Collaborating Centres
ANNUAL REPORT
Folder eCC_00021098 is in stage Annual_Report_Due
Name of the University, Hospital, Research Institute, Academy or Ministry
National Center for Global health and Medicine
Name of the Division, Department, Unit, Section or Area
AMR Clinical Refence Center
Reference Number

JPN-98

City

Shinjuku-ku

Title

WHO Collaborating Center for prevention, preparedness and response toAntimicrobial Resistance

Report Year02-2022 to 02-2023

1. Annual report on the agreed workplan
Describe progress made on the agreed workplan. For each activity, detail (1) the actions taken, (2) theoutputs delivered, as well as (3) any difficulties that may have been encountered. Three responses areexpected. [maximum 200 words per activity]. Indicate, if an activity has been completed previously,
has not yet started or has been placed on hold.
Activity 1
Title: 1. To provide support to WHO in developing and conducting training and mentoring activities forplanning, development and implementation of antimicrobial stewardship and infection prevention and control
activities, based on the request of WHO
Description: Member States have expressed their interest in receiving the technical support required to createcapacities at national, subnational and facility level, in order to strengthen IPC and antimicrobial stewardship.
The deliverables will support WHO’s work with Member States towards strengthening their capacity for IPC
and antimicrobial stewardship
Status: ongoing
Dr. Norio OHMAGARI, Dr. Nobuaki MATSUNAGA, Dr. Haruhiko ISHIOKA, and Dr. Akane ONO from NCGM
attended the Tokyo Antimicrobial Resistance (AMR) One Health Conference hosted by Japanese Ministry ofHealth, Labour, and Welfare on February 17, 2023. We introduced some of the initiatives and achievements ofJapan's National Action Plan on AMR to countries in the World Health Organization (WHO) Western PacificRegion and South East Asian Region, also with invitation of Prof. Masaru Usui from Rakuno Gakuen
University in Japan and Dr. Archawin Rojanawiwat from National Institute of Health Department of MedicalSciences in Thailand to make presentations. From NCGM, we reported the progress of our antimicrobial
stewardship introduction towards countries of the WPRO and presented the antimicrobial surveillance inJapan. We also showed our plan of the introduction of the Japanese manual of antimicrobial stewardship andantimicrobial stewardship program in hospitals.
Activity 2Title: 2. To inform WHO’s work as a core member of the AMR consortium through the provision of technicalinputsDescription: In order to support WHO’s work as a leading participant of the AMR consortium, technical inputs
in specific areas of work related to AMR are required from other institutions, which may inform the technicalwork conducted by WHO in such context

4/23/2023 2:40:19 AMPage (1/5)

Collaborating Centres
ANNUAL REPORT
Status: ongoing
Dr. Norio OHMAGARI, Dr. Nobuaki MATSUNAGA, Dr. Haruhiko ISHIOKA, and Dr. Akane ONO, with Prof.
Masaru USUI from Rakuno Gakuen University in Japan and Dr. Archawin Rojanawiwat from National Instituteof Health Department of Medical Sciences in Thailand participating and speaking, attended the Tokyo AMR
One Health Conference and discussed initiatives and achievements of Japan's National Action Plan on AMR(conducted by Japan’s Ministry of Health, Labor, and Welfare [MHLW] on February 17, 2023) to SEAR andWPR countries. We led the Working Group 3 on behalf of Japan’s MHLW and intend to initiate the following
activities. Dr. Norio OHMAGARI chaired with presentation by Dr. Haruhiko ISHIOKA, Prof. Masaru USUI andDr. Archawin Rojanawiwat. From NCGM, we presented regulations and enforcement of the antibiotic
prescription for selected countries. We will proceed our activity to obtain updated situation of prescription
antimicrobials not only in human area but also in animal area. Prof. USUI introduced guidelines for
antimicrobial use in Porcine Respiratory Disease Complex from Japan. Lastly, Dr. Archawin presented thecase study from Thailand regarding to the approach to AMR control from one-health perspective chaired thesession and led the discussion.
Activity 3Title: 3. To provide technical inputs to inform WHO’s work towards the development of AMR advocacy andawareness strategies and tools, to help champion AMR beyond the health sector in WPR Member States(particularly priority LMICs)
Description: The Framework for Accelerating Action to Fight Antimicrobial Resistance in the Western PacificRegion advances the formation of a movement to fight AMR as an overarching principle to mobilize massaction, underpinned by value formation – of protecting self, society and future generations. The aim is tosupport WHO’s efforts in order to recast AMR as a political and social issue and ingrain collective behavior
change through incremental, yet sustained, awareness-raising and adoption of good practices to reach a level
whereby acting responsibly to combat AMR will become a societal norm and a way of life. WHO will use thetechnical support from the institution in order to inform its work towards the design of awareness raisingstrategies and strategic communication tools, to enable communities to combat AMR

