December 19, 2022

Recommendations for the G7 Hiroshima Summit

The Political Leadership and International Collaboration
Needed to Advance Antimicrobial Resistance (AMR) Countermeasures
Background
Antimicrobial resistance (AMR) has been continuously recognized as a public health threat of greatest concern both in Japanand abroad and concentrated efforts from various related parties around the world have resulted in steady progress inmeasures to combat AMR. In recent years, the G7 has recognized that achieving comprehensive innovation in all areas ofdiagnosis, treatment, and prevention will be crucial for pandemic prevention, preparedness, and response (PPR). That
perspective is in line with that of the G7 Ise-Shima Summit held in 2016 (the last time Japan served as G7 President) as well as
those of Japan’s Basic Policies for Economic and Fiscal Management and Reform every year since 2016. Aiming to utilize thismomentum, Health and Global Policy Institute (HGPI) presents the following recommendations on promoting morecomprehensive and effective measures for AMR control in preparation for the upcoming G7 Hiroshima Summit in 2023. HGPI
has already generated various recommendations on AMR control, including those that focus on the utilization of pullincentives. To view our recommendations regarding this issue, please visit our website (https://hgpi.org/).
Recommendation 1: Continue providing the political leadership needed to combat AMR.
Every year since the 2016 G7 summit, the importance of taking action to combat AMR has been mentioned in statementsfrom the Health Ministers’ Meetings; the Finance Ministers and Central Bank Governors Meetings; the Agriculture Ministers’Meetings; the Climate, Energy and Environment Ministers’ Meetings; and even at Leaders’ Summits. In February 2022, British
medical journal The Lancet reported that in 2019, an estimated 1.27 million deaths worldwide were directly caused by AMR.
This was higher than the number of deaths from HIV/AIDS and malaria. The annual number of global deaths due to AMR
infections is projected to increase to about 10 million people by 2050, mostly in Asia and Africa. AMR is also a growing
problem for the three major infectious diseases (HIV/AIDS, tuberculosis, and malaria). If appropriate measures to combat
AMR had been in place among G7 members in 2019, a total of 500,000 lives may have been saved. G7 members should
stand at the forefront of the international community and continue providing political leadership to advance AMR
countermeasures.
Recommendation 2: Establish opportunities to examine AMR countermeasures at discussions that span multiple fields likethe Joint Conference of Foreign Ministers and Health Ministers.
Beyond the G7 members, the international community has come to recognize the need to address emerging and reemerging
infectious diseases including efforts to combat AMR. The Sustainable Development Goals (SDGs), which were adopted in2015 at the United Nations Sustainable Development Summit (UN Summit), provide a representative example of such efforts.
SDG Target 3.3 reads, “End the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis,
water-borne diseases and other communicable diseases by 2030.” The SDGs have also adopted “Percentage of bloodstream
infections due to selected antimicrobial-resistant organisms” as an indicator. In Japan, AMR was discussed as an independent
item during the 2022 revision of the “Global Health Strategy,” which emphasized the need for AMR countermeasures.
International society has come together to meet the SDGs by 2030 and AMR countermeasures must be positioned as a global
priority topic alongside climate change and similar issues that require international collaboration and a One Health approach.
Joint conferences such as those with Foreign Ministers and Health Ministers or Health Ministers and Finance Ministers shouldbe held and AMR measures should be discussed.

Health and Global Policy Institute AMR Project Team
Otemachi Financial City Grand Cube 3F 1-9-2, Otemachi Chiyoda-ku, Tokyo 100-0004 JAPAN
Tel: +81-3-4243-7156 Fax: +81-3-4243-7378 E-mail: info@hgpi.org

December 19, 2022

The international collaboration needed for AMR control and its significanceAs we enter the post-COVID-19 era, we must not overlook the role of antimicrobials as global public goods if we wish tocontinue enjoying peace, stability, and prosperity. For example, Ukraine is currently faced with the issue of AMR in the form ofan epidemic of multi-drug resistant tuberculosis (MDR-TB). As discussions on international agreements regarding infectious
diseases like the International Health Regulation (IHR) and the Pandemic Treaty continue to advance, it will be important topromote AMR countermeasures based on the concept of One Health, in which the health of humans, animals, and theenvironment are viewed as one. To this end, opportunities for discussions that cut across fields and advocate for thatapproach should be established at G7 Summits and other high-level meetings. As the next G7 President in 2023, it will becrucial for Japan to fulfill its commitments to the international community based on the fact that infectious disease control
cannot be fully implemented by countries acting alone and that each country’s interests are adjacent to those of the entire
world.
About Health and Global Policy InstituteHealth and Global Policy Institute (HGPI) is a non-profit, independent, non-partisan health policy think tank established in2004. In its capacity as a neutral think-tank, HGPI involves stakeholders from wide-ranging fields of expertise to provide policy
options to the public to successfully create citizen-focused healthcare policies. Looking to the future, HGPI produces novel
ideas and values from a standpoint that offers a wide perspective. It aims to realize a healthy and fair society while holding
fast to its independence to avoid being bound to the specific interests of political parties and other organizations. HGPI
intends for its policy options to be effective not only in Japan, but also in the wider world, and in this vein the institute willcontinue to be very active in creating policies for resolving global health challenges. HGPI’s activities have received global
recognition. It was ranked second in the “Domestic Health Policy Think Tanks” category and third in the “Global Health Policy
Think Tanks” category in the Global Go To Think Tank Index Report presented by the University of Pennsylvania (as of January
2021, the most recent report).

Health and Global Policy Institute AMR Project TeamOtemachi Financial City Grand Cube 3F 1-9-2, Otemachi Chiyoda-ku, Tokyo 100-0004 JAPAN
Tel: +81-3-4243-7156 Fax: +81-3-4243-7378 E-mail: info@hgpi.org