PROVISIONAL
TRANSLATION

Basic Strategy for International Cooperationfor Strengthening Measures on Emerging
Infectious Diseases

April 7, 2023
International Cooperation for Strengthening Measures on Emerging
Infectious Diseases
Cabinet Meeting

CONTENTS
I. Introduction ............................................................................................................................................ 2
II. Basic Concept ........................................................................................................................................ 3
1.

Background and Purpose of Formulating the Basic Strategy ........................................................ 3

2.

Issues and Basic Directions for Japan ............................................................................................ 4

III. Positioning of the Basic Strategy .......................................................................................................... 8
IV. Measures by Measure Group ............................................................................................................... 9
1.

Strengthening of PPR through the development of Global Health Architecture, and contributing

to the promotion of UHC, etc. ............................................................................................................... 92.

Development of human resources to deal with infectious diseases, international contribution

through human support, etc. .............................................................................................................. 18
3.

Promotion of testing, information collection and analysis, research, and other activities related

to infectious diseases........................................................................................................................... 23
4.

Promotion of the One Health approach ..................................................................................... 27

5.

Promotion of measures to control AMR ..................................................................................... 30

1

I. Introduction
Based on various lessons learned from the outbreaks of Middle East Respiratory
Syndrome (MERS) in the Arabian Peninsula and other regions since 2012, Ebola
hemorrhagic fever, which spread in West Africa in 2014, and other cases, as well as trends
in the international community, the "Ministerial Meeting on Measures on Emerging
Infectious Diseases" (hereinafter referred to as the "Ministerial Meeting") in September
2015 has approved the "Basic Guidelines for Strengthening Measures on Emerging
Infectious Diseases" (hereinafter referred to as the "Basic Guidelines"). In February 2016,
the Ministerial Meeting compiled the "Action Plan for Strengthening Measures on
Emerging Infectious Diseases" (hereinafter referred to as the "Basic Plan") to promotemeasures against emerging infectious diseases.
Moreover, regarding the worldwide spread of Antimicrobial Resistant (AMR) 1 bacteria,
the Global Action Plan was adopted by the World Health Assembly in May 2015. Amid
calls for further strengthening of antimicrobial resistance (AMR) countermeasures, theMinisterial Meeting has compiled the National Action Plan on Antimicrobial Resistance(AMR) (2016-2020) (hereinafter referred to as the "Action Plan") in April 2016 andpromoted these efforts.
The Basic Plan and Action Plan were originally scheduled to cover the period through2020, but due to the spread of the COVID-19 in the same year, the period was extended
to 2022. Recently, efforts to coexist with COVID-19 have been progressing in many
countries around the world, including Japan. Considering the Japanese G7 Presidency in2023, the Basic Guidelines and the Basic Plan will be unified and revised to compile the
Basic Strategy.

1

AMR: Antimicrobial resistance2II. Basic Concept
1. Background and Purpose of Formulating the Basic Strategy
The risk of acquiring infectious diseases through animals has increased due to forest
development and climate change on a global scale. In addition, due to the progress ofglobalization, various emerging and re-emerging infectious diseases, including zoonotic
diseases, are spreading across national borders to the international community.
In accordance with the WHO International Health Regulations (IHR) 2, the DirectorGeneral of WHO may declare a Public Health Emergency of International Concern(PHEIC) 3 in situations when the international spread of a disease is recognized as
posing a public health risk to other countries or when urgent international coordinationof measures is required. In the past, PHEIC has been declared for the international
outbreak of H1N1 influenza in April 2009, the outbreak of Ebola hemorrhagic fever inWest Africa in August 2014, and the recent international outbreak of COVID-19 infectionin January 2020.
With regard to countermeasures against infectious diseases, each country's active
contribution and role as a member of the international community will not only benefit
the international community in confronting the spread of infectious diseases acrossborders but will also give it an advantage in its own fight against infectious diseases.
The Basic Strategy includes measures for Japan to cooperate with developed
countries and contribute to the international community through international
cooperation with developing countries. If taken in coordination with domestic
countermeasures and implemented in an integrated manner by the relevant ministries
and agencies, these measures will help to strengthen Japan's response to infectious
diseases.
In addition, this Basic Strategy will be mutually coordinated and promoted in an
integrated manner with the "Global Health Strategy 4 " which summarizes related
measures based on the perspective that contributions to global health are importantfrom the perspectives of human health, diplomacy, economy, and security; the "Strategy
for Strengthening the Vaccine Development and Production System 5", a national strategy
for long-term, continuous efforts to create the strength to develop and produce vaccines
in Japan; the "National Action Plan for Pandemic Influenza and New Infectious Diseases6"
IHR: International Health Regulations
PHEIC: Public Health Emergency of International Concern
4 Global Health Strategy (approved by the Headquarters for Healthcare Policy on May 24, 2022):
https://www.kantei.go.jp/jp/singi/kenkouiryou/senryaku/r040524global_health.pdf
5 Strategy for Strengthening the Vaccine Development and Production System (Cabinet approval on
June 1, 2021)
6National Action Plan for Pandemic Influenza and New Infectious Diseases, etc. (Cabinet approval on
June 7, 2013)2
3

3

which establishes infection control measures and other measures to be implemented by
the government in preparation for outbreaks of new strains of influenza; the "Basic
Principles of the Asia Health and Wellbeing Initiative" and the "Basic Principles of theAfrica Health and Wellbeing Initiative" with a view to contributing to the achievement of
UHC in Asia and Africa; and other related governmental policies. This will allow topromote comprehensive measures against infectious diseases in Japan.
2. Issues and Basic Directions for Japan(1) Strengthening of PPR7 through the development of Global Health Architecture 8, andcontribution to the promotion of UHC 9
The history of international outbreaks of infectious diseases has led to therecognition of the importance of international cooperation for developing Global
Health Governance 10, not only from the perspective of humanitarian assistance, butalso from the perspective of preventing the spread of infectious diseases fromepidemic countries to their own countries and addressing threats to the security of theinternational community. Such cooperation includes rapid local response by theinternational community for the containment of infectious diseases from earlyoutbreaks and collaboration among countries, international organizations and NGOs
that implement measures at the local level.
It is also important to strengthen capacities for prevention, preparedness, andresponse (PPR) in peacetime as well as to achieve more resilient, equitable, andsustainable UHC in response to public health emergencies. UHC, in particular,
contributes to the concept of "Human Security"11 of which Japan has been a strong
proponent.
To realize these goals, it is essential to develop a Global Health Architecture,including the establishment of sustainable health systems through financial
contributions to relevant international organizations and public-private partnerships,
and strengthening of collaboration among financial and health authorities in eachcountry. Based on the Global Health Strategy, it is important for Japan to make its
7 Global Health Architecture: the status of mechanisms, organizations and other actors addressing

