Action Plan for Strengthening Measures on Emerging Infectious Diseases～Japanese actions challenging continuous threats of infectious diseases～
February 9, 2016
Ministerial Meeting on Measures on Emerging Infectious Diseases
Index
I．Introduction ……………………………………………………………………………2
II．Basic Concept…………………………………………………………………………5○ Purpose of formulating the Action Plan
○ Summary of the Action Plan
○ Ideal shape for Japan
III．Prior [[see note on p. 7]] Projects (Measures)…………………………8

1. Project for strengthening measures to tackle international infectious diseases indeveloping countries
2. Project for developing and dispatching human resources to take charge of measures totackle international infectious diseases
3. Project for strengthening crisis management system of infectious diseases
4. Project for promoting research system of infectious diseases
5. Project for strengthening domestic ability to address infectious diseases
IV．Individual Sectorial Measures ……………………………………………………20
1. Promoting international cooperation
2. Developing examination and research systems for high-risk pathogens involved in
infectious diseases in Japan
3. Developing the foundation of Japanese human resources involved in measures to tackle
infectious diseases taking an active role in the international community
4. Strengthening domestic measures on infection prevention and the safety measures forJapanese nationals overseas
V．Promotion of Measures based on this Action Plan ………………………………29(Annex) Process Schedule Chart1

I. Introduction
The recent spread of Ebola Virus Disease in West Africa not only had a significant
impact on people's daily lives and economic activities in the countries concerned but also
had a major impact on and caused fear in the international community. There is a possibility
that an emerging infectious disease just like this will occur also in the future.
Regarding Middle East Respiratory Syndrome (MERS), whose outbreaks have been
confirmed mainly in countries in the Arabian Peninsula, this disease was spread in South
Korea in May 2015; and spread in the developed countries. This has reminded Japan of thenecessity of further strengthening national systems as our own challenges.
Based on various lessons learned from this issue in West Africa, and developments in
the international community, the Government of Japan newly established a "Ministerial
Meeting on Measures on Emerging Infectious Diseases" (Verbal understanding, in thecabinet meeting of September 11, 2015) (hereinafter referred to as "the Ministerial
Meeting") which is presided over by the Prime Minister; and approved the "Basic
Guidelines for Strengthening Measures on Emerging Infectious Diseases" (hereinafterreferred as to "the Basic Guideline") in the Ministerial Meeting of September 11, 2015, inorder to effectively and comprehensively promote measures to tackle emerging infectious
diseases with the close cooperation and supervision of relevant administrative organizations.
Also, the Headquarters for Healthcare Policy approved the "Basic Design for Peace and
Health" on the same day.
Then, the "Team for Promoting Measures on Emerging Infectious Diseases" (approvedby the Ministerial Meeting on Measures on Emerging Infectious Diseases on September 11,2015) (hereinafter referred to as "the Promotion Team") which had been established under
the Ministerial Meeting convened on October 22, 2015 to start the discussion forformulating an action plan. This was in accordance with the Basic Guideline that says "thisMinisterial Meeting will formulate an action plan, including a process schedule chart, basedon the Basic Guidelines in the future."
In addition, the "Sub-Team of Team for Promoting Measures on Emerging Infectious
Diseases" (approved by the Team for Promoting Measures on Emerging Infectious Diseases
on October 22, 2015) was established under the Promotion Team to discuss practical issues
about cross-ministry important matters among relevant ministries and agencies. This
sub-team has had under consideration such fields as promoting of international cooperation,
the promotion of domestic examination and research systems, and the development andutilization of human resources, holding discussion in these areas while obtaining manypieces of advice from experts, private companies, and NGO/NPOs from technical and broad
perspectives.
2Moreover, regarding the worldwide spread of Antimicrobial Resistant (AMR) bacteria,
the Global Action Plan for antimicrobial resistance was adopted in the assembly of World
Health Organization (WHO) in May 2015; and this issue was picked up in the G7 Elmau
Summit 1, held on June 7 and 8, 2015; and the further strengthening of measures to tackle
antimicrobial resistance was required also at G7 Berlin Health Ministers' Meeting in
October 2015. Therefore, in order to address internationally-spread infections with resistantmicrobial resistant bacteria under and with the cooperation of relevant ministries andagencies the "Antimicrobial Resistance Review Meeting" (approved by the head of Teamfor Promoting Measures on Emerging Infectious Diseases on December 24, 2015) 2 wasestablished to formulate the action plan for promoting measures to tackle AMR anddiscussion for promoting these efforts in Japan.
Regarding Zika Virus Disease, that continues to spread in Latin America, WHOdeclared a "Public Health Emergency of International Concern (PHEIC) 3" in the light of thefrequent occurrence of microcephaly, on February 1, 2016. In response to the declaration,
the Government of Japan established the "Relevant Ministries and Agencies Meeting on
Measures on Zika Fever" (approved by the head of Team for Promoting Measures on
Emerging Infectious Diseases on February 2, 2016 (Hereinafter referred to as "the Relevant
Ministries and Agencies Meeting") under the Promotion Team in order to comprehensively
promote the measures while securing close cooperation among relevant ministries andagencies.
Further, various international discussions on global response against epidemic haveproceeded. At the G7 Elmau Summit, which was held in June 2015, the goal that "we will
coordinate to fight future epidemics" was included in the Leaders' declaration. Series ofother meetings were held such as the "The United Nations summit for the adoption of the2030 Agenda for Sustainable Development" (on September 25-27, 2015); "Side Event in the70th Session of the United Nations General Assembly 'The Path towards Universal Health
Coverage (UHC)'" (on September 28, 2015); the G7 Berlin Health Ministers' Meeting (onOctober 8 and 9, 2015); the 70th WB/IMF Joint Annual Discussion (on October 9, 2015);
and the third WHO financial dialogue (on November 5 and 6, 2015).
On December 16th 2015, Japan hosted the international meeting on Universal Health
Coverage (UHC) 4, entitled "Universal Health Coverage in the New Development Era:

