Basic Guidelines for Strengthening Measures on Emerging Infectious Diseases(Provisional translation)
September 11, 2015
February 9, 2016 (Revised)
Ministerial Meeting on Measures on Emerging Infectious Diseases
Regarding the recent spread of Ebola Virus Disease in West Africa, the international
community has promoted efforts to prevent it while some people have been infectedwith the disease in Europe and the United States as well. The Government of Japan also
carried out preparations for the case where domestic infection is confirmed or the casewhere a Japanese national is infected with the disease overseas. The Government ofJapan established the "Ministerial Meeting on the Response to the Ebola Virus Disease"that is presided over by the prime minister in October 2014, and made integrated
efforts. Moreover, in international efforts, the Government of Japan has also provided
support to West African countries directly or through cooperation with internationalorganizations.
Furthermore, regarding the Middle East respiratory syndrome (MERS) whose
outbreak was reported mainly in countries in Arabian Peninsula, an infected person was
confirmed and the spread of the disease was seen in South Korea in May 2015. The
Government of Japan also strengthened quarantine measures against the disease.
Infection with the Ebola Virus Disease in West Africa is under control through theefforts of the countries concerned and of the international community. In addition,
MERS infection in South Korea has ended through the country's efforts. However, thesecases not only had a significant impact on people's daily lives and economic activities inthe EVD-affected countries 1 but also had a major impact on and caused fear in theinternational community. There is a possibility that an emerging infectious disease 2 just1

In October 2014, World Bank published "The Economic Impact of the 2014 Ebola Epidemic
Short- and Medium-Term Estimates for West Africa." According to it, the amount of loss caused by
Ebola virus disease to the GDP of three affected countries, Guinea, Liberia, and Sierra Leone isestimated as follows: short-term impact in 2014 amounts to 359 million USD while themedium-term impact in 2015 is in the range of 129 million to 815 million USD.
2 Ebola virus disease, MERS, and other infectious diseases that spread beyond national borders andare likely to have a great impact on people's daily lives and economic activities as well as on
people's lives and health. Incidentally, measures are separately promoted against a new strain of
influenza, new infectious diseases (limited to those that are likely to rapidly spread nationwide), andavian flu (one that has been transmitted from birds to humans) based on the Act on Special Measuresfor Pandemic Influenza and New Infectious Diseases Preparedness and Response (Act No. 31 of
2012). However, the Basic Guidelines also contributes to such measures.
1

like these diseases will occur in the future.
Under these circumstances, the Basic Guidelines is compiled as follows based on
lessons learned from the cases of this time and in light of the actions of the international
community for the purpose of carrying forward the strengthening of measures against
emerging infectious diseases through the integrated efforts of the Government of Japan.
Incidentally, the Basic Guidelines is to be mutually coordinated with the "Basic
Design for Peace and Health" approved by the Headquarters for Healthcare Policy.
1. Background and purpose（1）

Threat of infectious diseases that spread to the entire international community
beyond national borders due to the progress of globalization
In March 2014, Guinea reported the recent outbreak of Ebola Virus Disease
to World Health Organization (WHO). The disease spread mainly in West Africa,
and infections by the disease were also confirmed in Europe and the UnitedStates, including secondary infections. On August 8th 2014, WHO declared a"Public Health Emergency of International Concern" in relation to this spread ofEbola Virus Disease in West Africa, and the situation came to be of international
concern.
Moreover, regarding MERS, the outbreak thereof has been reported mainly
in countries in the Arabian Peninsula since September 2012. After that,
infections with the disease have been sporadically confirmed in Europe, theUnited States, and Asia. Under such circumstances, a person infected withMERS was confirmed in May 2015 in South Korea, and subsequently, MERS
spread to those who had heavy contact with the infected person.
In this manner, the risk of acquiring infectious diseases through animals has
increased due to forest development and climate change. In addition, theprogress of globalization through increased exchange and migration of people
and articles along with the development of traffic has caused the increased
possibility of occurrence of the situation where a disease does not remain in thelimited area but spreads in a country and furthermore spreads to the wholeinternational community beyond national borders. In addition to Ebola Virus
Disease and MERS, various emerging and re-emerging infectious diseases arealso likely to become of international concern in the future.

