembly late in infection increases apoptosis induced by CHIKV.

In human and murine cells infected with CHIKV, the viral ubiqutinated capsid protein co-localises and co-immunoprecipates with p62/SQSTM1 mediated the UBA domain and subsequently is degraded via the formation of autophagosome and targeting to LAMP1 positive lysosomal structures; indeed, both the depletion of p62 and the expression of a p62/SQSTM1 ΔUBA mutant stabilise the capsid protein as well as treatment of infected with Bafilomycin A as well as increasing viral replication as measured by viral RNA and viral titers.


The viral capsid protein is degraded by p62/SQSTM1 and localised
to viral replication centers by NPD52


In cells infected with CHIKV or other members of the Alphaviridae, the nsPs associate with viral RNA to form the viral replication complexes (RC), which in turn are associated double membrane vesicles (DMV) -termed cytopathic vacuoles- located in the perinuclear region. The DMVs not only contain nsPs, viral RNA, and dsRNA intermediates, but also (in the case of SINV and SFV) but also markers of the endo-and lysosomal system such as TGN-46. As part of this complex, nsP2 in addition to the role in shutting off host cell translation and inducing apoptosis, also binds the viral RNA and forms autophagy like vesicles containing the viral RNA that are localised in the perinuclear region and positive for TGN-46. The latter structure is not only positive for nsP2, but also for the viral capsid protein and nsP3, thus representing the viral RC. The process of the localisation of nsP2-RNA complex is not only dependent on the nuclear localisation and the presence of the C-terminal domain, but also on a cellular protein, Nuclear Dot Protein (NDP52). NDP52 has been described as a receptor for xenophagy and extensive studied in cells infected with bacteria, in particular Listeria and Salmonella. In contrast to p62/SQSTM1, NDP52 lacks a UBA and therefore does not bind ubiqutinated proteins. In the case of CHIKV infected cells, NDP52 forms structures akin to but different from “classic” autophagosomes the viral capsid protein as well as nsP2, and dsRNA intermediates and LC3-C  -but not LC3-B- via binding to the non-canonical LIR of NDP52.

p62/SQSTM1 and NDP52


Binding to NDP52 therefore is being postulated to be required for viral assembly late in infection and contributes to the cytoxicity observed in cells in the late stages of viral infection. In the early stages of replication however, the viral proteins might preferentially degraded via selective, p62/SQSTM1 dependent, autophagy and thus allowing survival of the infected cells. Interestingly, the time at which this switch occurs might be different for CHIKV and SINV infected cells and thus might contribute to the pathology of the disease.

Targeting of viral nsP and structural proteins to TGN-46
positive structures may involve NDP52 and LC3-C 


Further to the role in targeting viral proteins to the RC, in the opinion of the author of these lines, NDP52 might be implicated in the clearance of damaged mitochondria by mitophagy at early timepoints p.i. . The induction of oxidative stress -characterised by increased levels in reactive oxygen species (ROS)- due to a decrease of antioxidant enzymes and an increase in the fold change of pro-inflammatory cytokines as a result of ER stress as well induction of mitochondrial damage leading to the release of Cytochrome C, not only induces apoptosis but also increases autophagy via inhibition of mTOR.

Switch between p62/SQSTM1 and NDP52 binding to structural proteins
may determine the localisation of these proteins and the induction of apoptosis as a
result of ER stress induced by the formation of vesicular structures

In summary, at early timepoints, the expression of the structural proteins of CHIKV, SINV, or SFV, induces ER  stress which in turn induce selective –p62/SQSTM1 dependent- autophagy, whereas at later timepoints the formation of replication centers in the perinuclear region is favoured by the localisation of viral proteins in a NDP52/LC3-C dependent pathway. Interestingly, microscopic studies using PALM, suggest that the capsid protein is located inside of double membrane structures, suggesting that the LC3-C/NDP52 coated vesicles fuse with the TGN-46 positive replication compartment.  