1

Annex to the Leaders' Declaration also includes "Cooperative Efforts against Antimicrobial Resistance"
Antimicrobial Resistance Review Meeting (http://www.kantei.go.jp/jp/singi/kokusai_kansen/)
3 Public Health Emergency of International Concern
4 Universal Health Coverage (UHC): This is the ability of all people worldwide to access and receive basic healthservices when they need it throughout their lifetimes at an affordable cost.
2

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Towards Building Resilient and Sustainable Health Systems" 5.
On December 12th, Japan expressed its commitment to continuously contribute to
global health through the Ise-Shima Summit in May 2016, of which Japan is the hostcountry in the article by Prime Minister Shinzo Abe in the Lancet titled "Japan's vision for apeaceful and healthier world" 6.
Since the countries, international institutions, and NGOs which take local actions were
not sufficiently coordinated in response to the current Ebola Virus Disease epidemic in West
Africa, the effective collaboration between organizations which are necessary to response toinfectious disease crisis in the future or so-called Global Health Governance (GHG), hasbeen internationally discussed at various opportunities 7; and the report by the High-level
Panel on the Global Response to Health Crisis of the UN is scheduled to be published soon.
"Combat HIV/AIDS, malaria and other diseases", which is one of the "Millennium
Development Goals" (MDGs) 8 adopted by the UN in 2000 showed significant
improvement; 9 and in the "2030 Agenda for Sustainable Development" (SDGs) 10 adopted
by the UN development summit in September 2015 includes a goal to "end the epidemics ofAIDS, tuberculosis, malaria, and neglected tropical diseases (NTDs) 11 and combat hepatitis,
water-borne diseases, and other communicable diseases by 2030".
Incidentally, "reduce child mortality by two thirds" which is one of the MDGs was notachieved and is now included in the new goals to SDGs as "end preventable deaths of5"Universal Health Coverage in the New Development Era: Towards Building Resilient and Sustainable Health
Systems" was jointly hosted by Japan Center for International Exchange, the Ministry of Foreign Affairs, theMinistry of Finance, the Ministry of Health, Labour and Welfare, and JICA and held in Tokyo on December 16,
2015. About 300 people such as government officials, representatives of international institutions, and private
experts, participated and held discussions.
6 The article by Prime Minister Shinzo Abe in the Lancet, "Japan's vision for a peaceful and healthier world"(Website of the Ministry of Health, Labour and Welfare) (http://www.mhlw.go.jp/stf/houdou/0000106535.html)
7 Reports were each published by the "Independent Panel on the Global Response to Ebola" in the London School ofHygiene and Tropical Medicine and Harvard Global Health Institute on November 22, 2015, and by the National
Academy of Medicine on January 13, 2016.
8 Millennium Development Goals (MDGs): The Millennium Declaration adopted by the United Nations Millennium
Summit held in New York in September 2000, and international development goals adopted in main international
meetings or summits held in 1990s were integrated into this common framework, which was adopted in 2001. Eightgoals to be achieved by 2015 are set with numerical targets: (i) Eradicate extreme poverty and hunger, (ii) Achieve
universal primary education, (iii) Promote gender equality and empower women, (iv) Reduce child mortality, (v)Improve maternal health, (vi) Combat HIV/AIDS, malaria and other diseases, (vii) Ensure environmental
sustainability, and (viii) Develop a global partnership for development.
9 It is estimated that infectious diseases of HIV/AIDS were reduced by about 40% in the world between 2000 and2013, and that more than 6.2 million lives were saved from malaria in the world between 2000 and 2015.
10 International goals from 2016 to 2030 decided by UN as a successor of MDGs. Sustainable Development Goals(SDGs) consisting of 17 goals and 169 targets were newly formulated in order to address remaining issues of
MDGs (e.g. health and education) and issues that newly became evident (e.g. environment and widening gaps). It
was agreed in the UN General Assembly in September 2015.
11 Neglected Tropical Diseases (NTD): WHO lists 17 diseases such as Dengue, leishmaniasis, Chagas disease, andschistosomiasis. (http://www.who.int/neglected_diseases/diseases/en/)
The Hashimoto Initiative in G8 Denver Summit in 1997 led the world to realize them, and the importance of NTDs
measures as was confirmed also in G7 Elmau Summit in 2015.