（2）
Major lessons learned from the spread of Ebola Virus Disease￮ Importance of containment of a disease and governance in affected countries in the2early stage of an outbreak
Regarding the spread of Ebola Virus Disease in West Africa, progression of theepidemic became evident after March 2014 due to a delay in measures forcontaining the disease taken by international organizations and countries around theworld in three affected countries in West Africa. After that, the international
community has strengthened intensive local measures, including establishment anddispatch of the UN Mission for Ebola Emergency Response (UNMEER) in
September, since WHO's PHEIC declaration in August. Owing to these measures,
the number of newly infected people reported per week amounted about 730 at
the peak in November 2014, but owing to these measures, WHO declared the endof the disease in Guinea and Liberia, in December 2015 and in January 2016
respectively. On the other hand, in Sierra Leone, where WHO once declared thatthe transmission was ended in November 2015, a new infected person was reported
again in January 2016, and continued vigilance is required. 3
Various countries' international cooperation through containment of the diseasein the three affected countries is conducted not only from the perspective ofhumanitarian assistance but also to prevent spread from the affected countries to thecountries themselves, as well as for addressing a threat to the safety of theinternational community. The international community should have promptly taken
local actions under such recognition from the very beginning. Moreover, it ispointed out by many people that at the time, countries, international organizations,and NGOs which took local actions could not sufficiently coordinate with eachother, thus allowing the spread of the disease. This problem with global healthgovernance was also revealed.
￮ Necessity of international cooperation that promotes the strengthening ofvulnerable health systems in the affected countries
In the three affected countries in West Africa where Ebola Virus Disease spread,vulnerable basic health and medical service systems caused a delay in taking action
even though the spread of the disease was known. In addition, the spread of thedisease caused originally-vulnerable health systems in the affected countries to failto function properly, and it became difficult to address not only infectious diseases
but also other diseases.
Given this situation, at a country level, it is important to support the building of
3

WHO announced a declaration to maintain the PHEIC on July 9th. This PHEIC has not been
removed (as of the end of August 2015).
3

a resilient health system from the medium- and long-term perspective and tostrengthen the prevention of infectious diseases through collaboration withinternational organizations. Specifically, the necessity of cooperating in designing
health systems and developing health workers at the country, region, andcommunity levels and of making contributions, such as support for strengthened
implementation of WHO’s International Health Regulations (IHR), was indicated.
In addition, in the event of an emergency, it is important to provide effective andefficient support through combination of personnel assistance including dispatch ofJapan Disaster Relief Team, in-kind assistance, and financial assistance, incoordination with other donor countries, related international organizations, andNGOs.
￮

Necessity of continued strengthening of infection prevention measures in Japan
In light of the status of the spread of Ebola Virus Disease and WHO's PHEIC
declaration, the Government of Japan has taken actions in an integrated manner inJapan by establishing the "Ministerial Meeting on the Response to the Ebola Virus
Disease." In addition, the Government of Japan has provided the latest information
to Japanese nationals living overseas and alerted them by releasing Travel Advice
and Warning on Infectious Diseases, and has also made preparations, such as
strengthening of quarantine measures taken at quarantine stations and developmentof designated medical institutions for specified infectious diseases, as domestic
measures. However, the possibility of repeat spread of the disease cannot be denied
as there are still many countries with a vulnerable health and medical service
system. Moreover, the possibility of a future outbreak of an emerging infectious
disease other than Ebola Virus Disease is also undeniable. It is necessary tocontinuously strengthen domestic infection prevention measures, including
quarantine measures, in the future with an awareness of the possibility of such
infectious diseases entering Japan in today's expanded range of social interactions.

￮ Necessity of establishment of testing and research systems in Japan
This spread of Ebola Virus Disease reminded us of the fact that there are no
facilities to possess specified Type 1 pathogens in Japan, despite other developed
countries having established testing and research systems for Ebola virus and otherhigh-risk pathogens (Type 1 pathogens.).
Under such circumstances, an advanced safety testing and inspection facility(biosafety level 4 (BSL 4)) in Murayama Branch of the National Institute of4

