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[Report and Summary of Expert Meeting] The 3rd AMR Global Expert Meeting: Tokyo AMR One-Health Conference Side Event ~ Measures Necessary at Home and Abroad for Promotion of the Action Plan (November 14, 2017)

[Report and Summary of Expert Meeting] The 3rd AMR Global Expert Meeting: Tokyo AMR One-Health Conference Side Event ~ Measures Necessary at Home and Abroad for Promotion of the Action Plan (November 14, 2017)
The 3rd AMR Global Expert Meeting: Tokyo AMR One-Health Conference Side Event ~ Measures Necessary at Home and Abroad for Promotion of the Action Plan was convened by Health and Global Policy Institute (HGPI) on Tuesday, November 14, 2017.
Antimicrobial resistance (AMR) presents an increasingly serious threat to global public health. It is imperative that all stakeholders urgently coordinate and takes necessary actions at national and international levels across both the public and private sectors.
On July 21, 2017, the 2nd AMR Global Expert Meeting entitled Post G7 Ise-Shima Summit ~ Reflecting upon Japan’s National Action Plan and Addressing Next Steps for Global Antimicrobial Resistance was convened, bringing together multi-stakeholders and culminating in “Seven Recommendations for the Promotion of AMR Policies (Expert Meeting Summary).” Held as a side event of the Tokyo AMR One-Health Conference, hosted November 13 and 14, 2017, by Japan’s Ministry of Health Labour and Welfare, the 3rd AMR Global Expert Meeting was convened in order to maintain momentum as well as promote the formulation of even more specific policies. Among the “Seven Recommendations…” proposed in the 2nd meeting, the 3rd AMR Global Expert Meeting focused on methods to deliver incentives for the development of new antibacterial drugs, the promotion of speedy and accurate diagnostic methods, and global contribution from Japan.
The discussions from this meeting are summarized below to compliment the “Seven Recommendations for the Promotion of AMR Policies (Expert Meeting Summary).”
Future Concerns and Desired Actions (Summary of the Expert Meeting):
1. Reaffirm the importance of rapid testing in order to promote appropriate diagnoses
  • Based on scientific evidence, Japan should consider the introduction of equipment for genetic diagnostic testing at an early date, as well as ways of promoting the utilization of genetic testing in clinical settings while also keeping in mind the limitations of insurance coverage.
  • To prevent outbreaks at medical facilities, Japan should work to create an environment that makes early containment possible, including by offering public support for the storage of surveillance cultures, and by promoting diagnostic thoroughness in order to prevent mass outbreaks, and an environment that encourages early containment.
  • To counteract infectious diseases at elderly care facilities or facilities where genetic diagnoses aren’t available, Japan should promote educational environments that can foster professionals such as microbiologists, or others with knowledge about public health.
2. Provide concrete incentives for R&D
  • -Alongside push incentives (subsidies for drug development) for R&D at universities and pharmaceutical companies, it is important to implement pull incentives (incentives designed to reward drug development or provide returns on investment) that could help to increase the profit predictability for antibiotics for which low returns are expected and reflect the value of the drugs in their prices by considering how the drugs would be used under ideal situations where drugs are used appropriately.
3. Promote both the cross-sectoral and international integration of examination data
  • To enable the permanent monitoring of AMR, Japan must consider methods for highly reliable, cross-specialty data collection and utilization, as well as data analysis methods in the short-term.
  • In order to comprehensively collect and utilize information about the kinds of resistant bacteria that commonly develop at elderly care facilities, Japan should consider working to promote the collection and utilization of data via regional networks.
  • In order to facilitate correct understanding about infectious diseases among governments, medical facilities, and citizens, and in order to make it possible for Japan to consider, as a country, what safety measures should be implemented, Japan should create a culture of broadly sharing data on the usage of antibacterial drugs and other relevant issues.
  • Japan should support the creation of scientific evidence that meets global standards for quality and reliability that has high, world-wide reliability and consider mechanisms for returning this evidence to clinical settings and to the public.
4. Seek concrete progress in areas of cooperation between academia, government, and industry
  • Japan should promote cooperation between the technology sector and pharmaceutical companies. We should also support the sharing of data among governments, industry, and academia.
  • Japan should display international leadership in combating AMR by investing funds in the promotion of basic research, both domestic and foreign, and in the maintenance and promotion of medical systems.
  • In order to bolster the efforts of the One Health Approach, Japan should consider how to establish innovative mechanisms that would promote cooperation among industry, government, and academia, including in the agricultural and environmental fields.