global health and medical issues.
PPR: Prevention, Preparedness, Response
9 UHC (Universal Health Coverage): Universal Health Coverage means that everyone receives highquality health services, when and where needed, without financial hardship.
10 Global Health Governance: organic cooperation among organizations necessary to respond to future
health crises.
11 Human Security: a concept that focuses on individual human beings and encourages sustainable
individual self-reliance and social development through protection and empowerment in order toprotect people from a wide range of serious threats to their survival, livelihood, and dignity, and torealize their rich potential.
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contribution in mutual cooperation with various stakeholders, including national
governments, international organizations, private companies, and civil society.
The number of tuberculosis patients in Japan has been decreasing, and theprevalence rate per 100,000 people (hereinafter referred to as "prevalence rate") was
9.2 in 2021, making Japan a low prevalence country with a prevalence rate of less than
10 as defined by the World Health Organization. Nevertheless, the number oftuberculosis patients in 2021 was 11,519, and tuberculosis remains the largest chronic
infectious disease in Japan. In Africa and Asia, the increase in multidrug-resistanttuberculosis caused by inadequate tuberculosis treatment is still one of the mostimportant challenges in tuberculosis control policy.
In response to the COVID-19, Japan has made efforts through internationalorganizations such as the WHO, the World Bank and the Asian Development Bank, andhas contributed to the establishment of the ACT Accelerator (hereinafter referred to as"ACT-A" 12 ) and the COVAX Facility (hereinafter referred to as "COVAX" 13 ), financial
support, and mobilization of funds. In addition, Japan has been promoting vaccine
donation and has provided "Last One Mile Support" for and cold chain systemdevelopment, and support to meet the needs of developing countries for economic
and social revitalization and resumption of cross-border travel after the acute phase of
a COVID-19 pandemic has passed. Such international cooperation must be continued.
Furthermore, while giving consideration to cross-sectoral approaches in related
fields such as education, water and sanitation, and trade, Japan, as a responsible
member of the international community, will make a positive contribution throughthese efforts to measures against infectious diseases that pose an international threat,
aiming to play a global leading role in this subject.
(2) Human resource development and personnel support for infectious disease control,
including international cooperation
It is extremely important to develop and secure human resources who havespecialized knowledge about infectious disease control, who can collect informationand study countermeasures, and who can play an active role in infectious diseaseresearch and control.
In response to the spread of infectious diseases overseas in the past, Japan has been
making efforts to develop human resources and international partnership bydispatching medical and other personnel in addition to financial cooperation. In view
12 A global collaboration to accelerate development, production, and equitable access to COVID-19 tools

such as vaccines, therapeutics, and diagnostics

13 A global framework supporting equitable worldwide access to COVID-19 vaccines.

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of the importance of such measures, it is necessary to further strengthen humanresource development and secure human resources capable of taking responsibility of
infectious disease control both in Japan and in international cooperation in the medium
to long term.
(3) Testing, information collection and analysis, and research systems for infectious
diseases
The spread of Ebola hemorrhagic fever since 2014 has led to the development of
testing and research systems for Ebola and other high-risk pathogens (type one
pathogen) in developed countries. In Japan it is also necessary to strengthen the testing,information collection and analysis, and research systems for pathogens and othersubstances related to infectious diseases that cause severe symptoms, such as Ebola
hemorrhagic fever.
Specifically, in preparation for outbreaks of Ebola hemorrhagic fever and other typeone infectious diseases, the testing system must be strengthened, including theestablishment of a public sector system and building a cooperative system with testing
institutions, so that necessary testing can be performed smoothly from the initial stage.
In addition, it is necessary to centralize information to strengthen the collection andanalysis of information on infectious diseases overseas at the National Institute of
Infectious Diseases.
Furthermore, given the fact that Japan has fallen behind other countries in thedevelopment of vaccines and therapeutics for the COVID-19, it is necessary to steadily
promote research on infectious diseases through the development of research systems
and human resources in ordinary times, including the establishment of the BSL4
facility 14 at Nagasaki University.
(4) Promotion of the One Health approach
The concept of "One Health" has been proposed as a way of thinking that in orderto protect human health, it is necessary to not only focus on human diseases, but also
to make cross-disciplinary efforts involving humans, animals, and the environment.
At past G7 summits, it has been confirmed that each country will strengthen its One
Health approach 15 and engage in research and development of new drugs, including
anti-microbial agents.

BSL4 facility: Bio Safety Lebel 4 facility. An advanced containment facility for the most hazardous
pathogens among facilities that handle viruses and other pathogens.
15 An approach stating that cross-disciplinary issues related to human and animal health and theenvironment should be addressed through collaboration among all concerned parties.
14

6

Japan has also been cooperating with concerned organizations and collecting
information on zoonotic diseases both domestically and internationally. However, therecent experience with the COVID-19 has reaffirmed the importance of measuresagainst zoonotic diseases. It is necessary to further strengthen these measures,
including building capacity for international measures, while working in unison withthe related ministries and agencies on One Health.
(5) Promotion of measures to control AMR
Antimicrobial resistance (AMR) has been acknowledged as a serious global healththreat and recognized as one of the priorities to be addressed in the health sector of
the Group of Seven (G7). WHO has placed AMR measures on its key policy agenda.
The Government of Japan formulated the National Action Plan on AMR in 2016 topromote and strengthen domestic measures and international cooperation on AMR,
the government has been making concerted efforts to promote AMR measures. Japanneeds to exert leadership in measures against antimicrobial resistance (AMR) not only
domestically but also globally.

7III. Positioning of the Basic Strategy
It is important that the government and related private organizations and enterprises,
including health and medical institutions, take comprehensive measures against
infectious diseases, based on the basic concept and direction presented in Section II.
From this perspective, the Basic Strategy presents specific measures in Section IV for eachof the five measure groups that Japan should mainly address over the next five years (seetable below).
Since countermeasures against infectious diseases must be taken continuously, always
taking into account the latest situation domestically and overseas, the progress of themeasures will be monitored on a regular basis, and the progress of measures listed in IV
will be followed up every fiscal year. If necessary, this Strategy will be revised in light ofinternational trends, such as discussions at the G7 Summit to be held in 2023, etc.
<Outline of measures for each of the five measure groups>
Measure Group1.

Strengthening

Measuresof PPR (1) Contribution to the development of Global Healththrough the development
ofGlobalHealth (2) Promotion of UHC initiatives

Architecture
contributing

Architectureand (3) Assistances through international organizations andtothepromotion of UHC, etc.

public-private partnerships(4) Promotion and utilization of bilateral cooperation(1) Training and career path support for human resources

2. Development of humanresources to deal with
infectious

diseases,international contribution
through human support,
etc.

dealing with infectious diseases.
(2) Promotion of efforts of the Japan Disaster Relief
Infectious Diseases Response Team.
(3) Cooperation with WHO and other internationalorganizations.
(4) Establishment of a system to improve the SDF's ability torespond to infectious diseases.
(5) Ensuring the safety of Japanese nationals abroad.

3. Promotion of testing,information collection and (1) Strengthening the testing system for infectious diseases.
analysis,

research,and (2) Strengthening information collection, analysis, andother activities related toresearch systems related to infectious diseases.

infectious diseases.
4. Promotion of the One
Health approach(1) Measures to prevent the introduction of infectious
diseases through imported animals.
8(2) Early response to infectious diseases that may bebrought to Japan by migratory birds crossing the border,etc.
(3) Promotion of research on the One Health approach.
(4) Efforts to build a cooperative framework for the One
Health approach.
5. Promotion of measures tocontrol AMR.

Promotion of measures to control AMR.