Infectious Diseases was designated as a facility to possess specified Type 1
pathogens by the Minister of Health, Labour and Welfare on August 7th,2015 basedon the Act on Prevention of Infectious Diseases and Medical Care for Patients
Suffering Infectious Diseases (Act No. 114 of 1998; hereinafter referred to as the"Infectious Diseases Act") by gaining the understanding and cooperation of local
residents.
In the future, it is necessary for Japan as a whole to consider desirable
full-scale testing and research systems for pathogens of infectious diseases thatcause serious symptoms, such as Ebola Virus Disease, mainly from the perspectiveof crisis management.
￮ Necessity of strengthening development of human resources who take charge ofmeasures against infectious diseases, including international cooperation
In response to the spread of Ebola Virus Disease in West Africa, Japan has also
dispatched medical experts. However, its personnel cooperation was not sufficient
relative to its financial cooperation. Japan has dispatched around 20 medical experts
in total through WHO. Therefore, it is necessary to strengthen development of suchhuman resources and secure human resources who can take charge not only ofdomestic measures against infectious diseases but also of measures against
infectious diseases in international cooperation in the medium and long term.
（3） Actions of the international community
Ebola Virus Disease outbreak in West Africa as a lesson, the necessity of
global health governance was recognized again. WHO, World Bank, United
Nations, and other international organizations are discussing toward building aninternational health system for ordinary times and for emergencies, andstrengthening the capacity to address emergencies.
WHO established a fund to enable quick initial response to an outbreak of
an infectious disease or another emergency (Contingency Fund) and also
approved its budget for 2016 to 2017, which includes an increase in the budget
for strengthening systems in the fields of preparation, surveillance and response.
In addition, a third party's provisional appraisal of WHO's response to Ebola
Virus Disease was issued in July 2015, and WHO's response will be consideredin light of this appraisal.
Moreover, World Bank is considering the launch of the Pandemic
Emergency Facility (PEF) in order to develop a mechanism for agile funding at5

the time of a pandemic to be used in developing countries. At the United Nations,the High-Level Panel established under the Secretary-General is also discussing
future responses based on lessons learned from the Ebola Virus Disease outbreak,and the report of the discussions is scheduled to be published in the near future.
Furthermore, in the Leaders' Declaration at the G7 Elmau Summit in June
2015, the leaders confirmed that they are "continuing their engagement in thisfield with a specific focus on strengthening health systems" and they "willcoordinate to fight future epidemics and will set up or strengthen mechanisms
for rapid deployment of multidisciplinary teams of experts coordinated through acommon platform." At the past G7 or G8 Summit meetings, Japan played aleading role in discussions and efforts in the health field, such as paving the way
to establish the Global Fund to Fight AIDS, Tuberculosis and Malaria (GlobalFund) and by publishing the Toyako Framework for Action on Global Health, forexample. Accordingly, Japan is expected to further fulfill its role by taking
actions in light of the aforementioned trends at the G7 Ise-Shima Summit and
the G7 Health Ministers Meeting in Kobe in 2016.
The Leaders' Declaration also touched on the issue of Antimicrobial
Resistance (AMR) which makes antibiotics ineffective supported the World
Action Plan on Antimicrobial Resistance (Global Action Plan) adopted at WHO
in May 2015. In October of the same year the G7 Berlin Health Ministers
Meeting also acknowledged that antimicrobial resistance (AMR) bacteria andthe like were rapidly expanding across national borders and making treatment
for infectious diseases more difficult, while research and development ofantibiotics and drugs remained stagnated. Based on it, the meeting called forfurther strengthening of countermeasures against the Antimicrobial Resistance(AMR).
（4） Purpose and positioning of the Basic Guidelines
In light of the backgrounds mentioned in (1) to (3) above, the Basic
Guidelines indicates the fundamental direction and priority matters to bestrengthened in relation to strengthening of measures against emerging
infectious diseases for around the next five years. The Government of Japan
will aim at ensuring the people's security and safety by strengthening theefforts of related administrative agencies and coordination among such efforts,
and will also fulfill its responsibility and role in the international community.

62. Fundamental direction（1） Integrated promotion of international response to and domestic measures against
emerging infectious diseases
In response to the spread of Ebola Virus Disease in West Africa, Japan has
given international responses, such as financial assistance, in-kind assistance,and personnel assistance, mainly from the perspective of the humanitarianassistance for the purpose of saving the lives of the people in the affected
countries while taking infection prevention measures in the country from theperspective of crisis management.
However, as a lesson learned from the spread of Ebola Virus Disease, thedeveloped countries of the West have taken actions not only from theaforementioned perspective of humanitarian assistance but also from theperspective of preventing the spread of the disease to themselves, and suchactions were promoted integrally with their domestic infectious prevention
measures.
In light of such recognition, the Government of Japan will recognize
international cooperation in relation to emerging infectious diseases that spreadbeyond national borders not only from the perspective of humanitarianassistance but also from the perspective of preventing the spread of such diseases
to Japan, and will promote this cooperation in organic collaboration withdomestic infection prevention measures taken in preparation for the first case inJapan. These measures include strengthening of risk assessment of infectious
diseases emerging abroad and development of human resources in charge ofmeasures against infectious diseases who can also take charge of international
responses.
（2）

Strengthening of Japan's contribution and role in countries and regions where an
emerging disease has occurred
The necessity of strengthening global health governance to enable theinternational community to promptly address public health emergencies,
containing a disease in the early stage of its outbreak, strengthening vulnerable
health systems, and strengthening the capacity to address other serious infectious
diseases were recognized as lessons learned from the spread of Ebola Virus
Disease in West Africa.