Apart from CHIKV, does NDP mediated localisation of viral proteins to their respective replication centers or complexes play a role during the replication of other viruses? The answer is…..we do not know. As always, the relevant experiments need to be done, but is it possible that both LC3-C and NDP52 are involved in localising components of the CoV replication centers to the ERGIC. In the case of COVID-19, this might explain why the virus is not cytotoxic in bats: similar to CHIKV, where the murine NDP52 does not bind viral proteins, bat derived bNDP52 (if it exists) might not bind COVID-19 and thus target viral proteins for degradation in a p62/SQSTM1 dependent or independent manner. So if anyone in the US has a place for me to study this and other questions, I am up for it. Are you?

ResearchBlogging.org






Further reading

Jose J, Snyder JE, & Kuhn RJ (2009). A structural and functional perspective of alphavirus replication and assembly. Future microbiology, 4 (7), 837-56 PMID: 19722838 

Froshauer S, Kartenbeck J, & Helenius A (1988). Alphavirus RNA replicase is located on the cytoplasmic surface of endosomes and lysosomes. The Journal of cell biology, 107 (6 Pt 1), 2075-86 PMID: 2904446 

Spuul P, Balistreri G, Kääriäinen L, & Ahola T (2010). Kujala P, Ikäheimonen A, Ehsani N, Vihinen H, Auvinen P, & Kääriäinen L (2001). Biogenesis of the Semliki Forest virus RNA replication complex. Journal of virology, 75 (8), 3873-84 PMID: 11264376 

Abraham R, Mudaliar P, Padmanabhan A, & Sreekumar E (2019). Induction of cytopathogenicity in human glioblastoma cells by chikungunya virus. PloS one, 8 (9) PMID: 24086645 

Laakkonen P, Ahola T, & Kääriäinen L (1996). The effects of palmitoylation on membrane association of Semliki forest virus RNA capping enzyme. The Journal of biological chemistry, 271 (45), 28567-71 PMID: 8910486 

Barry G, Fragkoudis R, Ferguson MC, Lulla A, Merits A, Kohl A, & Fazakerley JK (2010). Semliki forest virus-induced endoplasmic reticulum stress accelerates apoptotic death of mammalian cells. Journal of virology, 84 (14), 7369-77 PMID: 20427528 

Rikkonen M, Peränen J, & Kääriäinen L (1992). Nuclear and nucleolar targeting signals of Semliki Forest virus nonstructural protein nsP2. Virology, 189 (2), 462-73 PMID: 1386484 

Montgomery SA, Berglund P, Beard CW, & Johnston RE (2006). Ribosomal protein S6 associates with alphavirus nonstructural protein 2 and mediates expression from alphavirus messages. Journal of virology, 80 (15), 7729-39 PMID: 16840351 

Rathore AP, Ng ML, & Vasudevan SG (2019). Differential unfolded protein response during Chikungunya and Sindbis virus infection: CHIKV nsP4 suppresses eIF2α phosphorylation. Virology journal, 10 PMID: 23356742 

Migliaccio G, Pascale MC, Leone A, & Bonatti S (1989). Biosynthesis, membrane translocation, and surface expression of Sindbis virus E1 glycoprotein. Experimental cell research, 185 (1), 203-16 PMID: 2806407 

Wang M, Wey S, Zhang Y, Ye R, & Lee AS (2009). Role of the unfolded protein response regulator GRP78/BiP in development, cancer, and neurological disorders. Antioxidants & redox signaling, 11 (9), 2307-16 PMID: 19309259 

Mulvey M, & Brown DT (1995). Involvement of the molecular chaperone BiP in maturation of Sindbis virus envelope glycoproteins. Journal of virology, 69 (3), 1621-7 PMID: 7853497 

Krejbich-Trotot P, Gay B, Li-Pat-Yuen G, Hoarau JJ, Jaffar-Bandjee MC, Briant L, Gasque P, & Denizot M (2011). Chikungunya triggers an autophagic process which promotes viral replication. Virology journal, 8 PMID: 21902836 