IV. Measures by Measure Group
1. Strengthening of PPR through the development of Global Health Architecture andcontributing to the promotion of UHC, etc.
(1) Contribution to the establishment of Global Health Architecture① Participation in international discussions to strengthen PPR○ Taking into account the benefits and lessons learned from international collaborative
frameworks related to COVID-19 such as ACT-A (including COVAX), and bearing in
mind the WHO framework, the US-led COVID-19 global action plan, and discussions
at G7 and G20, etc., the government will respond appropriately to the movement tostrengthen Global Health Architecture, including new financial mechanisms(Pandemic Fund) 16 and related new platforms including finance and healthcollaboration. [Cabinet Secretariat, Ministry of Foreign Affairs, Ministry of Finance,
Ministry of Health, Labour and Welfare]② Contribution to the setting of international standards on pandemics○ The current IHR (2005) raises such issues as early warning and action, rapid
notification and information sharing, implementation and compliance, rapid
evaluation, and response, and PHEIC's decision-making process. To resolve theseissues, Japan will actively participate in the discussions to ensure that the Working
Group of Member States for targeted amendments to the IHR, whose establishment
was approved at the 75th Session of the World Health Assembly in 2022, will adopt
the revision proposal at its 77th Session in May 2024.
WHO has established an intergovernmental negotiating body to draft andnegotiate a WHO convention, agreement or other international instrument on
pandemic prevention, preparedness and response (WHO CA+) in 2022, and iscurrently preparing a new legal instrument. Negotiations have begun among
16

At the time of establishment, the name was “Financial Intermediary Fund for Pandemic Prevention
Preparedness-and Response (PPR FIF)”.

9

member states on the elements to be included in the instrument which will be
submitted at the 77th Session of the World Health Assembly in May 2024, and Japan
will contribute as a vice-chair. At the same time, Japan will be actively involved in theStanding Committee on Pandemic and Emergency Preparedness and Response,
which was newly established by the Executive Board in 2022.
The government will strengthen the global infectious disease control and support
WHO reform through targeted amendments and enhanced implementation of the
IHR, development of WHO CA+, and improvement of WHO's health crisis programs.
[Ministry of Foreign Affairs, Ministry of Health, Labour and Welfare]○ To respond promptly to infectious disease crises and to strengthen intelligence on
infectious diseases, training on the collection and analysis of infectious disease
intelligence overseas will be carried out starting in ordinary times at the National
Center for Global Health and Medicine in cooperation with the National Institute of
Infectious Diseases. The government will also secure specialized information
gathering capabilities overseas and consider and reach conclusions regarding thenature of overseas intelligence gathering and infectious disease research centers andimplement these conclusions sequentially. In addition, research will be conductedon strengthening the integrated system of infectious disease intelligence functionsin Japan and overseas. [Ministry of Education, Culture, Sports, Science andTechnology, Ministry of Health, Labour and Welfare](2) Promotion of UHC initiatives○ The idea of UHC is to ensure that all people have access to effective, high-quality
medical services at an affordable cost, including measures against infectious diseases.
UHC also contributes to the concept of human security, which focuses on eachindividual human being and protects people from a wide range of serious threats.
Japan will continue to lead international discussions toward achievement of UHC
around the world, including Asia, and form an organic international network by
utilizing the efforts of WHO. This will lead to the development of international healthpersonnel who can respond to local needs and the accelerated development of
medical technologies and drugs, etc. [Ministry of Foreign Affairs, Ministry of Health,Labour and Welfare]○Through international conferences on UHC, forums such as G7 and G20,
international organizations such as WHO, World Bank, Asian Development Bank,

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Global Fund 17, Gavi Vaccine Alliance 18, Global Health Innovative Technology Fund
(GHIT) 19 , and UHC2030 20 , as well as bilateral assistances, and their organic
collaboration, the government will promote effective and reliable implementationof efforts to achieve more resilient, equitable, and sustainable UHC at national,
regional, and global levels. In doing so, the government will respond appropriately
to trends in discussions in international fora. [Cabinet Secretariat, Ministry of Foreign
Affairs, Ministry of Finance, Ministry of Health, Labour and Welfare]○ The government will merge the National Institute of Infectious Diseases and the
National Center for Global Health and Medicine to create the institute for healthsecurity and establish a broad collaborative relationship with internationalorganizations and national public health authorities such as WHO and national CDCs
to realize UHC. This network will be used as a foundation to dispatch doctors andother medical personnel to partner countries, support the improvement of publichealth response capabilities, and develop local human resources. [Ministry of Health,Labour and Welfare](3) Initiatives through international organizations and public-private partnerships① Strengthening cooperation with international organizations and public-private
partnerships through appropriate contributions○ The government will strengthen cooperation through appropriate contributions tointernational organizations and public-private partnership funds such as WHO
Voluntary Contributions, World Bank, Global Fund, Gavi Vaccine Alliance, Coalition
for Epidemic Preparedness Innovations (CEPI) 21 , Global Drug Facility (StopTuberculosis Partnership) 22 , Global Antibiotic Research and Development
Global Fund: Established in 2002 in partnership with governments and the private sector to provide
financial support to fight AIDS, Tuberculosis and Malaria after the G8 Kyushu-Okinawa Summit in
2000.
18 Gavi, the Vaccine Alliance (Gavi): A public-private partnership intended to improve vaccine coverage indeveloping countries. In addition to donors (donor countries), governments of developing countries, andrelevant international organizations, the pharmaceutical industry, private foundations, and civilsociety are also participating in the alliance.
19 Global Health Innovative Technology Fund (GHIT Fund). A Japan-based global public-private
partnership involving Japanese pharmaceutical companies, universities and research institutes in
product development and collaboration with global partners for the promotion of development in thefields of pharmaceuticals, vaccines and diagnostics for Malaria, Tuberculosis and lesser-known tropicaldiseases
20 UHC2030: a multi-stakeholder platform involving nations, regions, international organizations, thepublic, charitable organizations, the private sector and other stakeholders. Its secretariat is co-hosted
by the World Bank, WHO and OECD..
21 An international fund that provides funding to pharmaceutical companies and research institutions
that develop vaccines.
22 Global Drug Facility (GDF): The Global Anti-Tuberculosis Drug Facility is a project managed by the
Stop Tuberculosis Partnership, a public-private partnership established in 2000 to fight tuberculosis
17

11Partnership (GARDP) 23 contributions, GHIT, UHC2030, Unitaid 24, UNFPA 25, IPPF 26,
etc., and promote efforts to strengthen Global Health Architecture and achieve more
resilient, equitable, and sustainable UHC. [Cabinet Secretariat, Ministry of Foreign
Affairs, Ministry of Finance, Ministry of Health, Labour and Welfare]○ In collaboration with relevant ministries and agencies, and in relationship with othercrisis funds (e.g., UN CERF 27), the government will actively participate in discussions
among member states on how the funds should be managed, including the roles andstrategies of the WHO "Emergency Response Fund" (CFE) 28, the World Bank "MultiDonor Trust Fund for Health Emergency Preparedness and Response" (HEPRTF) 29,
and the "Pandemic Fund" managed by the World Bank, taking a leading position, inparticular as the largest donor to HEPRTF. [Cabinet Secretariat, Ministry of Foreign
Affairs, Ministry of Finance, Ministry of Health, Labour and Welfare]○ The International Monetary Fund (IMF) immediately provides grant aid to eligible
countries through the "Catastrophe Containment and Relief Trust" (CCRT) 30 to cover
the debts of member countries to the IMF that are due within two years of a major
public health crisis. Japan will continue to participate in discussions at the IMF
Executive Board and other meetings to prepare for future public health crises using
this fund. [Ministry of Finance]② Efforts through research support organizations including GHIT against NTDs,
tuberculosis, malaria, and others.
○ Regarding the GHIT Fund, Japan will continue to promote support R&D andcontribute to supply preparation and supply of drugs and other products utilizing
Japanese technology through public-private partnerships by using the excellent R&D
capabilities of Japan's pharmaceutical industry to promote and expand the R&D ofworldwide. The project contributes to the global fight against tuberculosis by providing high-quality
drugs for multidrug-resistant tuberculosis.
23 Global Antibiotic Research and Development Partnership (GARDP): a public-private partnershipestablished to develop new drugs for drug-resistant bacterial infections.
24 Unitaid: An organization (WHO affiliated organization) established in 2006 under a French initiative
to achieve equitable access to medicines through innovative financing (e.g., solidarity tax on airplanetickets). Provides support for the rapid supply of high-quality medicines and other medical products todeveloping countries at low cost by subsidizing the activities of research institutes and internationalorganizations related to innovations in research, development, and improved access to medicines for
AIDS, tuberculosis, malaria, and other diseases.
25 UNFPA: United Nations Population Fund
26 IPPF: International Planned Parenthood Federation
27 Central Emergency Response Fund
28 Contingency Fund for Emergency
29 Health Emergency Pandemic Response Multi Donor Trust Fund
30 The Catastrophe Containment and Relief Trust