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newborns and children by 2030" 12.
In December 2015, Satoshi Ōmura, Emeritus Professor at Kitasato University, wasawarded the Nobel Prize for his discovery of raw materials of drugs for Onchocerciasis(River Blindness), which is a neglected tropical disease, and Lymphatic Filariasis(elephantiasis). His award reminded Japan that it should continuously make a persistentcontribution to fields in which it enjoys a competitive advantage such as medicines as well
as being the pride for Japan.
Based on the international trends as mentioned above, "Action Plan for Strengthening
Measures on Emerging Infectious Diseases" (hereinafter referred to as "the Action Plan")has been compiled it aims to strengthen international cooperation and domestic measures,
while leading international discussion as the Presidency for the G7 in 2016; and its
comprehensive and effective promotion is being strongly carried forward under close
cooperation among relevant administrative organizations.
II. Basic Concept(Purpose of formulating the Action Plan)
In the light of lessons learned from the spread of Ebola Virus Disease in West Africa
and the actions taken by developed countries and the international institutions, Japan lists
the following basic directions for future measures:(1) Integrated promotion of international response to and domestic measures to tackle
international infectious diseases(2) Strengthening of Japan's contribution and role in countries and regions where aninternational infectious disease has occurred(3) Strengthening of the crisis management system through improvement of the domestic
capacity to address international infectious diseases
Based on these basic directions, priority matters to be strengthened in Japan are shown as
follows:(i) Strengthening international cooperation and collection of overseas information(ii) Developing testing and research systems for high-risk pathogens involved in infectious
diseases in Japan(iii) Ways to strengthen the foundation of Japanese human resources involved in measures
to tackle infectious diseases who take an active role in the international community
12

Regarding "reduce child mortality" which is one of MDGs, the under-five mortality rate (per 1,000 people) in theworld was reduced by more than half from 90 people as of 1990 to 43 people in 2015. However, the goal to"reduce child mortality by two thirds" was not achieved.

5

(iv) Strengthening domestic measures on infection prevention and the safety measures forJapanese nationals overseas
It is necessary to carry forward efforts on these priority matters to be strengthened in a
concrete and steady manner under close cooperation among relevant administrative
organizations in the future.
(Summary of the Action Plan)
In the Action Plan for Strengthening Measures on Emerging Infectious Diseases,
the Government of Japan designates the coming five years as the planning period (byFY 2020) based on the Basic Guideline, presents an ideal shape for Japan, lists fiveprior [[NOTE: prior means ‘first’, priority’ means ‘main’, also see p.1. Possibly ‘main’ or‘general’ or ‘overall’ measures or you could say ‘main or overall’ measures. Another word
for prior measures’ is ‘initiatives’ that could be it]] projects (measures) and 67 individual
sectorial measures, carries forward efforts based on these, and thereby ensures thepeople's security and safety while fulfilling its responsibility and role in theinternational community in a steady manner.
(The Goals Japan Aims At)
The Government of Japan lists the following four points in the light of international
infectious diseases as the ideal shape for Japan, considering lessons from the spread ofEbola Virus Diseases in West Africa and cooperating with international institutions andrelevant countries from the perspective of "Human Security" 13 which Japan has
insisted on at various opportunities, as well as leading a role in the international
community, and promoting the measures listed in the Action Plan for theirachievement.
(a) The international community having a mechanism for the capacity to take promptand effective actions through the cooperation of various international institutionsin infectious disease crises
13