7

Based on such recognition, for emerging infectious diseases that could
spread beyond national borders, Japan will strengthen international cooperationin relation to the rebuilding of global health governance to enable theinternational community to promptly address public health emergencies, thecontainment of specific infectious diseases in the early stage of their overseas
outbreak, strengthening of health systems (UHC) in ordinary times in developing
countries and response to other serious infectious diseases. In addition, Japan
will consider the development of human resource foundation to deploy experts
as international cooperation.
Through these efforts, Japan will aim to contribute to measures against
emerging infectious diseases and to lead a role in the international community asa responsible member of the international community.
（3） Strengthening of the crisis management system through improvement of thecapacity to address emerging infectious diseases in JapanThe necessity of continuous strengthening of domestic infection prevention
measures, establishing full-scale testing and research systems for pathogens ofEbola Virus Disease and other infectious diseases from the perspective of crisis
management in Japan, and of having a research capacity that is sufficient topersuade the international community with evidence was recognized as lessons
learned from the spread of Ebola Virus Disease in West Africa.
Based on such recognition, for emerging infectious diseases that spreadbeyond national borders, Japan will develop testing and research systems on
high-risk pathogens in ordinary times and strengthen human resources
development of the personnel, who take charge of measures against infectious
diseases, including international cooperation, and continue to strengthen
quarantine measures and measures in preparation for the first case.
Through these efforts, Japan will develop a system for taking actions inrelation to measures against infectious diseases in ordinary times and at the timeof outbreak in an organized manner, and thereby will improve its capacity toaddress emerging infectious diseases and will continue to strengthen the crisis
management system.

8

3. Priority matters to be strengthened (including matters that require mediumand long-term efforts)
Based on the lessons learned from the spread of Ebola Virus Disease in West Africa,
and in light of the actions taken by developed countries and the internationalorganizations, Japan needs to intensively strengthen efforts in the future in such fields as
strengthening of international cooperation and collection of overseas information,
development of domestic testing and research systems, and development of humanresource foundation in relation to emerging infectious diseases. In doing so, a newframework for global health governance in consideration of the following matters is
also important in preparation for G7 Ise-Shima Summit in 2016, and related ministries
and agencies will hold discussions thereon.
（1） Strengthening international cooperation and collection of overseas information
The Government of Japan will strengthen measures of international
cooperation on containing the epidemics of specified infectious diseases overseas,building health systems in developing countries in ordinary times, and taking
measures against other serious infectious diseases. The Government of Japan will
also construct a framework for promptly dispatching human resources inemergencies and develop a framework for developing human resources. In doing
so, taking into consideration of the opinions and wisdom of experts, theGovernment of Japan will seek to play a leading role in international discussions
held at United Nations, WHO, and G7 and strengthen international cooperation inlight of such discussions, thereby making contributions to the building of global
health governance. In addition, the Government of Japan will consider
enhancement of the capacity to collect and analyze overseas information for the
purpose of improving risk assessment for infectious diseases.
(i) Preventing infection and the spread of infection in affected countries throughstrengthening of cooperation with international organizations for emergency
responses
The Government of Japan will consider strengthening of cooperation withinternational organizations for emergency responses in order to prevent infection
and the spread of infection in affected countries during the epidemic.
￮

Providing support for securing and strengthening the implementation of9

WHO's IHR 4 and strengthening the foundation of GOARN 5
The Government of Japan will provide technical cooperation relating to
the development of experts for promoting the security and strengthening of theimplementation of the Member States to reporting to WHO and the proceduresof quarantine and domestic response at the time of outbreak, which areprovided for in WHO's International Health Regulations (IHR). Moreover, theGovernment of Japan will also carry forward efforts for the development of
human resources who contribute to strengthening the GOARN system.

45￮Considering a method to address the formation of coherent expeditious
finance mechanisms for emergencies through the joint efforts of theContingency Fund of WHO and the Pandemic Emergency Facility (PEF) of
World BankThe Government of Japan will actively contribute to the development
process of the PEF and consider how to deal with the Contingency Fund andthe PEF in a coherent manner, based on WHO's decision to establish a fund toenable quick initial response to an outbreak or an emergency (Contingency
Fund), as well as World Bank's consideration regarding the development of amechanism for agile funding at the time of a pandemic in a developing country(PEF) while also observing the actions in other countries.