12drugs for neglected tropical diseases (NTDs), tuberculosis, malaria, and other urgent
issues. [Ministry of Foreign Affairs, Ministry of Health, Labour and Welfare]③ Addressing NTDs, tuberculosis, malaria, and other infectious diseases individually○ The government will accelerate the eradication of tropical diseases, implement
information sharing and exchange platforms, expand treatment, and build capacity
to provide quality health services in the African region through contributions toWHO's ESPEN (Expanded Special Project for the Eradication of Neglected Tropical
Diseases). [Ministry of Health, Labour and Welfare]○ The Global Fund was established in 2002 as a financial support organization to fightthe three major infectious diseases (AIDS, tuberculosis, and malaria), which was
proposed by Japan at the 2000 Kyushu-Okinawa Summit. Its 7th replenishment forthe period from 2023 to 2025has a goal to save 20 million people in developing
countries from the three major infectious diseases during the period from 2024 to
2026, and to reduce the mortality rate from the three major infectious diseases tothe same year by 64% comparing to the 2020 level. Japan will continue to promotesupport during these periods, and with a view to achieving UHC, we will promote
prevention, treatment, and care of the three major infectious diseases and healthsystems strengthening in developing countries in a timely manner. [Ministry ofForeign Affairs, Ministry of Health, Labour and Welfare]○ In particular, for tuberculosis, the government will promote collaboration withexisting programs in public-private partnerships such as the Global Fund, Unitaid,
and the Stop Tuberculosis Partnership. [Ministry of Foreign Affairs, Ministry of Health,Labour and Welfare]○ The government will promote international joint research for the prevention,
diagnosis, development of drugs and treatments for NTDs, tuberculosis, malaria, andH. pylori infection based on local needs under the "International Joint Research andDevelopment Promotion Project for Science and Technology in Medical Fields"(Science and Technology Research Partnership for Sustainable Development(SATREPS) 31 program and International Joint Research Program to Fight Neglected
Tropical Diseases (NTDs) in Africa) managed by the Japan Agency for Medical

31(SATREPS: Science and Technology Research Partnership for Sustainable Development) is
implemented in cooperation with the Japan International Cooperation Agency (JICA).

13

Research and Development (AMED) 32 . [Ministry of Foreign Affairs, Ministry of
Education, Culture, Sports, Science and Technology]④ Contributions to international efforts○ The government will participate in discussions within the international framework toensure equitable access to medical countermeasures, based on the knowledge,
issues, and lessons learned from the comprehensive financing and supply
coordination mechanism for equitable access to vaccines during the pandemic of
COVID-19. [Ministry of Foreign Affairs, Ministry of Health, Labour and Welfare]○ The Gavi Vaccine Alliance, a public-private partnership established to protect
children's lives and health by increasing immunization coverage in low‐income
countries, has four goals: to expand the number of supported diseases from 13 to
18 by 2025, to strengthen health systems to increase equity in immunisation to
improve sustainability of immunization programs, and to ensure healthy markets for
vaccines and related products. The government will promote support for achieving
these goals and assist in the implementation of comprehensive efforts to provide
cost-effective immunizations at affordable prices.
In addition, since the impact of the COVID-19 highlighted the importance ofensuring equitable access to vaccines whose safety, efficacy, and quality are
guaranteed regardless of a nation's economic strength, the government willcontinue to support vaccine supply and other efforts to ensure equitable access tovaccines. [Ministry of Foreign Affairs, Ministry of Health, Labour and Welfare]○ In collaboration with relevant ministries and agencies, the government will consider
engagement in the Medicines Patent Pool (MPP)33 established by Unitaid and active
contribution to the framework to enable the supply of affordable medicines todeveloping countries. At the same time, the government will pursue theparticipation of Japanese companies in international markets through Unitaid and
MPP. [Ministry of Foreign Affairs, Ministry of Health, Labour and Welfare]○ To create a system in which companies that develop vaccines can expect to recover
their investment, the government will, for example, consider ways to facilitate thedomestic supply of vaccines, such as the purchase of vaccines by the government for
32
33

Japan Agency for Medical Research and Development (AMED)MPP (Medicines Patent Pool): Mechanism to promote access to medicines and other products byencouraging voluntary licensing of patents for medicines and other products.

14

immunization in the event of outbreaks of new infectious diseases, and will takenecessary measures such as supporting the acquisition of WHO prequalification for
vaccines that have been successfully developed. In addition, the government willconsider global supply through international frameworks such as the Gavi Vaccine
Alliance, and the use of ODA in response to the assistance needs of developing
countries. [Ministry of Foreign Affairs, Ministry of Health, Labour and Welfare]○ Contribute to One Health 34 initiatives in line with the framework of relevantinternational organizations such as WHO, WOAH35, FAO 36, etc. [Ministry of Health,Labour and Welfare, Ministry of Agriculture, Forestry and Fisheries](4) Promotion and utilization of bilateral cooperation① Efforts to Strengthen Health Systems Using Bilateral ODA○ The challenges faced by developing countries are diverse, and the economic situationof each country and the condition of the health system that is a prerequisite for thecooperation are also diverse. Since it is also important to support the self-help effortsof partner countries and provide cooperation for their self-sustaining development,
the government will organically combine technical cooperation, loan assistance andgrant assistance according to the situation in partner countries. The government will
operate in a prompt and flexible manner, paying attention to the possibility ofcollaboration with other donors (including international organizations engaged indisease-specific initiatives) and the private sector. [Ministry of Foreign Affairs,
Ministry of Finance]○ The government will develop expert human resources and deploy them overseas
through "Infectious Disease Emergency Specialist (IDES 37 ) Training Program" in
addition to direct support by deploying subject-matter experts through GOARN 38
and also, actively share Japan's knowledge in this area. [Ministry of Health, Labourand Welfare]
One Health: A concept that promotes the integration of the fields of human and animal health and theenvironment under a single policy.
35 World Organization for Animal Health: An intergovernmental organization with headquarters inFrance whose goal is to improve animal health around the world.
36 Food and Agriculture Organization of the United Nations: An international organization with
headquarters in Italy whose goals are the development of the world economy and freeing humanityfrom hunger.
37 IDES: Infectious Disease Emergency Specialist
38Global Outbreak Alert and Response Network (GOARN): An international framework for infectious
disease control led by WHO. The purpose of the network is to collect information on infected persons,disseminate important information, and provide technical support for early response in outbreakcountries. The National Institute of Infectious Diseases participates in this network in Japan.
34