Human Security: Concept to focus on every single person, protect him/her from critical and pervasive threats tohuman lives, livelihood and dignity, and facilitate sustainable self-reliance and communities through protection andempowerment in order to develop human potential, under the situation where globalization had led issues such as
poverty and infectious diseases to critically affect human life and livelihood across borders. In the international
community, the Human Development Report 1994 of UNDP was the first to officially pick up the concept of Human
Security. Then Prime Minister Mori declared that Japan made Human Security one of the pillars of its diplomacy.
After that, former prime ministers proposed Human Security at various opportunities such as the World Economic
Forum Annual Meeting (Davos), Japan-Pacific Islands Forum (PIF), and TICAD.
Recently, Prime Minister Abe mentioned this at "The United Nations summit for the adoption of the 2030 Agenda for
Sustainable Development", "Side Event in the 70th Session of the UN General Assembly 'The Path towards UHC'",and the "international meeting on UHC".

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Considering lessons from the spread of Ebola Virus Diseases in West Africa,
the Government of Japan will aim to furnish the international community with amechanism in which affected countries, donor countries, and various international
institutions such as WHO and UN organizations can organically coordinate witheach other and take prompt and effective actions in cooperation with NGOs, so as toprevent, detect and contain infectious diseases at an early stage in the affected
countries to stop the spread of infectious disease crises. [[Note: ‘a mechanism’ refers
to a specific mechanism that is proposed that someone might ask about,‘mechanisms’ is more general, so ‘ a mechanism’ would mean one identifiable real
way of doing this, an identifiable proposal]](b) A strengthened and developed international community to enable health system indeveloping countries to respond to infectious disease crisis
The Government of Japan will make an active and concrete contribution to
help the strengthening health systems including a response to the spreading
infections with resistant bacteria for developing countries having vulnerable basic
health and medical service systems, in order to improve preparedness in ordinary
times to appropriately respond to infectious disease crisis.
(c) Asia-Pacific and Africa capable of appropriately responding to infectious diseasecrisis through Japan's leading efforts
Japan will promote the leading efforts specifically in Asia Pacific and makeactive contribution in Africa through TICAD VI14 regarding (a) the construction ofa mechanism to respond to infectious disease crisis and (b) strengthening anddevelopment of health systems.
(d) Japanese community with established systems related to measures to tackle
infectious diseases
The Government of Japan will establish domestic systems such as health andmedical service systems, examination and research systems related to infectious
diseases, and the foundation of human resources to respond to infectious diseases,
recognizing that measures to tackle infectious diseases are the important
prerequisite for the realization of the Japanese growth strategy also with the
14

TICAD (Tokyo International Conference on African Development) is an international meeting fordevelopment in Africa the Government of Japan has led and jointly held with the United Nations /UNDP, the African Union Commission (AUC), and the World Bank. TICAD VI, the sixth meeting, will
be held in 2016 in Africa for the first time.

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perspective of Japan sufficiently playing a role in measures to tackle infectious
diseases in the international community and the MERS economic effects 15 in
Korea.

III. Prior Projects (Measures)
Regarding the strengthening of measures to tackle emerging infectious diseases, thefollowing five matters are positioned as prior projects, which are specific measures to be
strategically carried forward under the coordination and cooperation of relevant
administrative organizations, and relevant measures to be integrally and strongly promoted.
1. Project for strengthening measures on infectious diseases in developing countries(1) Making a leading contribution to the construction of a new framework for global healthgovernance○

The government will lead international discussion as the G7 Presidency in 2016 on
desirable Global Health Governance to control infectious diseases, specifically, of theroles of international institutions and the mechanism for treatment related to future
response to infectious disease crisis, in light of the response of international institutions
to the spread of Ebola Virus Diseases in West Africa and reports of the UN High-level
Panel; and support WHO reform for strengthening the command line in WHO for
response to and preparation for public health emergencies.

