Topics Held the Pharmaceutical Manufacturers Association of Japan (PMAJ) Media Forum. -Drug Resistance (AMR) Awareness Month
In order to promote the development of new antimicrobial agents against Antimicrobial Resistance (AMR), the Global Health Subcommittee of the International Committee of the Pharmaceutical Manufacturers Association of Japan (PMAJ) is working daily to gain the understanding and support of many people regarding the importance of the problems caused by AMR and the urgent need for countermeasures. November is the "Month to Promote Measures against Drug Resistance (AMR)" designated by the Japanese government, and on November 8, 2022, we held the "Pharmaceutical Co-op Media Forum - For the Month to Promote Measures against Drug Resistance (AMR)" at the Nihonbashi Life Science Building (Chuo-ku, Tokyo). The event was attended by the Parliamentary Secretary of the Ministry of Health, Labour and Welfare.
The venue
Introduction
The event was opened by Ms. Akiko Honda, Parliamentary Secretary of the Minister of Health, Labour and Welfare and a member of the House of Councillors, followed by opening remarks by Mr. Tomohiro Onishi, Deputy Director of the Cabinet Secretariat, Office for the Promotion of Countermeasures against Infectious Diseases including New-type Coronavirus, Cabinet Secretariat; Mr. Kazuhiro Tateda, Professor of Toho University School of Medicine and Chairman of the Joint Study Committee on the Promotion of Therapy and Drug Discovery for Infectious Diseases among 7 academic societies; Mr. Yui Kono, Manager of Japan Health Policy Institute, Yusuke Ariyoshi, a member of the Global Health Subcommittee of the International Committee of the Pharmaceutical Manufacturers Association of Japan (PMAJ), gave a lecture and participated in a panel discussion. Twenty-one media representatives from 19 companies participated at the venue and via webcast, and the forum provided an opportunity to deepen understanding of the threat of AMR and the need for research and development of new antimicrobial agents to combat the disease.
Opening Remarks
Ms. Akiko Honda, Parliamentary Secretary, Minister of Health, Labour and Welfare, Member of the House of Councillors
He introduced the MHLW's AMR awareness activities in 2022, including the distribution of posters and videos in collaboration with the popular TV animation "Hataraku Cell" and a call for entries of a certain willow poem about drug resistance, in an effort to make AMR more familiar to the general public. He also pointed out that even in an era when public health is in a critical situation, as many medical practitioners are experiencing with the new coronavirus infection (COVID-19), it is necessary to make unceasing efforts toward countermeasures.
Lecture 1
Activities to Raise Awareness of Drug Resistance (AMR)
Mr. Tomohiro Onishi, Deputy Director-General, Cabinet Secretariat, Office for the Promotion of Countermeasures against Infectious Diseases including the New Type of Coronavirus
In the Cabinet Secretariat, the "International Coordination Office for Countermeasures against Infectious Diseases" has been in charge of AMR countermeasures, but in 2021, the Cabinet Secretariat will reorganize the organization related to infectious disease countermeasures and consolidate this office with the "Office for Countermeasures against New Strains of Influenza, etc." and the "Office for the Promotion of Countermeasures against New Coronavirus Infections". The Office for the Promotion of Countermeasures against Infectious Diseases including New Coronavirus" is now in charge of this office. In addition, as part of the government's efforts to strengthen its command post function to respond to the next infectious disease crisis, a government policy has been decided to establish a "Cabinet Office for Infectious Disease Crisis Management (tentative name)" in FY2023, and AMR measures are being considered to be taken over by this agency.
In a public opinion survey on drug resistance (AMR) conducted in 2019, about half of the public said they were familiar with drug resistance, of which 70% said that antibiotics are no longer effective against bacteria that cause infections, and 50% said that if antibiotics are not taken correctly, drug-resistant bacteria may increase in the body correctly understood that "if antibiotics are not taken correctly, drug-resistant bacteria may increase in the body" ( Figure 1 ). However, only half of the public still knows about AMR, and it was explained that further raising awareness is an important issue in the fight against AMR.