￮

Considering a way of dealing with the Catastrophe Containment and Relief
Trust of the International Monetary Fund (IMF)
The Government of Japan will consider its contributions to the Catastrophe
Containment and Relief Trust from the perspective of support for economic
stabilization at the time of a pandemic. The Trust was established by the IMF
in February 2015 based on the request made at the G20 Brisbane Summit inNovember 2014 to reduce the debt burdens of countries where a disaster or
infectious disease has occurred for the purpose of addressing the economic
stagnation in such countries that is expected to arise after a pandemic andalleviating impact on the macro economies.

￮

Cooperation and policy dialogues with implementing agencies such as UNDP,
UNICEF, UNFPAInternational Health Regulations
Global Outbreak Alert and Response Network
10Implementing agencies such as the UN Development Programme(UNDP), UN Children's Fund (UNICEF), UN Population Fund (UNFPA) areengaging in assistances with the expertise of each agency in the three affected
countries experiencing the Ebola Virus Disease and their neighboring countries.
Therefore, the Government of Japan will promote cooperation with theseagencies to implement further effective measures against infectious diseases
through policy dialogues with these agencies, and will also consider
strengthening of direct support to these agencies.
(ii) Strengthening cooperation with related international organizations that implement
assistances on measures against serious infectious diseases
The Government of Japan will strengthen cooperation with internationalorganizations for the following measures against serious infectious diseases interms of public health, as follows in light of the fact that sufficient actions were
not taken for such infectious diseases, while the originally vulnerable healthsystems in West Africa failed to function properly due to the spread of Ebola Virus
Disease.
￮Support for measures against the three major infectious diseases through the
Global Fund 6
The Global Fund provides support for measures against the three major
infectious diseases, AIDS, Tuberculosis, and Malaria. Measures against these
infectious diseases in addition to Ebola Virus Disease also continue to beimportant. Therefore, the Government of Japan will carry on providing
necessary support to projects that realize and promote appropriate prevention,
treatment, and care of these three major infectious diseases in developing
countries through the Global Fund. Those projects include purchase anddistribution of medicines, diagnostic kits and mosquito nets, educational
activities for prevention, training and other human resources development,collection of data, and establishment of a monitoring system.

￮

Support for vaccination activities by Gavi, the Vaccine Alliance 7
The Government of Japan will provide support for disseminating and

6

Some 3.6 million die from the three major infectious diseases annually.
Gavi, the Vaccine Alliance: An international framework that engages mainly in the promotion of
vaccination to children under five
7

11

promoting the use of vaccines, such as those for measles, pneumococcus, androtavirus, through Gavi, the Vaccine Alliance, in order to control infectious
diseases and reduce the child mortality rate (MDG4) and the maternal mortality
rate (MDG5).
￮

Support for activities for the research and development of new drugs throughthe Global Health Innovative Technology Fund (GHIT) 8.
The Government of Japan will promote necessary involvement in andsupport for activities relating to the research and development, and support for
supplying medicines (medicines for neglected tropical diseases such as Chagas
disease and Leishmaniasis) for developing countries through the GHIT.

￮

Support for the utilization of the results of research and development in Japanin international cooperation
In Japan, universities and private companies are also conducting excellent
research and development in relation to medicines and diagnostic agents for
Ebola Virus Disease and other serious infectious diseases. The Government ofJapan will take necessary actions to ensure such results are also utilized ininternational cooperation.

(iii) Strengthening health systems in developing countries to prevent outbreaks
It has been pointed out that the vulnerable health systems caused further
spread of Ebola in the three Ebola affected countries in West Africa. Thus, theGovernment of Japan will strengthen health systems in developing countries toprevent and respond to infectious disease outbreaks.
￮

8

Strengthening health systems and promoting universal health coverage (UHC)by utilizing development cooperation
The Government of Japan will strengthen health systems and promote UHC
in Africa and Asia by synergistically combining grant aid, government loan,
and technical cooperation. In addition, the Government of Japan will carryforward support for the activities of World Bank that contribute to UHC
building on the results of studies by the Japan-World Bank Partnership
Program on Universal Health Coverage.

Global Health Innovative Technology Fund
12￮

Support for capacity building on diagnose, surveillance, and quarantine
towards the implementation of WHO's IHR in developing countries
The Government of Japan will make efforts to build the capacities ofdiagnose, surveillance, and quarantine to implement WHO's IHR in developing
countries through support the GHSA 9 framework and through capacity
building and networking of research institutions and hub organizations Japan
has been assisting thus far.