○

In doing so, the government will carry forward discussion and adjustment to compile
guidelines on role divisions of international institutions according to the scale of15

Economic loss due to the spread of Ebola Virus Diseases and MERS

○ Economic loss due to spread of Ebola Virus Diseases in West Africa
Unit: 1 billion US dollars
Economic loss (※1)

2015

2014
0.359
(GDP ratio 2.4%)(※2)(Low expectation)(High expectation)

0.129

0.815

○ Economic loss due to outbreak and spread of MERS in South Korea
As of the end of July, 2015
Economic loss expectation (※3)
9.3377 trillion won (※4) (GDP ratio 0.61%) (※2)(※1) The Economic Impact of the 2014 Ebola Epidemic: Short and Medium Term Estimates for Guinea, Liberia, andSierra Leone. WORLD BANK, October 7, 2014(※2) Estimation from World Economic Outlook Database,IMF,April,2015(※3) Korea Economic Institute "Estimation Report on Economic Loss from MERS" (June 2015)(※4) About 995.4 billion yen (in July 30, 2015 rate)○ If infectious diseases just like the one in Korea were to spread in Japan, which caused the economic loss to thesame extent, the economic loss would be about 3 trillion yen (≒ Japanese GDP is about 489.6 trillion yen (※5) ×
0.61％)) according to rough estimation based on the above Korean economic loss.
(※5) Nominal GDP on the "System of National Accounts" (Cabinet Office) in TY 20148

infectious disease and the response capacity of affected countries; a coordination
mechanism of international institutions, donor/developing countries, and NGOs topromptly and effectively deliver human resources/materials/funds to the field which
requires support; measures for securing explanation responsibility and accountability;
systems for facilitating research and development (R&D); and support measures fordeveloping countries to strengthen health systems.
○

The government will continue to play an active role so as to develop a concrete system
to make an international response sufficiently function even after G7 Presidency, basedon these fundamental concepts. 【The Cabinet Secretariat, the Ministry of Foreign
Affairs, the Ministry of Finance, and the Ministry of Health, Labour and Welfare】(2) Make contribution to the construction of expeditious finance mechanisms for
emergencies through the joint efforts of the Contingency Fund for Emergency of WHO
and the Pandemic Emergency Financing Facility (PEF) of the World Bank○

Regarding the "Contingency Fund for Emergency" (CFE) 16 of WHO and "Pandemic
Emergency Financing Facility" (PEF) 17 of the World Bank which function as a financemechanism in infectious disease crisis, the government will make active contribution to
the WHO's strengthening of emergency responses through support to CFE and make anappropriate contribution as Japan to the launch of the PEF. In doing so, it is important tocomplementarily function without duplication and therefore the government will make acontribution to discussion between both organizations to realize this by expressing
Japan's view at various opportunities under coordination with relevant ministries andagencies so as to make smooth the adjustment between WHO and World Bank. 【TheCabinet Secretariat, the Ministry of Foreign Affairs, the Ministry of Finance, and theMinistry of Health, Labour and Welfare】

16

Contingency Fund for Emergency (CFE): It was approved to be founded in the WHO executive board in January
2015 to enable WHO's quick initial response to an outbreak of an infectious disease or another emergency,
considering the delay of funding and adjustment restrictions on flexible use of funds in the spread of Ebola Virus
Diseases in West Africa (The fund scale is 1 million US dollars). Japan posted 1.2 billion yen as its contribution to
the fund in the TY 2015 supplementary budget. As of now, the countries which expressed contribution to the fundare the UK (10 million US dollars), China (2 million US dollars), France (1.3 million Euro), Germany (1 million
Euros), and India (1 million US dollars).
17 The Pandemic Emergency Financing Facility (PEF): New fund mechanism for pandemic response using private
insurance scheme, which the World Bank is considering in light of the lessons from Ebola Virus Disease. It is amechanism for funding if certain requirements are met when the infectious disease spreads regardless of the initial
response of WHO by using CFE, and the initiative of World Bank which constructs PEF is supported also in the
G7 Elmau Summit Leaders' declaration in June 2015. In the mechanism, the fund for PEF is scheduled to be
distributed to international institutions including WHO and non-governmental organizations in addition to affected
countries.