Eng KE, Panas MD, Murphy D, Karlsson Hedestam GB, & McInerney GM (2012). Accumulation of autophagosomes in Semliki Forest virus-infected cells is dependent on expression of the viral glycoproteins. Journal of virology, 86 (10), 5674-85 PMID: 22438538 

Mostowy S, Sancho-Shimizu V, Hamon MA, Simeone R, Brosch R, Johansen T, & Cossart P (2011). p62 and NDP52 proteins target intracytosolic Shigella and Listeria to different autophagy pathways. The Journal of biological chemistry, 286 (30), 26987-95 PMID: 21646350 

Randow F (2011). How cells deploy ubiquitin and autophagy to defend their cytosol from bacterial invasion. Autophagy, 7 (3), 304-9 PMID: 21193841 Xie Z, & Klionsky DJ (2007). Autophagosome formation: core machinery and adaptations. Nature cell biology, 9 (10), 1102-9 PMID: 17909521

Lippai M, & Lőw P (2019). The role of the selective adaptor p62 and ubiquitin-like proteins in autophagy. BioMed research international, 2019 PMID: 25013806 

von Muhlinen N, Akutsu M, Ravenhill BJ, Foeglein Á, Bloor S, Rutherford TJ, Freund SM, Komander D, & Randow F (2012). LC3C, bound selectively by a noncanonical LIR motif in NDP52, is required for antibacterial autophagy. Molecular cell, 48 (3), 329-42 PMID: 23022382 

Joubert PE, Werneke SW, de la Calle C, Guivel-Benhassine F, Giodini A, Peduto L, Levine B, Schwartz O, Lenschow DJ, & Albert ML (2012). Chikungunya virus-induced autophagy delays caspase-dependent cell death. The Journal of experimental medicine, 209 (5), 1029-47 PMID: 22508836

Judith D, Mostowy S, Bourai M, Gangneux N, Lelek M, Lucas-Hourani M, Cayet N, Jacob Y, Prévost MC, Pierre P, Tangy F, Zimmer C, Vidalain PO, Couderc T, & Lecuit M (2019). Species-specific impact of the autophagy machinery on Chikungunya virus infection. EMBO reports, 14 (6), 534-44 PMID: 23619093 

Münz C (2019). Macroautophagy--friend or foe of viral replication? EMBO reports, 14 (6), 483-4 PMID: 23661081 

Barry G, Fragkoudis R, Ferguson MC, Lulla A, Merits A, Kohl A, & Fazakerley JK (2010). Semliki forest virus-induced endoplasmic reticulum stress accelerates apoptotic death of mammalian cells. Journal of virology, 84 (14), 7369-77 PMID: 20427528

Lower pre-school fees and more help with fertility treatments to encourage marriage and parenthood from 2020

Full-day childcare may cost only $3 a month for needy; more help too with fertility treatments
By Amelia Teng, Education Correspondent, The Straits Times, 29 Aug 2019

Pre-school expenses will be cut for many and more help will be offered with fertility treatments - even for older couples - as part of the latest moves to encourage more Singaporeans to start families.

From next year, lower-income families may only need to pay as little as $3 a month for full-day childcare. The monthly household income ceiling for additional childcare and kindergarten subsidies is also being raised to $12,000.



Meanwhile, there will be no more age limit for women undergoing assisted reproductive technology (ART) treatments from January. It currently stands at 45 years old.

Manpower Minister Josephine Teo, who oversees population matters, Minister for Social and Family Development Desmond Lee and Senior Minister of State for Health Amy Khor announced the measures at a My First Skool pre-school in Punggol yesterday.

With the higher subsidies from next year, more families could find themselves paying between $3 and $390 a month for full-day childcare at pre-schools run by anchor operators that charge monthly fees of $770.

With the measures, eight in 10 young children should have a place in more affordable government-supported pre-schools by around 2025.