15

○ Based on the results of long-standing cooperation in the health sector between the
Government of Japan and the World Bank, the government will promote support for
activities by the World Bank that contribute to strengthening PPR and UHC throughthe World Bank's Japan Trust Fund and other means. [Ministry of Finance]○ The government will provide Emergency Grant Aid and Emergency Relief Goods,
contribute funds and supplies to international organizations, dispatch experts andother human resources support in response to the need for assistance in the eventof an outbreak of infectious diseases. The government will strive to prevent further
outbreaks and spreads of infectious diseases by restoring the dysfunctional healthsystems and improving their resilience through emergency response support, humanresource development, provision of medical supplies, and establishment of healthinformation systems in the affected countries. [Ministry of Foreign Affairs, Ministryof Health, Labour and Welfare]② Promotion of bilateral relations through public-private partnership, etc.
○ Regarding countermeasures against infectious diseases in developing countries, thegovernment will collect information on the health needs surrounding infectious
diseases in developing countries from the viewpoint of further promotinginternational contributions and contributing to the development of new markets for
the Japanese medical industry, etc. Relevant government agencies, organizations,and groups, etc. will study and coordinate the provision of therapeutic drugs,
diagnostic drugs, vaccines, protective clothing, and other materials and equipment
to developing countries, the nature of the delivery system including technicalsupport for the equipment and materials, and how the relevant local organizations
should work together to provide such support, in order to ensure its smooth
implementation by relevant organizations. [Cabinet Secretariat, Ministry of Foreign
Affairs, Ministry of Health, Labour and Welfare]○ For medicines that must be developed urgently during infectious disease crises indeveloping countries, the public and private sectors will work together to promptly
consider measures to support clinical research and supply systems and implementthem.
To this end, the government will collect information related to infectious diseases
overseas in ordinary times and provide necessary support for the development ofdrugs for anticipated infectious diseases. [Cabinet Secretariat, Ministry of Foreign16

Affairs, Ministry of Health, Labour and Welfare]○ Japan's products and technologies for prevention, diagnosis, and treatment ofvarious infectious diseases will be packaged and deployed internationally as
products originated from Japan, with the public and private sectors working together
to study and coordinate this process. [Cabinet Secretariat, Ministry of Foreign Affairs,
Ministry of Health, Labour and Welfare]○ The government will promote the activation of support for initiatives by internationalorganizations related to infectious diseases such as crowdfunding which is widely
provided by domestic NGOs and other organizations together to citizens andcompanies and vaccine bonds issued by companies. [Cabinet Secretariat, Ministry ofForeign Affairs, Ministry of Health, Labour and Welfare]③ Promotion of technical support○ The government will cooperate with international organizations that promoteresearch and development of therapeutic drugs for chagas, malaria, and otherinfectious diseases. Support research and development of compounds effective
against infectious diseases that are in high demand internationally.
In addition, regarding countermeasures against antimicrobial resistance (AMR), thegovernment will work together with international organizations that promoteresearch and development of therapeutic drugs, support joint development ofcompounds obtained through the Booster Program, promote the expansion of
antibiotic resistant bacteria surveillance using ASIARS-Net 39 developed in Japan andtechnical support for One Health surveillance in Asia.
Furthermore, the government will promote education and research projects in
infectious disease laboratory centers as support for developing countries. [Cabinet
Office (Health), Ministry of Foreign Affairs, Ministry of Health, Labour and Welfare]○ The government will develop and revise guidelines for regulatory harmonization ofdrugs at the International Council for Harmonization of Technical Requirements for
Pharmaceuticals (ICH) involving regulatory authorities in Japan, the U.S., and Europe
based on the Global Health Strategy and in accordance with the technologicalprogress for the smooth supply of drugs developed in Japan for the treatment of
infectious diseases. The government will promote dissemination to other countries

39

ASIARS- Net: Asian Antimicrobial Resistance Surveillance Network

17

through training and seminars held at the PMDA 40 Asia Training Center for
Pharmaceuticals and Medical Devices. [Ministry of Health, Labour and Welfare]○ The government will support the appropriate use of drugs for infectious diseases in
Asian countries and actively provide information on Japan's findings and safety
information on adverse reactions for drugs for infectious diseases developed inJapan through training and seminars according to the needs of Asian regulatory
authorities held at the PMDA Asia Training Center for Pharmaceuticals and Medical
Devices, and by disseminating the information in English on the PMDA website.
[Ministry of Health, Labour and Welfare]
2. Development of human resources to deal with infectious diseases, international
contribution through human support, etc.
(1) Training and career path support for human resources to control infectious diseases① Promotion of training to develop human resources to control infectious diseases○ The Japan Disaster Relief Infectious Diseases Response Team and the Ministry of
Health, Labour and Welfare will provide cross-disciplinary and effective training in
epidemiology, laboratory diagnosis, clinical management and infection prevention
and control (IPC), public health response, logistics, management, and international
health policy to personnel registered for deployment in order to develop andimprove the system for training and dispatching global health personnel. Relevantorganizations (National Center for Global Health and Medicine (NCGM)41, National
Institute of Infectious Diseases, JICA, etc.) will systematically conduct training
programs to provide this training, further increase the number of registeredpersonnel and promote human resource development on infectious diseases atuniversities [Cabinet Secretariat, Ministry of Foreign Affairs, Ministry of Education,
Culture, Sports, Science and Technology, Ministry of Health, Labour and Welfare]○ As part of the training and human resource development at universities, practicaltraining and research will be conducted abroad. Trainees be deployed overseas
through the FETP-J 42 (Field Epidemiology Training Program for Professionals in
PMDA: Pharmaceuticals and Medical Devices Agency. An organization established in 2004 thatprovides examination, safety, and relief services for pharmaceuticals and medical devices.
41 National Center for Global Health and Medicine
42 Field Epidemiology Training Program: This program was established in 1999 at the National Instituteof Infectious Diseases with the aim of creating a nationwide network to train field epidemiologists whowill serve as the core for rapid detection and appropriate response to infectious disease crisis
management cases. In principle, this is a two-year practical training program for physicians,
veterinarians, and other specialists involved in infectious disease countermeasures, as well as those
who are engaged in community health services such as infectious disease countermeasures by the40

18Epidemiology) course at the National Institute of Infectious Diseases and will use
overseas R&D centers under the "Research Infrastructure Development Project for
Emerging and Re-emerging Infections" managed by the AMED. In addition, thegovernment will continue training approximately five specialists in infectious disease
emergency management every year with comprehensive knowledge and abilities,
including clinical and epidemiological knowledge related to infectious diseases,
public health response skills, and international coordination skills through the"Infectious Disease Emergency Specialist (IDES) Training Program" run by the
Ministry of Health, Labour and Welfare. [Ministry of Education, Culture, Sports,
Science and Technology, Ministry of Health, Labour and Welfare]○ In light of the increased risk of serious imported infectious diseases entering Japan,
as evidenced by the cross-border spread of Ebola hemorrhagic fever, Middle East
Respiratory Syndrome (MERS), and other infectious diseases, and pandemic
outbreaks of the COVID-19, the National Institute for Infectious Diseases will
establish a more robust, strategic, and flexible system that will contribute to both
domestic and international monitoring and response. The National Institute of
Infectious Diseases (NIID) will further strengthen its capacity for "Basic humanresource development" because of its role in fostering human resources who willserve as the foundation for contributing to epidemiological surveys and publichealth control in various institutions in local and national governments.
From the perspective of early detection and response, training in hands-on
epidemiology and risk assessment of cases that can be directly linked to effective
public health control in crisis management, the ability to collect intelligence
information based on the characteristics of domestic and foreign infectious
diseases and pathogens will be enhanced. Continuous training will be provided toacquire basic infection control techniques that can be used in a variety of situations,such as suspected outbreaks of unknown pathogens. [Ministry of Health, Labourand Welfare]② Career path support for international health personnel○ Regarding FETP-J, the government will conduct research on upgrading, diversifying,and making the training content available online, in order to train excellent field
epidemiology specialists with the ability to collect, analyze, apply and disseminate
information, who can effectively respond to emerging infectious diseases and othernational and prefectural governments. Currently, a total of 92 trainees have completed the course
during 24 terms.