Fig. 1 Results of Public Opinion Survey on Drug Resistance (AMR) (2)
In addition, due to COVID-19, the government's public awareness campaign has been dormant for the past two years, and it is possible that AMR awareness has declined. For this reason, during the AMR Countermeasures Promotion Month in 2022 (November), the message "What is drug resistance (AMR)?" will be included, going back to the basics, The Ministry of Health, Labour and Welfare (MHLW) and other ministries and agencies are also promoting the awareness of AMR.
In addition, the Cabinet Secretariat emphasized that the future challenge for the Cabinet Secretariat is how to strengthen the spread of AMR awareness activities from FY2023 onward, including the "National Conference on Drug Resistance (AMR) Measures" and other suspended events ( Figures 2 and 3 ).
Awareness-raising poster
Fig. 2 Drug Resistance (AMR) Promotion Month (2)
Fig. 3 Drug Resistance (AMR) Promotion Month (3)
Lecture 2
Efforts as an academic society
Kazuhiro Tateda, Professor, Toho University, Chairman, Joint Committee of Seven Academic Societies for the Promotion of Therapy and Drug Discovery for Infectious Diseases
AMR spreads without being known because healthy people are not infected. Its spread is also known as a silent pandemic, and can occur both as a community-acquired and nosocomial infection. In developing countries, antimicrobial agents can be purchased without a prescription, which facilitates the spread of resistant strains.
On the other hand, it is also true that some lives are saved by the availability of antimicrobials, and it was pointed out that resistant bacteria is not only a medical problem, but also a problem for society as a whole, including the economy and poverty, which is a difficulty when tackling AMR issues.
Despite the fact that Japanese pharmaceutical companies once produced many antimicrobial agents that became the global standard, they have been unable to continue investing in the development of new antimicrobial agents and have withdrawn from the antimicrobial drug area. As a reason for this, he explained that compared to drugs for chronic diseases, the field of antimicrobials is not a viable business in terms of duration of administration and proper use ( Figure 4 ).
Fig. 4 Development of Infectious Drugs Cannot Continue...
As Japanese efforts to solve this stagnation in R&D, he introduced the Drug Discovery Promotion Review Committee and the Antimicrobial Agents Industry-Academia-Government Liaison Committee of the Japan Agency for Medical Research and Development (AMED). He also introduced the ongoing joint efforts of seven Japanese academic societies to disseminate recommendations on AMR, and the need for pull-type incentives and other systems to enable continued research and development of therapeutic drugs, vaccines, and testing methods in July 2022 ( Fig. 5 ).
Fig. 5 Joint Study Committee on Promoting Infectious Disease Treatment and Drug Discovery among Seven Societies Recommendations
Finally, he expressed his hope that the G7 Hiroshima Summit in 2023 will be a good opportunity for Japan to lead the discussion on pull-type incentives that began at the Ise-Shima Summit in 2016, including the perspectives of international contribution, drug discovery promotion, and diagnostics development, and to build momentum toward this Summit.
Lecture 3
AMR Alliance Japan
Dr. Yui Kono, Manager, Japan Health Policy Organization (JHPO)
In this lecture, he first introduced the Japan Health Policy Institute (HGPI), a non-profit organization, which has been focusing on AMR since the G7 Ise-Shima Summit in 2016 and has been recognized as a platform to discuss AMR issues from a neutral standpoint in response to growing social demands in Japan and abroad. In November 2018, the AMR Alliance Japan was launched as a platform to discuss AMR issues from a neutral standpoint ( Figure 6 ).
Fig. 6 AMR Alliance Japan
The symposium was followed by a wide range of AMR-related symposiums and roundtables, a proposal for the introduction of pull-type incentives as a measure against AMR in 2021, policy proposals for the G7 Hiroshima Summit in 2023, and other activities to raise awareness through gathering narratives through interviews with patients, collaboration with citizens, messaging surveys, etc. The wide range of activities of the AMR Alliance Japan were introduced, including the AMR Alliance Japan's activities such as the AMR Alliance Japan's "AMR Alliance Japan" and the messaging survey.