Status: ongoing
Dr.Yumiko Fujitomo worked with academic groups to translate the WHO hand hygiene campaign posters anddistribute them to healthcare facilities In the World Antimicrobial Awareness Week (WAAW) campaign(November, 2022).
ICARS (International Centre for Antimicrobial Resistance Solutions) is an organization that supports the fightagainst AMR in LMICs. We collaborated with them on activities where Japan and Denmark work together tosupport the fight against AMR in Asia. Dr. Norio OHMAGARI, Dr. Nobuaki MATSUNAGA, Dr.Yumiko
Fujitomo, Dr Shinya Tsuzuki, Dr. Haruhiko ISHIOKA, and Dr. Akane ONO exchanged views with ICARS
members on microbiological and one-health surveillance. Dr. Norio OHMAGARI attended a meeting inDenmark-Japan AMR Expert Meeting.
The institution participated in the fourth Regional Forum of WHO Collaborating Centers in the Western Pacific(November 28-29, 2022, Siem Reap,Cambodia). At the meeting, we discussed that WHO and CCs work
together at the strategic planning stages to best leverage the breadth of expertise, capacities, networks andresources of the CCs to broaden CC contributions to accelerating implementation of For the Future.
Activity 4Title: 4. Provision of technical support to assist WHO’s work in the response to infectious disease outbreak
including AMR pathogens, as requested
Description: Technical support provided by the institution will assist WHO’s activities to deal with outbreak
response, in particular AMR pathogens in the Western-Pacific Region

4/23/2023 2:40:19 AMPage (2/5)

Collaborating Centres
ANNUAL REPORT
Status: ongoing
Under the Global Outbreak Alert and Response Network project, Dr. Shinya TSUZUKI and Dr. Yusuke ASAI
were deployed to the WPRO as data management officers between November 2021 to February 2022 andDecember 2021 to March 2022, respectively. These researchers were involved with the management ofepidemiological data associated with coronavirus disease (COVID-19). They prepared daily reports of theepidemiological situation of COVID-19 in the WPR and forwarded this information to the World HealthOrganization Health Emergency Team Lead and Information and Planning Pillar. They also provided current
information regarding the epidemic and public health countermeasures in Japan through regular meetings,discussions, and presentations. Deployment of these researchers led to appropriate maintenance andimprovement in the data aggregation system.
Activity 5Title: 5. To assist WHO’s work in the provision of technical assistance to support preparedness for outbreak
due to AMR pathogens, including technical assistance for IPC, AMS, diagnostic stewardship and clinicalmanagement
Description: Technical support provided by the institution will assist WHO’s efforts towards building capacities
in the Western-Pacific Region on outbreak preparedness due to AMR pathogens
Status: ongoing
Dr. Norio OHMAGARI, Dr. Nobuaki MATSUNAGA, Dr. Haruhiko ISHIOKA, and Dr. Akane ONO attended theTokyo Antimicrobial Resistance (AMR) One Health Conference and described the initiatives andachievements of Japan's National Action Plan on AMR (conducted by Japan’s Ministry of Health, Labor, andWelfare on February 17, 2023) to the WPRO countries. We also described the role of the antimicrobialstewardship team (AST) in hospitals across Japan. We discussed the importance of the AST and the systems
implemented to support the appropriate use of antimicrobials.
Mr. Koizumi collaborated with participant members and staff of the Infection Control Department of a hospitalin Hoa Binh Province, Viet Nam, on nosocomial infection control measures through field training provided bybureau of international health cooperation of NCGM International Medical Cooperation Bureau. They
examined measures and assessment methods for the discharge of wastes at risk of infection. They introduced
lectures on proper waste disposal for hospitalized patients and their families and produced awareness-raisingmaterials (posters, videos).
Activity 6Title: 6. To assist WHO’s work in the provision of technical assistance to support antimicrobial consumption
monitoring, through capacity building for WPR Member States and by providing technical support to WHO’s
activities in the contents of WPRACCS
Description: Technical expertise provided by the institution will assist WHO’s efforts towards advancing
antimicrobial consumption monitoring in the WPR region to improve antimicrobial stewardship

4/23/2023 2:40:19 AMPage (3/5)