19crises such as outbreaks of drug-resistant bacterial infections as part of support forstrengthening the response in the Asia-Pacific region as advocated at the AMR One
Health Tokyo Conference. The goal is to have 157 students complete the course by2027.
The government will also consider how to conduct refresher training for those
who have completed the training a certain number of years ago. [Ministry of Health,Labour and Welfare]○ In light of support career paths for international health personnel (policy andtechnical personnel) in a wide range of fields, including infectious diseases, who are
expected to play active roles in international organizations, the Ministry of Health,Labour and Welfare, with the cooperation of the Ministry of Foreign Affairs, theMinistry of Education, Culture, Sports, Science and Technology, and other relevant
ministries, will continuously collect and provide information and analyze current
conditions of international organizations and relevant domestic organizations towhich personnel can be dispatched, such as positions and required abilities, and will
also use this information to match the relevant personnel with relevant domesticorganizations. [Ministry of Foreign Affairs, Ministry of Education, Culture, Sports,
Science and Technology, Ministry of Health, Labour and Welfare, Ministry ofAgriculture, Forestry and Fisheries]○ To build a system that enables international contribution with human resources andto strengthen the ability to respond to infectious disease emergency managementin Japan, the IDES training program will continue to train specialists infectious
disease emergency management who have clinical and epidemiological knowledgeof infectious diseases, public health response abilities, and international
coordination skills, etc. [Ministry of Health, Labour and Welfare]○ The Global Health Human Resource Strategy Center, which was established in
September 2017 at the National Center for Global Health and Medicine, is a centerfor human resources registration and search system for registrants. The center
provides information on available positions in the Global Health field according topreferences and individual support to applicants such as career consultation,
document correction, and exam preparation. The government will continue toprovide information and other employment assistance in the future to internationalorganizations when infectious disease-related posts arise. [Ministry of Foreign
Affairs, Ministry of Health, Labour and Welfare]20

(2) Promotion of efforts of the Japan Disaster Relief Infectious Diseases Response Team
① Development of deployment system○ To further improve the deployment system of the Japan Disaster Relief Infectious
Diseases Response Team and to deployment the teams effectively, the Advisory
Committee, the Technical Committee, and the Task Review Committee of the
Infectious Diseases Response Team will discuss and examine the dispatch system,
matters to be considered, medium-term issues, and team activities and operations,and strive to implement improvement measures. [Ministry of Foreign Affairs,
Ministry of Health, Labour and Welfare]② Support for activities of the Japan Disaster Relief Infectious Diseases Response Team○ To improve the deployment system for the Japan Disaster Relief Infectious Diseases
Response Team, case studies will be conducted during introductory training by JICA,
and the introduction, storage, maintenance, management, and review of the team’s
portable equipment and materials will be continuously performed.
In addition, to ensure the appropriate and safe activities of the teams, thegovernment will fully utilize the expertise and networks of WHO to collect, share,and exchange opinions on the latest information on infectious diseases. [Ministry ofForeign Affairs]○ When the Japan Disaster Relief Infectious Diseases Response Team conduct
international disaster relief activities that cannot be handled by civilian assets andother alternative means are not available, upon consultation with the Ministry ofForeign Affairs and the Ministry of Defense, and in cooperation with the Ministry of
Health, Labour and Welfare, the Ministry of Foreign Affairs, and other relevant
ministries and agencies, the necessary personnel, equipment/material and othersupplies will be transported to overseas areas by the SDF in order to support said
activities. [Cabinet Secretariat, Ministry of Foreign Affairs, Ministry of Health, Labourand Welfare, Ministry of Defense]○ The government will continue to contract with private companies that provide
services such as transportation to a safe location, including Japan, in the event thatmembers of the Japan Disaster Relief Infectious Diseases Response Team get
infected and suffer from an infectious disease during their activities, in order tominimize the health damage to their health and ensure the safety of their lives.
[Ministry of Foreign Affairs]
21

(3) Cooperation with WHO and other international organizations○ In addition to collecting and sharing information through WHO to ensure quick
response to outbreak of infectious disease crises, the government will collaborate
with WHO to dispatch appropriate personnel to GOARN and other frameworks in atimely manner by promoting support for infectious disease control projects at WHO.
[Ministry of Health, Labour and Welfare](4) Establishment of a system to improve the SDF's ability to respond to infectious diseases○ In order to train excellent SDF medical officers and nurses with expertise in infectious
disease control who can respond to national emergency , the National Defense
Medical College will secure a variety of cases and improve education and training bystrengthening the infectious disease treatment system, train medical officers whowill play leading roles in advanced infectious disease protection research and in unit
protection, diagnosis, and treatment in the event when infectious disease incidents
occur in Japan and overseas, and study promotion of projects to strengthen
collaboration with SDF. [Ministry of Defense](5) Ensuring the safety of Japanese nationals abroad○ The Ministry of Foreign Affairs issues, Travel Advice and Warning on Infectious
Diseases, Region-wide Safety Information, and Spot Information on the overseas
safety website according to the outbreak status of infectious diseases occurring
overseas, provide timely and appropriate information and warnings to Japanesenationals overseas, as well as health and safety lectures 43 by medical specialists forJapanese nationals overseas. [Ministry of Foreign Affairs]○ The diplomatic missions abroad collect information on outbreaks of infectious
diseases in the area under its jurisdiction from the authorities and relevantorganizations, etc. and promptly report to the Ministry of Foreign Affairs.
Information and warnings will be provided timely and appropriately to Japanesenationals overseas through websites and consular e-mails. [Ministry of Foreign
Affairs]○ The Ministry of Foreign Affairs and the Ministry of Health, Labour and Welfare willclosely share the information obtained through diplomatic missions abroad and
43

The government will provide accurate medical knowledge and information on preventive measures toJapanese nationals living abroad who are concerned about infectious diseases.

22

through the IHR framework, and collaborate to utilize this information, respectively,
for safety measures for Japanese nationals overseas and in Japan. [Ministry ofForeign Affairs, Ministry of Health, Labour and Welfare]○ In case where Japanese nationals living overseas are infected with a disease, support
framework at diplomatic missions overseas will be established in cooperation with
relevant ministries and agencies to ensure that the Japanese national can receive thebest possible treatment, including local treatment and emergency transport to athird country or Japan, taking into consideration medical judgments and the requestsof the individual or his/her family. [Cabinet Secretariat, Ministry of Foreign Affairs,
Ministry of Health, Labour and Welfare]○ In peace time, the government works through diplomatic missions abroad to gather
information on commercial airlines and crisis management companies that can
respond to infectious diseases. The government will build cooperative relationships
with them so that private companies and other countries can provide prompt
support if Japanese nationals living overseas are infected. They can assist when it isdetermined that emergency transport to a third country, or Japan, is the best courseof action as a result of comprehensive consideration of a medical doctor’s decisionand the requests of the individual or their family. Furthermore, the government will
strengthen measures by cooperating with relevant ministries and agencies, and by
developing response procedures to ensure the safety of Japanese nationals overseas
by taking all possible measures including consideration of the use of SDF transport
aircraft when there are no charter planes or other alternatives available. [Cabinet
Secretariat, Ministry of Foreign Affairs, Ministry of Health, Labour and Welfare,
Ministry of Defense]
3. Promotion of testing, information collection and analysis, research, and other activities
related to infectious diseases(1) Strengthening the testing system, etc. for infectious diseases○ In Japan, the risk of outbreaks of Type I infectious diseases (imported cases, bioterrorism, etc.) will increase with the G7 summit in 2023 and the Osaka-Kansai Expoin 2025, so from the perspective of health risk management, the government willtake necessary measures to maintain the functions and infrastructure of BSL4
facilities to enable more practical operations in diagnosis and treatment. [Ministryof Health, Labour and Welfare]23