9(3) Setting up a public-private partnership platform involved in measures to tackle
infectious diseases in developing countries (provisional name)○

The government will set up a "public-private partnership platform involved inmeasures to tackle infectious diseases in developing countries (provisional name)"(hereinafter referred to as the "public-private partnership platform") from the perspectiveof making further contribution to international measures to tackle infectious diseases inpublic-private cooperation between the Japanese medical industry with advanced
medical technology and the Government of Japan together with various international
institutions and developing new markets of Japan's medical industry. 【The Cabinet
Secretariat, the Ministry of Foreign Affairs, and the Ministry of Health, Labour andWelfare】○

The public-private partnership platform consists of relevant ministries and agencies,
Japan International Cooperation Agency (JICA), Japan Agency for Medical Researchand Development (AMED) 18, and domestic organizations related to drugs and medical
equipment; and if necessary, requests participation of organizations such as the Global
Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), Global Health Innovative
Technology Fund (GHIT Fund) 19 , and Gavi, the Vaccine Alliance 20 . The platform
discusses and explores the possibility of providing materials and equipment such as
medicines, diagnostic agents, vaccines, and protective equipment

to developing

countries, its effective and continuous provision methods, desirable delivery systems
including technical support of materials and equipment, and desirable coordination
between relevant organizations involved in this support in the field while collecting
information on health needs surrounding infectious diseases in developing countries; andmakes the relevant organizations smoothly implement them. 【The Cabinet Secretariat,
the Ministry of Foreign Affairs, and the Ministry of Health, Labour and Welfare】(4) Promotion of prompt and smooth supply of medicines to developing countries○

The government will jointly formulate guidelines to harmonize regulations on
medicines in the International Conference on Harmonization of Technical Requirements
for Registration of Pharmaceuticals for Human Use (ICH), in which the regulatory

18

Japan Agency for Medical Research and Development (AMED)
Global Health Innovative Technology Fund (GHIT Fund)
20 Gavi, the Vaccine Alliance (Gavi): Public-private partnership established for the purpose of protecting child lifeand people's health by improving immunization rates in developing countries. Pharmaceutical industries, private
foundations, and civil societies have participated in addition to government donors developing country governments
and relevant international institutions.
19

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authorities of Japan, US, and Europe have participated; and disseminate the guidelines toforeign countries based on the International Pharmaceutical Regulatory Harmonization
Strategy toward smooth supply of infectious disease medicines developed in Japan.
【The Ministry of Health, Labour and Welfare】○

The government will attempt this prompt development by utilizing the SAKIGAKE
Designation System (preferential designation, for examination) and the designation of
medicines as priority face-to-face advice products by the Pharmaceuticals and Medical
Devices Agency (PMDA) in the development and approval of innovative medicines for
infectious diseases; and develop a smooth supply system for the medicines even in
emergency by concluding an agreement with recipient countries. 【The Ministry of
Health, Labour and Welfare】○

The government will promptly discuss and implement support measures and supply
systems for clinical research in the "Development Promotion Team" (relevant ministries
and agencies, AMED, PMDA, GHIT Fund, and the medicine makers) established under
the public-private partnership platform regarding the medicines required for emergent
development in infectious disease crisis. 【The Cabinet Secretariat, the Ministry ofForeign Affairs, and the Ministry of Health, Labour and Welfare】○

The government will discuss and adjust a series of Japan's products and technologies
from diagnosis to treatment and prevention involved in measures on various infectious
diseases in the public-private partnership platform, make packaging 21 , andinternationally deploy products "from Japan". 【The Cabinet Secretariat, the Ministry ofForeign Affairs, and the Ministry of Health, Labour and Welfare】○

In the PMDA "Asia Training Center for Pharmaceuticals and Medical Devices
Regulatory Affairs" established in April 2016, the government will actively provide
Japan's knowledge and adverse-effect information of medicines for infectious diseases
developed in Japan according to the needs of Asian regulatory authorities, and support
appropriate use of medicines for infectious diseases in Asian countries. 【The Ministryof Health, Labour and Welfare】(5) Strengthening of measures to tackle infectious diseases in developing countries by
21

For example, it promotes efforts to make the packaging of diagnostic methods, testing methods for resistance, andmedicines which pharmaceutical companies are each developing, as an effective combination.

