A Speech by Yasuhisa Shiozaki
Technical Workshop Hosted by CDC East Asia and Pacific Regional Office"Strengthening Technical Partnerships to Combat Antimicrobial Resistancein the East Asia and Pacific Region and Around the World"
August 28-29, 2024, Tokyo, Japan

Ladies and Gentlemen, Colleagues, and Esteemed Partners,
It is my great honor to address you today at the technical workshop on
antimicrobial resistance organized by CDC East Asia and Pacific Regional Office,a new vital hub for health security in our region.
First, let me extend my heartfelt gratitude to Dr. Michelle McConnell fororganizing this meaningful conference ahead of the UN General Assembly HighLevel Meeting on AMR. Timing, as they say, is of essence, and I am glad we aremaking the most of it to strengthen collaboration in the Asia-Pacific region atjust the right moment.
As we face this critical moment in global health, the COVID-19 pandemic hasunderscored the urgent need for international cooperation, with AMR being amajor challenge.
Over the past decade, I have been engaged in addressing AMR from a politicalperspective. As we approach the UN General Assembly AMR High-LevelMeeting, I would like to reflect on both past efforts and future directions fromthat perspective.
(AMR: A Persistent Challenge)
AMR has been a concern since Dr. Alexander Fleming's warning in 1945, but it
has only gained significant political attention in the past decade. The turning
point came around 2014-2015 when leaders like UK Prime Minister Cameron,1

US President Obama, and German Chancellor Merkel recognized AMR as a globalthreat.
Following the 2015 WHO resolution on the AMR Global Action Plan, Germany
immediately responded at the G7 Summit in Elmau a month later. This wasfollowed by the G7 Health Ministers' Meeting in Berlin in October 2015, where I
saw firsthand the gaps in our response as the Health Minister of Japan.
Imagine my surprise when I realized Japan was the only G7 country without a
National Action Plan !
In June 2016, Prime Minister Abe addressed AMR at the Ise-Shima Summit, andlater that year, I highlighted the issue at the G7 Health Ministers' Meeting inKobe. These efforts culminated in the first UN General Assembly High-Level
Meeting on AMR in the same month of September 2016.
(Lessons from COVID-19 in Combating AMR)
The COVID-19 pandemic has taught us vital lessons that we must apply to ourfight against AMR. Key among them is the need for standardized real-time data
sharing and robust surveillance systems to detect resistance patterns early andtake effective action.
The pandemic also underscored the importance of clear public messaging. We
now have the chance to launch awareness and antibiotic stewardship programs,
leveraging the communication strategies refined during COVID-19.
The global response to the pandemic showed the power of united action, and wemust now channel that same spirit into enhancing cooperation and funding for
AMR initiatives and research.
(Recognizing Pandemics and AMR as Security Threats)
The COVID-19 pandemic has shown us that health crises, including pandemics
and AMR, are not just public health issues—they are national and economic
security threats. We must all recognize that AMR also has the potential todisrupt economies, strain national resources, and challenge societal stability.

2In my 28-year career as a Member of Parliament, I have learned that "globalhealth" does not usually win votes, as politicians often focus on specific groupinterests and public opinion. However, between 2014 and 2017, when I served
as Minister of Health, there was an exception.
During the Ebola outbreak, with Prime Minister Abe’s support, we led Japan’s
investment in CEPI—a pandemic vaccine development engine—by framing healthcrises as national security issues. This approach, combined with dialogue
between health and financial authorities, made it easier to secure politicalcommitment.
Integrating AMR into national security frameworks and treating it with urgency
would secure greater political commitment and ensure a more effective crisis
response. Promoting collaboration between health and financial authorities islikely to ensure smoother budget allocation and more effective responses whencrises arise.
（Addressing Untapped Agendas）
While the global community has focused on pandemic preparedness, efforts todevelop new antibiotics have lagged. Despite some progress with "push andpull incentives" in G7 discussions, the commitment remains far insufficient. We
must overcome this serious “market failure”with the strongest political will.
Another overlooked issue is the balance between antibiotic use and regulation,much like the tension between economic growth and environment in climatechange debates.
This conflict exists both within and between nations, especially in the context ofAMR and the One Health approach. We must place greater emphasis on theimportance of "AMR in the environment." Like climate change, it is a sharedchallenge that requires innovative solutions and strong political leadership.
(Global Leadership and the UNGA High-Level Meeting on AMR)
A key milestone in our efforts is the AMR High-Level Meeting next month in New
York, where heads of state, government, and health ministers will address thiscritical issue. AMR has secured this opportunity twice—first in 2016 and now3again—but it may be another five years before we get a third chance.
make the most of this opportunity.