○ Regarding regional public health institutes, the government will promote theestablishment of a system in municipalities at ordinary times and improve thetesting system by strengthening cooperation with the National Institute of Infectious
Diseases, in preparation for outbreaks of emerging and reemerging infectious
diseases in Japan [Ministry of Health, Labour and Welfare]○The government will promote the establishment of a system to secure test reagentsand testing facilities to expand the testing capacity and respond immediately to theincreasing demand for testing, in the event that a case of an infectious disease isconfirmed in Japan and the infection spreads rapidly. [Ministry of Health, Labour andWelfare](2) Strengthening information collection, analysis, and research systems related to
infectious diseases① Strengthening overseas information collection and analysis capabilities, etc.
○ At the institute for health security, the government will conduct surveys and researchthat contribute to international cooperation in prevention and medical care,including promotion of building network for joint multi-center clinical trials, etc. inJapan and abroad, and train and improve the quality of human resources who canplay an active role in Japan and abroad. [Ministry of Health, Labour and Welfare]○ To strengthen the information collection, analysis, and evaluation functions of the
National Institute of Infectious Diseases, the government will integrate and manage
the necessary information from WHO and other international organizations, the U.S.
CDC 44 , public health organizations in other countries, and domestic and foreign
media. Furthermore, the government will establish a system to quickly andaccurately analyze and evaluate this information by training personnel capable ofsuch evaluation and utilizing various information services. [Ministry of Foreign Affairs,
Ministry of Health, Labour and Welfare]○ For infectious disease outbreaks overseas, the government will participate in training(FETP-J 45 initial induction training), including online format, organized by the
National Institute of Infectious Diseases to acquire specialized knowledge in
infectious diseases for medical attachés in diplomatic missions abroad, andstrengthen information gathering on public health in countries affected by outbreaks.
44
45

Centers for Disease Control and Prevention in the U.S.
FETP-J: Field Epidemiology Training Program Japan

24

[Ministry of Foreign Affairs, Ministry of Health, Labour and Welfare]② Strengthening research systems, including BSL4 facilities○ Nagasaki University has planned and completed construction of a BSL4 facility
equipped with state-of-the-art equipment for R&D in the fields of pathogen analysis,animal experiments, and the development of treatments and vaccines, etc., withmaximum consideration for safety, in order to improve basic research capabilities in
infectious diseases at domestic universities and other research institutions, and to
train and secure personnel familiar with the handling of highly dangerous pathogens,etc., including zoonotic diseases. The government will provide necessary support forsafe and stable management and operation of the facility.
In addition, the government will provide necessary support for the formation of
an infectious disease research center based on the BSL4 facility and strengthen theinfectious disease research function in Japan so that it can quickly respond to
emerging and reemerging infectious diseases that pose an international threat.
[Cabinet Secretariat, Ministry of Education, Culture, Sports, Science and Technology,
Ministry of Health, Labour and Welfare]○ There is one BSL4 facility in Japan operated by the National Institute of Infectious
Diseases, and another one is being prepared at Nagasaki University. Regarding thedivision of roles between the two institutions, the National Institute of Infectious
Diseases will function as a first responder in case of emergency, especially inestablishing a rapid and accurate testing function and treatment system, while
Nagasaki University is expected to play a central role in academic research on specificType I pathogen in Japan in the future.
Furthermore, the National Institute of Infectious Diseases will actively participate
in building the infrastructure for the management and operation of the BSL4 facility
at Nagasaki University and promote collaboration between the two institutions.
[Ministry of Education, Culture, Sports, Science and Technology, Ministry of Health,Labour and Welfare]○ The government will discuss the construction of an integrated system for biosafety
and biosecurity and continue to actively promote the computerization of pathogen
management with the goal of strengthening the maintenance and enhancement of
biosafety and biosecurity. [Ministry of Health, Labour and Welfare]○ The National Institute of Infectious Diseases in FY2022 began works on the25

construction of a treatment system for specific Type I pathogen infectious diseases
approved by the city and local communities with a goal of human resource
development at the BSL4 facility. The institution will continue to develop practicalhuman resources skilled in operations using infectious pathogens, cultured cells, andlaboratory animals. [Ministry of Health, Labour and Welfare]○ Regarding communication with the local communities on the subject of the BSL4
facility, in addition to safety and security reports on the BSL4 facility and outreachactivities at the Murayama Town Hall using the active disclosure of research activities
promoted by the National Institute of Infectious Diseases as a model, the National
Institute of Infectious Diseases will make BSL4 facility operations more transparent
by actively disseminating the results of projects related to the BSL4 facility. [Ministryof Health, Labour and Welfare]○ The “Investigation Committee for the Formation of Research Centers for Infectious
Diseases” will promote the safe management and operation of BSL4 facilities andthe formation of research centers for infectious diseases based on these facilities,
while monitoring progress in the development of BSL4 facilities. The Committee will
also discuss, coordinate, and promote necessary support measures among relevant
parties. [Cabinet Secretariat, Ministry of Education, Culture, Sports, Science andTechnology, Ministry of Health, Labour and Welfare]○ Based on the “Plan for the Promotion of Research and Development in the Medical
Field” (partially revised on April 6, 2021, approved by the Headquarters for
Healthcare Policy), the government will steadily promote R&D related to infectious
diseases with seamless research support by AMED from foundation to practicalapplication.
In addition to promoting measures based on scientific evidence and connecting
research results to the development of therapeutic drugs, diagnostic drugs, vaccines,
etc., AMED will maintain and improve the network of overseas R&D centers for
infectious diseases researched and managed by this organization, promote joint
research, etc. using this network, and develop human resources at universities andother research institutions, including multidisciplinary collaboration. [Cabinet Office(Health), Ministry of Education, Culture, Sports, Science and Technology, Ministry of
Health, Labour and Welfare, Ministry of Economy, Trade and Industry]○ Based on the “Strategy for Strengthening the Vaccine Development and Production
26

System” (approved by the Cabinet on June 1, 2021), the Strategic Center ofBiomedical Advanced Vaccine Research and Development for Preparedness andResponse (SCARDA) was established at AMED in March 2022. The Center will
strengthen and promote related research with a clear vision of the final product torealize domestically produced vaccines through the “Project for Establishment ofWorld-Class R&D Center for Vaccine Development”. This center will be the core of
the research in ordinary times. In addition, SCARDA will adopt research projects on
vaccines and new modalities for important infectious diseases, and provide strategic
funding to support long-term, stable, and strategic R&D in ordinary times in orderto deliver vaccines against important infectious diseases as quickly as possible in theevent of an infectious disease outbreak. [Cabinet Office (Health), Ministry of
Education, Culture, Sports, Science and Technology, Ministry of Economy, Trade andIndustry]○ The government will enrich clinical information and specimen collection through amechanism that serves as a foundation for research and development of drugs for
emerging and reemerging infectious diseases (Repository of Data and Biospecimenof Infectious Diseases (REBIND 46 )), and promote its utilization by research
institutions. [Ministry of Health, Labour and Welfare]○ The Japan Antimicrobial Resistant Bacterial Bank (JARBB) currently storesapproximately 210,000 strains, including strains derived from humans (healthy
individuals / infectious diseases), livestock / pets, the environment, food, and their
genetic information. JARBB plans to develop and distribute on demand three panels:
Quality Control Panels (for hospital laboratories and for test kits), Basic Research
Panels, and Drug Development Research Panels (for for new drug development andfor regulatory, approval). Government will continue to collect drug-resistant bacteria
strains and promote generating genomic sequencing data of them. [Ministry of
Health, Labour and Welfare, Ministry of Agriculture, Forestry and Fisheries]
4. Promotion of the One Health approach(1) Measures to prevent the introduction of infectious diseases through imported animals○ The government will inspect the range and measures of target animals and infectious
diseases and measures to strengthen monitoring of imported animals and takenecessary actions. At the same time, the government will also consider the46