He explained that antimicrobial agents are public goods of society and that everyone needs to work together to prevent the occurrence and spread of drug resistance, and that the power of the media is also necessary to spread awareness that antimicrobial agents are used in a wide range of fields, including anticancer therapy, in addition to infectious diseases ( Figure 7 ).
Fig. 7 To the Media
Lecture 4
Efforts by the Japan Pharmaceutical Manufacturers Association (JPMA) against drug resistance (AMR)
Yusuke Ariyoshi, Leader, Infectious Disease Group, Global Health Subcommittee, International Committee, Pharmaceutical Manufacturers Association of Japan (PALMA)
In this lecture, the current status of AMR, the efforts of the Pharmaceutical Manufacturers Association of Japan (PMAJ) in AMR, and the proposals made by the PMAJ and the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) to the G7 Hiroshima Summit of the pharmaceutical industry were introduced. It is estimated that 10 million people worldwide will die from AMR in 2050 if no action is taken now. Despite the fact that many countries have established and implemented action plans to combat AMR, unfortunately, the progression of the disease has not been curbed, with approximately 1.27 million people dying from AMR in 2019. In Japan, it was introduced that about 8,000 people were estimated to have died in 2017 from bacteremia caused by methicillin-resistant Staphylococcus aureus (MRSA) and fluoroquinolone-resistant E. coli, and that AMR is a problem in many medical departments.
On the other hand, he introduced a survey conducted by the Pharmaceutical Manufacturers Association of Japan (PMAJ) on the public's awareness of the development of new antimicrobial agents to combat drug resistance, which showed that the awareness of AMR is low.
He then introduced the AMR efforts of the Pharmaceutical Manufacturers Association of Japan ( Figure 8 ). Currently, industry, academia, and government are working together on AMR countermeasures, with the two key concepts being "efforts for proper use to prevent the increase of resistant bacteria" and "the need to develop drugs that can deal with new resistant bacteria.
Fig. 8 The Pharmaceutical Manufacturers Association of Japan's Approach to AMR
The Pharmaceutical Manufacturers Association of Japan (PMAJ) has continued awareness-raising activities through posters, flyers, videos, events and websites since 2017, and in 2021, in light of the importance of providing information to the media, it was introduced that a media forum will be held and an awareness survey initiated to identify issues and changes in these issues.
The pharmaceutical industry's recommendations for the G7 Hiroshima Summit consist of achieving sustainable UHC (Universal Health Coverage)*1, preparing for the next pandemic, and addressing AMR. In particular, for addressing AMR, the importance of promoting research and development, including pull-type incentives, improving access, including in low- and middle-income countries, and surveillance efforts was introduced ( Figure 9 ).
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1UHC: Universal Health Coverage (UHC) is the provision of basic health services to all people throughout their lives when they need them, at a cost they can afford.
Fig. 9 Summary
Closing remarks
Tatsuya Ito, Chairperson, International Committee, Pharmaceutical Manufacturers Association of Japan (PALMA)
He reiterated the importance of increasing public understanding of AMR, the proper use of antimicrobial agents to prevent the development of drug-resistant bacteria, and the preparation of antimicrobial agents to fight resistant bacteria in the event of an outbreak.
The G7 Summit will be held in Hiroshima in 2023, and Japan will hold the G7 Summit in Hiroshima, Japan. The Forum closed with the statement that Japan's leadership is expected in the global fight against AMR.
Closing Remarks
It is important to raise public awareness of AMR as an important global health issue, and the development of antimicrobial agents against AMR is an issue that should be addressed through collaboration between industry, academia, and government. The Pharmaceutical Manufacturers Association of Japan (PMAJ) will continue to promote various activities to solve the problem of AMR while proactively adopting new knowledge.
( Takeshi Watanabe, Kyoko Nakano, Shinji Tsubakihara, Global Health Subcommittee, International Committee)