Collaborating Centres
ANNUAL REPORT
Status: ongoing
The Antimicrobial Resistance Clinical Reference Center members informed the WPRO on the methodology
adopted by the Japanese antimicrobial use surveillance system, the provision of information, andmanagement of data regarding the methodology of the Western Pacific Regional Antimicrobial Consumption
Surveillance System (WPRACSS), which WPRO has launched. We also provided advice on the online
dashboard, which is being developed by WPRO as an important monitoring component of the WPRACSS.
Following a request from the WPRO, data on the volume of antimicrobials exported and produced in Japan
was applied for and obtained to form another national level consumption monitoring system in Japan. An
analysis is currently being conducted to provide the information.
With request from WHO, Dr Kei YAMAMOTO reviewed and gave expert advice on the first AMR national
surveillance bulletin for Cambodia, which was published in December 2022.
Mr. Ryuji KOIZUMI reviewed and submitted applications for antimicrobials that are currently unregistered in
the Anatomical Therapeutic Chemical/Defined Daily Dose system for drug statistics conducted by a WHO CC(The Norwegian Institute of Public Health, Norway, NOR-11). We responded for approximately 2 days in
January and August. One antimicrobials were registered for antimicrobial consumption surveillance and one
are under application.
2. Annual report on other activities requested
Should WHO have requested activities in addition to the agreed workplan, please describe related
actions taken by your institution [maximum 200 words]. Please do not include in this report any
activity done by your institution thatwas not requested by and agreed with WHO.
Requested by WPRO, based on the expert advice from Dr YAMAMOTO, CARBGEM Inc. developed an AI
application that can identify the name of bacteria from microscopic images of gram-stained bacteria (Bacterialinfection teller and treatment estimator: BiTTE). This AI application aims to reduce the occurrence of AMR due
to inappropriate use of antimicrobial agents through image recognition. This was presented at The Second
WHO Innovation Forum in the Western Pacific Region (April 28, 2022)(https://www.who.int/westernpacific/initiatives/innovation-for-health-impact/innovation-challenge/carbgem).
Dr. Norio OHMAGARI as a facilitator and members of the AMCRC as co-organisers, attended the high-level
conference on “Universal Health Coverage (UHC) in an Era of Antimicrobial Resistance (AMR) andPandemics” co-organised by Asia-Europe Foundation (ASEF) and the Ministry of Foreign Affairs of Japan(held in Tokyo on 21-22 February 2023). The aim was to identify priority actions for the next steps inaddressing this global public health challenge. We and participants agreed on the importance of recognising
the linkage between AMR, UHC and Pandemic Preparedness and Response (PPR). It will be essential forgovernments, as well as financial support from other sources, to confront this challenge, and to establish aglobal system of cooperation.
3. Resources
Indicate staff time spent on the implementation of activities agreed with WHO (i.e. those mentioned inquestions no. 1 and no. 2 above). Do not include any data related to other activities done by yourinstitution without the agreement of WHO. Please indicate staff time using the number of “full-dayequivalents” – a day of work comprising 8 hours (e.g. 4 hours work per day for 7 days should berecorded as 3.5 full-day equivalents).
Number of staff involved (either partially or fully)
Senior staff

Mid-career staff

Junior staff, PhD students

700

Number of full-day equivalents, total for all staff involved

4/23/2023 2:40:19 AMPage (4/5)

Collaborating Centres
ANNUAL REPORT
Senior staff

Mid-career staff

Junior staff, PhD students

20000Implementation of the agreed workplan activities (i.e. those mentioned in questions no. 1 and no. 2above) normally require resources beyond staff-time, such as the use of laboratory facilities,
purchasing of materials, travel, etc. Please estimate the costs of these other resources as apercentage of the total costs incurred (e.g. if you incurred costs of USD 100 and the value of your staff
time was USD 50 which makes the total of USD 150, please report 33.3% and 66.7%).
Percentage of costs
associated with staff time

Percentage of costs associated with Totalother resources

50.00

50.00

100.004. Networking
Describe any interactions or collaboration with other WHO Collaborating Centres in the context of theimplementation of the agreed activities If you are part of a network of WHO Collaborating Centres,
please also mention the name of the network and describe your involvement in that network[maximum 200 words].
The AMCRC performs surveys on the current coronavirus disease (COVID-19) status in Japan, particularly
with regard to AMR and antimicrobial usage associated with COVID-19, in collaboration with another WHO
CC (Disease Control and Prevention Center, the National Center for Global Health and Medicine [NCGM],JPN-94).
At the request of a WHO CC (Bureau of International Health Cooperation, NCGM, JPN-45), we participated in
the 4th WHO CC Conference in Japan in April 2022, which was attended by Dr. Takeshi KASAI, Regional
Director of the WPRO.

4/23/2023 2:40:19 AM

Page (5/5)