REpository of Data and Biospecimens of INfectious Diseases
27establishment of a system that will enable quick action when a new infectious
disease threat becomes apparent. [Ministry of Health, Labour and Welfare, Ministryof Agriculture, Forestry and Fisheries]○ The government will provide training for quarantine station staff on zoonotic diseases
to improve their ability to respond to cases. The government will also provide
training for livestock quarantine officers and education and training in inspection
techniques for diseases that are subject to animal quarantine to improve the ability
to identify and diagnose similar diseases. [Ministry of Health, Labour and Welfare,
Ministry of Agriculture, Forestry and Fisheries](2) Early response to infectious diseases that may be brought to Japan by migratory birds
crossing the border, etc.
○ In the event of an outbreak of highly pathogenic avian influenza, the following actions
will be taken to determine the extent of the virus infection. In the case of domestic
poultry, epidemiological surveys will be conducted at infected farms, etc., andmonitoring of wild birds in the vicinity of outbreak areas will be strengthened. In
addition, for wild birds and birds raised in zoos, etc., surveys of migratory birds flying
around the outbreak area and bird habitat conditions will be conducted, andmonitoring of wild birds will be strengthened. [Ministry of Agriculture, Forestry and
Fisheries, Ministry of the Environment]○ The government will conduct necessary surveillance on infectious diseases related
to wild birds and animals from the viewpoint of biodiversity conservation incooperation with research institutes, etc. In addition, if there is information which isalso useful for public health and livestock health, it will be shared with the Ministryof Health, Labour and Welfare, Ministry of Agriculture, Forestry and Fisheries, etc.,
as necessary. [Ministry of the Environment]○ The government will take necessary measures for livestock hygiene centers tostrengthen diagnostic capabilities related to highly pathogenic avian influenza andother diseases affecting domestic poultry. [Ministry of Agriculture, Forestry and
Fisheries]○ The government will take necessary actions for the National Institute forEnvironmental Studies and other institutions to strengthen the surveillance system
for highly pathogenic avian influenza and other diseases affecting wild birds, etc.
28

[Ministry of the Environment]○ The government will take necessary actions such as providing training to regional
public health institutes to strengthen their ability to diagnose rabies and otherdiseases in wild animals and to promote surveillance. [Ministry of Health, Labourand Welfare](3) Promotion of research on the One Health approach○ The National Institute of Infectious Diseases, the National Institute of Animal Healthof the National Agriculture and Food Research Organization, the National Institutefor Environmental Studies, and other institutions work together on conducting
research on pathogens carried by animals, including zoonotic diseases. The
government will continue to promote cross-disciplinary collaboration among related
institutions in the analysis of genomic characterization of avian influenza virus andother zoonotic pathogens and research to clarify the actual status of drug-resistantbacteria. [Ministry of Health, Labour and Welfare, Ministry of Agriculture, Forestry
and Fisheries, Ministry of the Environment]○ Led by the National Institute of Infectious Diseases, research institutes under thejurisdiction of other ministries, universities, local governments, and other relatedorganizations will collaborate to collect comprehensive information on occurrenceof zoonotic diseases in Japan and overseas, conduct analysis and research, develop
human resources, and utilize the obtained knowledge to promote the One HealthApproach.
In addition, the government will support local government’ other initiatives suchas surveys and research to promote the One Health Approach in local regions.
[Ministry of Health, Labour and Welfare]○ In the Division of Zoonosis Research, which was newly organized in FY2021 in the
National Institute of Animal Health of the National Agriculture and Food Research
Organization, a database of zoonotic pathogens derived from animals will be created,
and a monitoring method for early detection of pathogens will be developed using
this database. [Ministry of Agriculture, Forestry and Fisheries]○ Under leadership of the National Institute for Environmental Studies, which is thecontact point for the International Epizootic Office for wild animals, the monitoring
information on the spatial and temporal distribution and dynamics of wild animals
29and their pathogens in Japan and East Asia will be collected in cooperation withresearch institutes, universities, and other related organizations. This information
will be used to study the origin and evolution of pathogens and their relationship tobiodiversity, and to contribute to countermeasures against zoonotic diseases inJapan and overseas through the results of these studies. [Ministry of theEnvironment](4) Efforts to build a cooperative framework for the One Health approach○ Collaboration among the relevant ministries such as the Ministry of Health, Labourand Welfare, the Ministry of Agriculture, Forestry and Fisheries, and the Ministry of
the Environment is important for the promotion of the One Health Approach.
Currently, the ministries are working together on initiatives to address avian
influenza and to regulate the import of animals. The government will continue topromote cross-disciplinary collaboration among related organizations and work
closely with local governments to further promote One Health. In addition, thegovernment will promote close cooperation between departments within local
governments, such as building local cross-departmental quarantine systems.
[Ministry of Health, Labour and Welfare, Ministry of Agriculture, Forestry and
Fisheries, Ministry of the Environment]○ To further promote One Health Approach, the government will continue to shareawareness of issues and a collaborative mindset, and discuss issues that need to beaddressed and necessary actions/framework to be taken, in the Infectious Disease
Committee of the Health Science Council and collaborative symposium of, Japan
Medical Association, Japan Veterinary Medical Association, and Ministry of Health,Labour and Welfare to further promote the One Health Approach and discuss issues
that need to be addressed and necessary actions and systems. [Ministry of Health,Labour and Welfare]
5. Promotion of measures to control AMR○ The government will promote AMR measures in a unified manner, based on therevised National Action Plan on Antimicrobial Resistance (AMR). [Cabinet
Secretariat, Cabinet Office (Food Safety), Ministry of Foreign Affairs, Ministry of
Education, Culture, Sports, Science and Technology, Ministry of Health, Labour andWelfare, Ministry of Agriculture, Forestry and Fisheries, Ministry of theEnvironment]30

○ The government will promote R&D that contributes to antimicrobial resistance (AMR)
measures, including introduction of market incentives for antimicrobial drug
development, and will exert a leadership over global AMR policies. [Ministry ofForeign Affairs, Ministry of Health, Labour and Welfare]○ The government will continue to support WHO's response to antimicrobial resistance(AMR) and will advance measures against AMR in the Group of Seven (G7) process.
The government will strengthen international collaboration among developed
countries by supporting or contributing to antimicrobial resistance (AMR) efforts
through the Food and Agriculture Organization (FAO), the World Organization for
Animal Health (WOAH), United Nations Environment Programme (UNEP), Global
Drug Facility (Stop Tuberculosis Partnership), Global Antibiotic Research andDevelopment Partnership (GARDP) fund, Pandemic fund and other international
initiatives, and will lead international discussions through contributions to the Stop
Tuberculosis Partnership and GARDP. [Ministry of Foreign Affairs, Ministry of Finance,
Ministry of Health, Labour and Welfare, Ministry of Agriculture, Forestry and
Fisheries, Ministry of the Environment]

Concluded31