This is similar to the proportion that receives government help in the housing and healthcare sectors.

Mr Lee said fee caps will also be lowered at government-supported pre-schools as their share of the sector expands. In time, this would allow working families with a child in full-day childcare to pay about $300 per month, even without additional subsidy.

In 2021, the partner operator scheme will also be expanded to more childcare operators beyond the existing 23. For the first time, it will also include a small number of kindergartens which offer quality programmes.


Subsidy amounts for families at different income tiers will go up. From next year, the monthly household income ceiling for additional kindergarten subsidies and childcare subsidies will be raised from $6,000 and $7,500 respectively to $12,000 so that it benefits 30,000 more households.

Currently, 41,000 families receive these means-tested subsidies.

Low-income families will pay even less, with those earning $3,000 or less per month paying just $3 per month for full-day childcare at anchor operators, or $1 per month for kindergartens run by anchor operators and the Education Ministry.

Mrs Teo noted that there is strong interest among Singaporeans to marry and have children. "But it is also a fact that our people are marrying later. And they're also starting families and they're having children later," she said.

She encouraged couples to marry earlier and start trying to conceive earlier, so that they would be more successful in having children.

Nonetheless, older couples trying for babies will also get more support from January next year, amid fewer marriages last year and an eight-year low in the number of babies born here last year.



The Health Ministry will remove the age limit for women undergoing ART treatments.

There will also be no cap on the number of cycles they can go for.

In addition, couples undergoing intra-uterine insemination procedures - a less invasive fertility treatment than ART - will benefit from government co-funding of up to 75 per cent, capped at $1,000 per treatment cycle, for three such cycles.

And to provide even more help, parents of Singaporean babies born in or after January next year will also not need to pay the application fees for their newborns' first passports. The current application fee is $70.

Parents must submit applications for their newborns online before their first birthday to enjoy the waiver.










 
















Govt to lift age limit for women seeking IVF treatment, increase co-funding for assisted reproduction; more subsidies for child vaccinations
Number of assisted reproductive tech cycles will also no longer be capped from January 2020
By Goh Yan Han, The Straits Times, 29 Aug 2019

The Government will lift the age limit of 45 for women seeking to undergo in-vitro fertilisation (IVF), and will allow some co-funded treatments to be carried out at a later age.

The number of assisted reproduction technology (ART) cycles a woman can undergo will also no longer be capped, said Senior Minister of State for Health Amy Khor yesterday. At present, a woman is allowed to undergo only a maximum of 10 cycles up to the age of 40, and five cycles after that age.

Currently, the Government co-funds up to six ART cycles - which include IVF - only for women who begin a cycle before turning 40.

From Jan 1 next year, up to two of the six cycles can be carried out when the woman is 40 or older, as long as the couple had tried ART or intra-uterine insemination (IUI) procedures before the woman turned 40.

There is no subsidy right now for those undergoing IUI procedures, which are less invasive than ART treatments. But from next year, eligible couples receiving IUI treatment at public assisted reproduction centres will also get subsidies.

The moves come against a backdrop of later marriages, which mean more couples may need help conceiving, said Manpower Minister Josephine Teo, who also oversees population matters, yesterday.

For ART treatments, couples will receive co-funding of up to $7,700 per fresh cycle and $2,200 per frozen cycle, for three fresh cycles and three frozen cycles, provided that the woman is medically assessed to be fit to carry a pregnancy to term. Fresh cycles refer to treatments involving fresh embryos, and are more costly than those involving frozen ones. More support is given if both spouses are Singaporeans than if just one of them is.

The Ministry of Health (MOH) said that last year, there were 992 ART cycles done by those aged between 41 and 45, compared with 709 in 2014.

The changes come as the medical risk for older women has been reduced with the advancement of medical technology, said MOH.

Singaporeans attempt about 2,000 IUI cycles a year, each costing about $1,300.