We mustThe Global Leaders Group (GLG) on AMR, of which I am a member, wasestablished in the fall of 2020 and is chaired by Mia Amor Mottley, the Prime
Minister of Barbados. The GLG is an independent, high-level global body,comprising around 20 prominent figures from various fields, including Dame Sally
Davies, a former Chief Medical Officer for England. The GLG has been providing
key recommendations, emphasizing the need for sustained political commitment,
increased funding for AMR initiatives, and stronger global coordination.
The significance of the High-Level Meeting lies in adopting a Political
Declaration, which, while not legally binding, carries the weight of global
consensus and drives action. This commitment can be pivotal in solving globalchallenges.
I believe there are two particularly important steps forward in the Political
Declaration so far.
First is the establishment of an independent panel for evidence for action
against AMR, as the lack of solid data on antibiotic resistance has hindered
progress. This panel, with a clear timeline, will lay the necessary groundwork
for AMR measures.
Second, the emphasis on“access”to antibiotics. While efforts have focusedfor some time on appropriate use, developing countries stress that“access”isequally critical. Ensuring “access” is as important as proper use, as more
people die from lack of access than from AMR itself.
（Building on Our Legacy in the Asia-Pacific）
As we look back, the lead-up to the High-Level Meeting has been exhilarating,but the real work begins after the "celebration." It is crucial to use the Political
Declaration to implement actions at national, regional, and global levels. To dothis, stakeholders must regularly come together, as we are today, to review
progress and challenges.

4Our commitment to combating AMR in the Asia-Pacific region is unwavering.
Japan brought AMR to the forefront of our regional health agenda, by hosting thefirst Ministerial conference on AMR in the Asia-Pacific in April of 2016, the yearof Ise-Shima G7 Summit. While the ministerial meetings paused due to COVID19, discussions have still continued at the working level. I hope that theministerial meetings would resume soon.
As we build on this legacy, we must strengthen regional collaboration byenhancing AMR coordination mechanisms—networks that unite governments,
health organizations, research institutions, the private sector, and civil society.
Sharing best practices and coordinating initiatives will create a unified regional
approach greater than the sum of its parts.
(The Role of the CDC in Supporting Regional and Global AMR Efforts)
The CDC has been, and will continue to be, an indispensable partner in ourshared regional AMR priorities. The CDC can offer technical assistance andcapacity-building support to strengthen regional surveillance, laboratory
capabilities, and health system responses. The CDC can also facilitate theestablishment or enhancement of platforms for sharing standardized AMR data
within the region and globally.
Additionally, the CDC can assist in developing harmonized AMR policies andtreatment guidelines, ensuring a consistent and effective approach to AMR. By
supporting regional public awareness campaigns, the CDC can help changebehaviors around antibiotic use, which is critical to reducing resistance.
(Conclusion)
In conclusion, combating AMR demands the same urgency we applied to COVID19. We must strengthen surveillance, promote responsible antibiotic use,
harmonize policies, and enhance regional collaboration. Recognizing AMR as anational and economic security threat for each country is key to mobilizing thenecessary resources and political will.

5With support from the CDC, global partners, and the Global Leaders Group onAMR, I am confident that we can turn AMR from a looming threat into a challenge
we can overcome with determination and unity.
Thank you.

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