￮Support for health systems strengthening through the Global FundThe Government of Japan will promote its assistances for strengthening ofhealth systems in developing countries through cooperation with the Global
Fund, other international organizations and other donors. To that end, theGovernment of Japan will promote wider utilization of human resources who
were developed through the Global Fund's vertical programs that place anemphasis on measures against three specific diseases.

￮

Support for the recovery of health systems after an outbreak
The Government of Japan will provide support that contributes to therecovery of health systems after an outbreak through technical assistance,
including the dispatch of experts, as well as provision of emergency grant aid,
emergency aid supplies, contributions, and funds and materials to internationalorganizations.

(iv) Considering the construction of a system for the timely dispatch of personnel toaffected countries
The Government of Japan will consider the construction of a system for thetimely dispatch of personnel to requesting countries where a pandemic has been
occurred through construction of a new system for dispatching Japan Disaster
Relief Team, and cooperation with international organizations in light of thestatus of personnel assistance provided by developed countries to the threeaffected countries in West Africa experiencing the outbreak of Ebola Virus
Disease.
9

Global Health Security Agenda: The Agenda was advocated by the United States to strengthen theimplementation of WHO's IHR (International Health Regulations) in cooperation with othercountries, FAO (UN Food and Agriculture Organization), and OIE (UN World Organization for
Animal Health) for the purpose of improving each country's ability to take measures against
infectious diseases.
13￮Considering a framework for dispatching the Japan Disaster Relief Infectious
Diseases Response TeamThrough the experience of the outbreak of Ebola Virus Disease, theGovernment of Japan will consider a framework for dispatching the Japan
Disaster Relief Infectious Diseases Response Team as well as for securing andtraining human resources and procuring, maintaining, and managing materials
and equipment necessary for dispatching the team.

￮Promoting cooperation with WHO and other international organizations
The Government of Japan has dispatched experts through the frameworkof WHO in response to the spread of Ebola Virus Disease. The Government ofJapan will also continue to work with WHO and other internationalorganizations to ensure the timely and appropriate dispatch of human resources.

￮

Exploring measures to develop a system for responding to a case of infected
Japanese personnel overseas
The Government of Japan will explore measures to develop a system for
responding to a case of infected Japanese personnel overseas, including on-site
response and transportation to Japan, in order to minimize their health damageand ensure their safety.

(v)

Enhancing domestic ability to collect and analyze overseas information for the
purpose of improving risk assessment for infectious diseases for Japan’s own
security
Building on the overseas information gathering and analysis by otherdeveloped countries and international organizations during the outbreak of theEbola Virus Disease, the Government of Japan will enhance the ability to collectrelevant information on infectious diseases through strengthening cooperation
with international organizations such as WHO and public health research
institutes in other countries such as the CDC of the United States. Furthermore,
the Government of Japan will consider measures to strengthen the capacity of
the National Institute of Infectious Diseases such as testing and to further
improve Japan's capacity of risk judgment concerning emerging infectious
diseases.

14

(vi) Making contribution to the construction of a new framework for global healthgovernanceIn relation to the construction of an international response framework that
can immediately respond to emergencies, the Government of Japan will makeactive contributions and attempt to lead related discussions throughstrengthening of collaboration and cooperation with WHO, World Bank, other
UN organizations, donor countries and private NGOs and support for
implementation of the IHR, taking into account the fact that Japan will host G7
Ise-Shima Summit in 2016. In doing so, the Government of Japan will also
contribute to discussions at the UN High-level Panel on Global Response to
Health Crises and various other related discussions regarding the desirable
division of roles, and will use the results of such discussions as a reference.
（2） Developing testing and research systems on high-risk pathogens of infectious
diseases in Japan
In relation to the testing and research systems on high-risk pathogens, theGovernment of Japan will strengthen a system for implementing testing at the
National Institute of Infectious Diseases and develop systems for improving
basic research capacity of universities and other research institutes in light of
responses to this spread of Ebola Virus Disease. The Government of Japan as awhole will further improve the capability for crisis management in light ofdiscussions concerning desirable future BSL4 facilities in Japan.
(i) Strengthening the testing system at the National Institute of Infectious Diseases
The National Institute of Infectious Diseases will make efforts to dispel
worries and concerns among near-by residents in the neighborhoods bypromoting active information disclosure and communication with local
communities, and will establish a system that ensures safety implementation ofoperations at advanced safety testing and inspection facilities (BSL 4).
(ii) Strengthening infectious disease research function by developing systems for
improving the basic research capabilities and human resources development atuniversities and other research institutes
The Government of Japan will strengthen the infectious disease researchfunction by forming an infectious disease research center with BSL 4 facilities as
the core by installing the latest equipment that enables analysis of pathogens,15