From Jan 1, eligible couples undergoing IUI treatment at public hospitals will get assistance of up to 75 per cent, capped at $1,000 per cycle, for a maximum of three cycles. To qualify, women have to be under 40 at the start of the IUI cycle.



Mrs Teo encouraged couples who wish to start a family to begin trying for a baby earlier, as fertility treatments do not always lead to successful conception.

These moves signal "that the Government is serious about helping Singaporeans achieve their desire to have children in regard to facilitating fertility, and addressing Singaporeans' preference for having a large 'Singaporean core' of 'natural' citizens", said sociologist Tan Ern Ser.

He added that surveys show Singaporeans do desire to have two or more children, and a significant number of married women have difficulties conceiving.

Voluntary welfare organisation I Love Children's president Joni Ong welcomed the moves. "We must grant the choice to a woman to have a baby if she really wants it," she said. "ART doesn't just succeed straight away - there may be disappointment with several cycles. Before you know it, the woman would be older, and funds may have dried up."



Dr Khor said by the end of next year, childhood vaccinations and developmental screenings will also be more accessible and affordable.

Currently, there are subsidies for selected National Childhood Immunisation Schedule vaccinations, targeted at diseases with high outbreak potential such as measles, mumps and rubella, at polyclinics. However, vaccinations against pneumococcal disease and the human papillomavirus, which are for personal protection, are not subsidised. By the end of next year, subsidies for these will be rolled out at polyclinics and Community Health Assist Scheme (Chas) general practitioner clinics.

Developmental screenings for Singaporean children now subsidised at polyclinics will also be subsidised at Chas clinics.

























Extra subsidies for pre-school fees a relief for couple with 2 kids
By Goh Yan Han, The Straits Times, 29 Aug 2019

With no savings put aside for a rainy day, and much of the family's income spent on loan repayments, bills and pre-school fees, Mr Mohammad Faizal Jaafar was glad to hear about the changes to the additional subsidy scheme for pre-school fees.

The extra subsidies would help ease the family's financial burden.

Mr Faizal, 36, works as a safety officer, and his wife, Ms Nurkaramariah Aman, 33, is a bank executive. Together, they earn about $9,600 a month, and have two children aged five and three.

Now, they are not eligible for the additional subsidy, which applies to families earning up to $7,500 a month. The income ceiling will be raised to $12,000 from next year.

More details about the subsidy were announced yesterday. Mr Faizal's family may receive up to $130 per child in additional subsidies.

He told The Straits Times: "Right now, we are quite stretched financially; we don't even have enough savings for a rainy day or an emergency.

"The subsidies can help us save more money, and we can use the extra money saved for urgent household needs."

About 10 per cent of the couple's combined salary goes towards paying for full-day childcare services at NTUC First Campus' My First Skool at Block 208B Punggol Place. They currently pay about $900 a month for both children.

"Childcare can be costly but it doesn't matter because at the end of the day, the education will benefit them. Now, the additional subsidies will be a relief," said Mr Faizal.

















Marriage & Parenthood: Govt signals it sees the 'pain points' but societal shift in attitudes needed
By Amelia Teng, Education Correspondent, The Straits Times, 29 Aug 2019

Of all the new measures announced yesterday, one seemed slightly out of place.

Singaporean babies born in or after January 2020 will get their first passports for free, as long as their parents apply for them before their first birthday.

The current fee is $70.

Manpower Minister Josephine Teo, who oversees population matters, said this is a "small gesture" to tell parents to "relax, enjoy", and even travel with an infant or toddler.

Parents with young children would be amused by the irony of that sentence, knowing how tough it is to truly relax on a holiday with young children. Yet, this advice may be exactly what they need.

Ask young people today and most of them have wanderlust - they want to see the world before they are tied down to family and the home.

And the desire to travel does not lessen when they become parents.

Immigration and Checkpoints Authority statistics show that passport applications are made for about four in five Singaporean children before they turn one.