5. Proceed with the implementation of the Action Plan while taking special care not to bring too many restrictions to bear
  • Along with ensuring access to antibacterial drugs in such a way that takes into account the actual circumstances of regional medical systems, Japan should go even further to exhaustively promote the proper use of antibacterial drugs in order to prevent the proliferation of resistant bacteria.
  • Japan should recognize that AMR is a global concern and promote the further implementation of its National Action Plan, including from the perspective of the One Health Approach.
6. Japan must continue to assume global leadership
  • Japan should work to communicate information about AMR around the world in the form of an action package that includes specific measures for achieving the goals specified in the action plan.
  • While promoting the international development of advanced technologies to counteract infectious diseases, Japan should consider bilateral cooperation aimed at achieving universal health coverage (UHC) globally, as well as technological collaboration among specialists working in collaboration with the UN and other international agencies, and mechanisms that promote R&D.
  • Japan should work independently as well to foster the international cooperation for the initiatives of the action plan.
7. Promote further awareness-raising activities
  • From the perspective of the One Health Approach, Japan should maintain an environment conducive to the sharing of initiatives across government organizations, academic research institutes, and industry related to AMR countermeasures, which are linked to a wide variety of issues such as the environment and food supplies.
  • Not only governments, industry, and academia, but also the media and other stakeholders should take an active role in conveying correct information to the public.
Opening Remarks
  • Kiyoshi Kurokawa (Chairman, Health and Global Policy Institute)
Dr. Kurokawa emphasized that drug-resistant bacteria (i.e. Antimicrobial Resistance or AMR) is globally on the rise, and the development of new antibacterial drugs is in decline. It is necessary to take a One Health Approach to solve this problem, based on the premise that humans, animals, and the environment mutually affect each other.
Opening Speech 
  • Chieko Ikeda (Senior Assistant Minister for Global Health, Ministry of Health, Labour and Welfare) 
Dr. Ikeda shared her view that strict implementation of the “Global Action Plan on Drug Resistance (AMR)” adopted at the 2015 World Health Assembly (WHA) remains necessary on a country-by-country basis, and that the world also requires cooperation among governments, industry, and academia in order to support ongoing international frameworks and R&D for novel antimicrobials.
Panel Discussion “Domestic and international measures for promoting the action plan”
  • Chifumi Umeda (Executive Officer in charge of the Vaccine Business Unit and the Acute Diseases & Hospital Products Business Unit, MSD K.K.)
  • Mitsuo Kaku (Professor, Infection Control and Laboratory Diagnostics, Internal Medicine, Department of Medical Sciences, Graduate School of Medicine, Tohoku University)
  • Tomohiko Makino (Medical Officer, WHO West Pacific Regional Office)
  • Michael Bell (Deputy Director, Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention)
  • Manami Takamatsu (Manager, Health and Global Policy Institute)
The panel discussion reflected on three main areas—methods to deliver incentives for the development of new antibacterial drugs, the promotion of speedy and accurate diagnostic methods, and global contribution from Japan—areas proposed in the “Seven Recommendations for the Promotion of AMR Policies (Expert Meeting Summary).” Panellists also discussed the necessity of regional data collection and usage via regional networks and the importance of integrating regional medical systems to promote appropriate and thorough use of antibiotics. Furthermore, the audience joined in the lively discussion, offering many questions and comments on the formulation of international cooperation frameworks.
Keynote Lecture: The Global Challenge of Antimicrobial Resistance: a UK Case Study
  • Dame Sally Davies (Chief Medical Adviser to the UK Government/ Co-convener of the UN Inter-Agency Co-ordination Group on AMR.)
Dame Sally Davies explained that AMR is a top priority for the U.K government and emphasized the importance of accordingly expanding government efforts to fight AMR both at home and abroad based on the One Health Approach. She also explained that demonstrating international leadership by investing funds for domestic and overseas promotion of basic research as well as maintaining and improving systems is important for governments.
Closing Remarks
  • Yasuhisa Shiozaki (Member of the House of Representatives/ Former Minister of Health, Labour and Welfare)
Mr. Shiozaki explained that under the aggressive AMR measures taken in European countries, Japan formulated its own National Action Plan as a starting point, emphasizing the necessity for international cooperation and leadership as well as for raising awareness on this issue within the agriculture and environmental sectors.
(No particular order and title omitted)
(Photographed by: Kazunori Izawa)

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