animal experiments, development of treatment methods and vaccines, and otherresearch and development activities, in order to improve the basic research
capacity of universities and other research institutes and develop and secure
human resources who are acquainted with the handling of high-risk pathogens.
(iii) Considering how to designate BSL 4 facilities in JapanThe necessity of setting up BSL 4 facilities at places where a scientific basis
has been established and constructing multiple BSL 4 facilities in geographicallydistant areas in preparation for the possibility of the facilities becoming
inoperable due to an earthquake or other natural disaster, and the need for thenational government to take responsibility for the operation and management of
BSL 4 facilities was pointed out in the recommendation 10 of the Science
Council of Japanin March 2014.
The Government of Japan as a whole will improve its crisis management
capacity in relation to infectious diseases by considering desirable placement
and roles of BSL 4 facilities in Japan from the perspective of safety at the timeof an outbreak of an infectious disease, development of a testing system, andpromotion of research and development from a medium- and long-term
standpoint in light of the actions of developed countries and the aforementioned
opinions of intellectuals in Japan.
(iv) Promoting research and development relating to infectious diseases
The Government of Japan will collect necessary epidemiological information
to protect the people's health and conduct risk assessment based on the "Plan for
Promotion of Medical Research and Development (approved by the
Headquarters for Healthcare Policy on July 22, 2014). The Government of Japan
will also promote basic and clinical research relating to emerging andre-emerging infectious diseases with the aim of creating medicines, diagnostic
agents, and vaccines in Japan. In addition, the Government of Japan will
strengthen the foundation for measures against infectious diseases by promotinginternational joint research through strategic development of the Science andTechnology Research Partnership for Sustainable Development.

10

Recommendation "Necessity of BSL 4 Facilities in Japan" (March 20, 2014; Joint Comprehensive
Microbial Sciences Sectional Committee of the Committee on Basic Biology, the Committee on
Integrative Biology, the Committee on Agriculture, the Committee on Basic Medicine and theCommittee on Clinical Medicine of the Science Council of Japan)
16

（3） Ways to strengthen the foundation of Japanese human resources involved inmeasures against infectious diseases who take an active role in the international
community
The Government of Japan will study the ways to scale up the quality andquantity of the foundation of human resources involved in measures against
infectious diseases who can also take active role in the international communityfrom a medium- to long-term standpoint, in light of the status of dispatch ofhuman resources from other countries in the spread of Ebola Virus Disease.
(i) Promoting human resources development through the Infectious Disease
Emergency Specialist Training Program and other measures
The Field Epidemiology Training Program Japan (FETP-J) provided by the
National Institute of Infectious Diseases will be continuously conducted, and theMinistry of Health, Labour and Welfare will lead the building of a network oforganizations related to infectious disease crisis management (quarantine stations,
the National Institute of Infectious Diseases, the National Center for Global
Health and Medicine).The Government of Japan will promote human resources
development by training specialists in infectious disease crisis management who
have acquired sufficient expertise to conduct management of infectious disease
control on an international basis through steady implementation of the Infectious
Disease Emergency Specialist Training Program, which was newly set upin
April 2015, and other measures.
(ii)

Considering the development of a human resource registration system for Japan
Disaster Relief TeamWith regard to the system for dispatching the Japan Disaster Relief Infectious
Diseases Response Team, which will be newly set up in Japan Disaster Relief
Team, the Government of Japan will consider developing a system toappropriately register members of the Japan Disaster Relief Medical Team, those
who registered with WHO's GOARN, and those who completed the Infectious
Disease Emergency Specialist Training Program provided by the Ministry of
Health, Labour and Welfare, among others.

(iii)

Developing human resources to improve the ability to address emerging
infectious diseases at the Japan Self-Defense Forces and establishing aframework including the National Defense Medical College
17The Government of Japan will promote the improvement of the ability toaddress emerging infectious diseases at the Ministry of Defense and the Japan
Self-Defense Forces by training human resources who have expertise that isnecessary to contribute to the Japan Self-Defense Forces' overseas activities andby accelerating the establishment of a framework that includes the National
Defense Medical College.
(iv)

Studying methods to scale up the quality and quantity of domestic humanresources involved in measures against emerging infectious diseases
Human resources who engage in measures in the case of an outbreak inJapan and human resources who can be dispatched overseas in the case of an
outbreak overseas (including those who engage in the arrangement andmanagement of logistics and evacuation) are necessary as domestic humanresources to engage in measures against emerging infectious diseases. The
Government of Japan will identify the current circumstances of such humanresources and will also study the methods and strategies to scale up the quality
and quantity of such human resources, as well as the role Japan should play andthe training and registration of such human resources, from a medium- tolong-term standpoint.