Just like how they want to travel to as many countries as they can, young couples hope to achieve as much as they can in their education and reach as high as they can in their careers, before they think about starting a family.



Singaporeans expect much from themselves and those around them. They feel driven to excel in all their pursuits, whether academic or work-related.

Likewise, they demand the same in their commitment to family. National surveys and polls have shown there is still a strong desire to get married and have children, but there is also an increasing pressure that young couples feel in having to balance "doing well" in everything.

Acknowledging this, Mrs Teo said yesterday that society at large must have an honest conversation about resolving this tension and striking the right balance between work aspirations and family aspirations.

The measures announced yesterday to make pre-school education more affordable for more families and increase support for couples undergoing fertility treatments will help to "lighten the burden", as Mrs Teo said.

Collectively, they send a strong signal that the Government sees the "pain points" of families facing high expenses because of multiple children in pre-school, as well as the struggle that older couples go through in their attempts to have a baby.

Singapore Management University professor of sociology (practice) Paulin Straughan said structural barriers that hinder young adults from seeking a significant other and building a family must be removed through policy intervention.

But the truth is, parenting is hard, with or without government support. It will take more than government resources to convince people to have babies.

As Prof Straughan said: "Raising children must come with private cost as it is a private endeavour. After all, it is your child."

A greater societal shift in attitudes is needed, from employers to co-workers to parents themselves, so that raising children can be an enjoyable experience.

Parents are a key part of this equation, said Mrs Teo, adding that in some countries, more government funding did not necessarily improve fertility rates, for various reasons.



If the increased pre-school subsidies are not taken in the right spirit, she said, and parents merely channel the cost savings into more enrichment programmes for their children, the changes will be self-defeating.

The latest measures - the eighth round of enhancements to pro-family incentives since 2001 - is as much as the Government can do to persuade Singaporeans to have children, without being intrusive, added Mrs Teo.

A young woman told Mrs Teo recently that she was not sure if investing her time in a relationship with another person would pay off, whereas working hard in one's career would likely lead to returns.

"If you look at the support... I'll be very honest, this is about as far as the Government can go, without putting our noses into people's personal lives, without dictating to them what they do," said Mrs Teo.

Benefits will help young couples know there is help out there, if they choose to have children, but that is still a choice left entirely up to them, and very much depends on priorities and personal aspirations.

Just like the option to "relax, enjoy" and travel with young children.











* Higher income ceiling under KidStart to benefit more children from low-income families
Firms and individuals can also chip in with contributions under new initiative from 2020
By Goh Yan Han, The Straits Times, 14 Sep 2019

More children from low-income families will get help under the KidStart programme, as the household income ceiling goes up from $1,900 to $2,500, Minister for Social and Family Development Desmond Lee announced yesterday.

Speaking at the Early Childhood Conference, he also announced an initiative where companies and individuals can partner the Government to help children under KidStart.

KidStart, a government pilot programme to help children up to age six from low-income families, began in 2016 and has helped about 1,000 families since. It supports families in areas such as nutrition, child development and parent-child interaction.

It was announced at the National Day Rally in August that the pilot programme would be expanded to benefit another 5,000 families.



Next year, the expansion will cover more locations in Singapore, with priority for areas with Community Link (ComLink) centres such as Kembangan-Chai Chee and Marsiling, said Mr Lee.

ComLink centres are where government agencies and community partners work together to help families living in rental blocks.

In the first round of the pilot, the programme targeted children from low-income families in Bukit Merah, Kreta Ayer, Boon Lay, Taman Jurong and Geylang Serai.

Companies and individuals who wish to contribute to KidStart can do so through the Growing Together with KidStart initiative from next year. They can partner a KidStart community through volunteering or providing families with items such as milk and diapers, transport to attend pre-school or KidStart programmes, or learning resources.

Those interested can also donate money to top up the Child Development Accounts of KidStart children, which will be matched by the Government up to a certain cap.