（4）

Strengthening the domestic measures on infection prevention and the safetymeasures for Japanese nationals overseas
Given the spread of infectious diseases such as the Ebola virus diseases inWest Africa, the Government of Japan will continue to strengthen the domestic
measures on infection prevention and the safety measures for Japanesenationals overseas from the perspective of crisis management.

(i)

Promoting provision of information on infectious diseases in Japan to thepeopleThe Government of Japan strengthened the system for collecting
information on infectious diseases by stipulating in the revised Infectious
Diseases Act enacted in November 2014 that prefectural governors may
request all infected patients to agree to the collection of specimens, etc. andmay also request medical institutions to submit the specimens they possess.
Taking into account that this revised Infectious Diseases Act will come into
force on April 1, 2016, the Government of Japan will collect and analyze
18information on infectious diseases in Japan and will also promote provision of
information, including measures to be taken in the case where an infection is
confirmed, to the populace by utilizing various media.
(ii)

Improving the ability to address emerging infectious diseases of quarantine
stations and other related organizations
In light of the spread of Ebola Virus Disease, the Government of Japan willcontinuously promote the improvement of the ability to address emerging
infectious diseases of quarantine stations, local governments, public healthcenters, prefectural and municipal public health institutes, medical institutions,the police, fire departments, and other organizations by continuously
implementing training and by developing necessary equipment.

(iii) Developing designated medical institutions for specified infectious diseases
It is important to develop an appropriate medical system in order to address
infectious diseases that occur in Japan. Therefore, the Government of Japan willcontinue to aid the operations of designated medical institutions for Type I
infectious diseases and designated medical institutions for Type II infectious
diseases, and will also promote elimination of cases where prefectures have notyet established a designated medical institution for Type I infectious diseases.
(iv) Developing policies for responses to Type I infectious diseases at medical
institutions and administrative agencies.
As Japan has almost no experience in relation to Type I infectious diseases,
it is necessary for healthcare professionals to share guidelines for diagnosis andtreatment in advance. Therefore, the Government of Japan will develop policies
for responses to Type I infectious diseases at administrative agencies in light ofJapan's response to the spread of Ebola Virus Disease in West Africa.
(v)

Securing the quarantine system at quarantine stations and responses in the casewhere an infection (including a suspected infection) has been confirmed in JapanThe Government of Japan will continue to secure the quarantine system as ameasure based on its past experience and as a response when a suspected patientis confirmed in Japan. In addition, the Government of Japan will promotesecuring of related organizations' coordinated responses, including transportationof a patient to a medical institution and delivery of a specimen, through19

implementation of training in preparation for the situation where the first casewill be confirmed in Japan.
(vi) Ensuring the provision of timely and appropriate information and traveladvice/warning on infectious diseases to Japanese nationals overseas
The Government of Japan will advise/warn Japanese nationals abroad byproviding timely and appropriate information through websites and consulare-mails of overseas establishments. Depending on the situation of the outbreak,the Government of Japan will issue the travel advice/warning on infectious
diseases to suggest taking safety measures and consider evacuation, and also callupon future travelers to postpone their travel in order to assure their safety.
(vii) Strengthening safety measures such as medical evacuation
In case of infection, relevant Ministries and Agencies will coordinate andstrengthen cooperation to assure the safety of Japanese nationals through every
measure possible such as treatment on site or medical evacuation to a third
country or Japan, in order to provide Japanese nationals abroad with the best
medical treatment, taking into all account the doctor's judgment and thepreference of the patient.
(5) Promotion of measures against Antimicrobial Resistance（AMR）
In order to facilitate and strengthen domestic measures as well asinternational cooperation against Antimicrobial Resistance （ AMR ） , theGovernment of Japan will formulate a comprehensive action plan and aim for its
promotion under the cooperation of relevant ministries and agencies.
4. System to promote next step
Regarding the matters advocated in the Basic Guidelines, the Government ofJapan will promote efforts by strengthening cooperation among related ministries andagencies through establishment of a framework for liaison and coordination among
them under this Ministerial Meeting. In addition, this Ministerial Meeting will formulate
an action plan, including a process schedule chart, based on the Basic Guidelines in the
future.
This Ministerial Meeting will strategically carry forward formulation of an action
plan while obtaining the advice and wisdom of experts from a technical perspective.
In addition, in formulating an action plan in the future, the government of Japan
will consider the content thereof in anticipation for G7 Ise-Shima Summit in 2016.

20