Mr Lee said feedback from existing partners and other organisations has shown that they wanted to do more.

"We hope that our children on KidStart will grow together with well-wishers and volunteers, in their relationships and interactions," Mr Lee added on the first day of the two-day conference held at the Suntec Singapore Convention and Exhibition Centre.

The event, organised by the Early Childhood Development Agency, is a platform for professionals and parents to keep up with trends, share practices and build networks.



In line with the theme this year, Beyond The Classroom: Take Learning Outdoors, Mr Lee announced that two prototype outdoor learning spaces will be launched in Bukit Batok and Jurong West to test how existing pre-schools in Housing Board estates can tap the environment outside their centres for outdoor learning.

In Jurong West, the prototype will introduce ways to allow easier access going from indoors to outdoors, such as by extending the centre's window to an outdoor open area.

The second prototype in Bukit Batok will create outdoor learning trails, such as music walls with old pots and pans and obstacle courses using recycled items.



The National Institute of Early Childhood Development will also introduce courses for early childhood educators on outdoor learning next year, and offer training for centre leaders on how to support teachers carrying out outdoor learning.

As he concluded his speech, Mr Lee said: "The next frontier (for the early childhood sector) requires us to forge strong partnerships, in the intersection of government, civil society and enterprise.

"This approach is a key part of our vision for a society that cares, that creates opportunities for all."



At the conference, 112 pre-schools received their Singapore Pre-school Accreditation Framework (Spark) certifications from Senior Parliamentary Secretary for Education Low Yen Ling.

Spark is a benchmark to assess and increase the quality of programmes in pre-schools. Ms Low said 951 centres have been certified since the framework was introduced in 2011, making up more than half of the early childhood sector.

She also announced a new Spark quality rating scale that would cover programmes for children from birth until age six from next year. The current scale applies to programmes for ages four to six, and programmes for children from birth to three years of age are assessed only via self-appraisal.

"As we strive to make pre-schools more affordable and accessible, it is important that we continue to raise the quality of pre-school education," said Ms Low.





















** Pre-school to cost less with enhanced subsidies: Early Childhood Development Agency

We refer to the report (330 childcare centres to raise fees next year, Sept 18), which raised concerns that some pre-school operators may be opportunistically profiting from the recent subsidy enhancements.

There are about 1,530 childcare centres, run by some 380 operators, both commercial and not-for-profit.

About a fifth of them have announced they will raise fees for full-day childcare for Singapore citizens next year.

Last year, 540 childcare centres raised their fees. This year, 220 did so. The median fee increase next year is broadly comparable with that of past years, within 5 per cent.



All centres must inform parents and the Early Childhood Development Agency (ECDA) of any increase in fees by Sept 1 of the preceding year. A large majority of the centres raising fees next year informed ECDA of their intention even before the subsidy enhancements were announced.

With the enhanced subsidies from January, the bulk of working families earning $12,000 and below a month will pay less for childcare.

For example, families receiving these subsidies can expect to pay between 20 and 90 per cent less per month for full-day childcare at anchor operator childcare centres.

Childcare centres run by anchor and partner operators are subject to fee caps stipulated by ECDA. These caps have been maintained since 2014 and 2016 respectively. Together, they have helped to bring down industry median fees, which have remained unchanged at $856 since 2016. In 2021, we will lower the fee caps for partner operator centres.



We will grow the anchor-operator and partner-operator share of pre-school places to 80 per cent by around 2025, from about 50 per cent today.

This will allow fee caps of government-supported operators to be reduced further in the medium term. This means that for full-day childcare, working families can expect to pay around the equivalent of fees for primary school plus after-school student care, which are currently around $300 per month, before means-tested childcare subsidies.

These enhancements will more than double annual government spending on pre-school, from $1 billion today.

We are committed to making quality pre-school more affordable and accessible, to give every child a good start in life.

Charlene Han
Director, Policy, Planning and Development
Early Childhood Development Agency
ST Forum, 21 Sep 2019