11

strengthening cooperation with international institutions
The measures to tackle infectious diseases will be strengthened in developing countries
by strengthening the following cooperation with international institutions.
(5)-1 Support for measures to tackle the three major infectious diseases through the Global
Fund○

The discussion at the Kyushu-Okinawa Summit in 2000 hosted by Japan paved theway for the establishment of "Global Fund to Fight AIDS, Tuberculosis and Malaria(Global Fund)" in 2002, which is a financing institution to fight the three major
infectious diseases of AIDS, tuberculosis and malaria. Its strategy 2012-2016 set a goal
to save 10 million lives. Japan continues to support the Fund during the 4th
replenishment period (2014-2016) in order to realize prevention, treatment and care forthe three major infectious diseases as well as promotion of the strengthening of thesystems for health in the developing countries without delay. 【The Ministry of Foreign
Affairs】○

The 5th voluntary Global Fund replenishment conference is scheduled to convene in2016. Taking into consideration the relevant discussions including the 5th replenishment
preparatory meeting held in Tokyo December 2015, Japan will make an appropriate
support to the next replenishment period (2017-2019). 【The Ministry of Foreign
Affairs】(5)-2 Support for vaccination activities by Gavi, the Vaccine Alliance○

Regarding "Gavi, the Vaccine Alliance" (Gavi), which is a public-private partnershipestablished for the purpose of protecting child lives and health by improving vaccination
rates in developing countries, Japan will assist Gavi to achieve its goal of saving morethan 12 million people by 2020 (7.1 million deaths have been averted as of 2014),
promote assistance 22 in order to support the dissemination of pentavalent vaccine(diphtheria, tetanus, pertussis, hepatitis B and Haemophilus influenza Type b (Hib)),
vaccines for yellow fever and measles, and new vaccines (pneumococcal and rotavirus)
and strengthen the health system to effectively disseminate vaccination, and support theimplementation of comprehensive efforts to supply cost-effective vaccination at low cost.
【The Ministry of Foreign Affairs】(5)-3 Promotion of development of new drugs through GHIT Fund
22

Japan contributed 740 million yen in the FY 2013 initial budget, 840 million yen in the FY 2014 initial budget,and 1.7 billion yen in the FY 2014 supplementary budget and the FY 2015 initial budget so far, and appropriated 2
billion yen for the FY 2015 supplementary budget.

12○Regarding GHIT Fund established by a public-private partnership formed through apartnership of the Ministry of Foreign Affairs, the Ministry of Health, Labour andWelfare, domestic-affiliated pharmaceutical companies and the Bill & Melinda Gates
Foundation in 2012, the government, in order to promote, through public-private
partnership, R&D for medicines for NTDs, Tuberculosis and Malaria, which are urgent
issues for developing countries, by making use of the advanced drug development
technology possessed by Japan’s pharmaceutical manufacturing industries, will promoteassistance 23 to the GHIT, and assist R&D for medicines for developing countries, andconduct delivery preparation and support for such medicines. 【The Ministry of Foreign
Affairs and the Ministry of Health, Labour and Welfare】○

In the "International Collaborative Research Program" (Science and Technology
Research Partnership for Sustainable Development (SATREPS) 24 and international joint
research program for measures to tackle NTDs in Africa) managed by AMED, thegovernment will promote international joint research for developing therapeutic drugs,
diagnostic drugs and vaccines based on needs in the field. 【The Ministry of Foreign
Affairs, the Ministry of Education, Culture, Sports, Science and Technology, and theMinistry of Health, Labour and Welfare】(5)-4 Promotion of national support by utilizing cloud funding 25○

Regarding relief by cloud funding which domestic NGOs jointly perform to the
populace and companies in light of efforts of international institutions involved in
infectious diseases, or support by vaccine bonds 26 issued by companies, the government
will promote this also by utilizing public-private partnership platform. 【The Cabinet
Secretariat, the Ministry of Foreign Affairs, and the Ministry of Health, Labour andWelfare】

23

Japan contributed 1.4 billion yen in the TY 2012 supplementary budget and 5.6 billion yen in the TY 2013supplementary budget so far in activities of UNDP coordinated with GHIT, and allocated 1.4 billion yen for the TY
2015 supplementary budget.24 Science and Technology Research Partnership for Sustainable Development(SATREPS) is conducted in coordination with the Ministry of Foreign Affairs and JICA.
24 Science and Technology Research Partnership for Sustainable Development (SATREPS) is conducted incoordination with the Ministry of Foreign Affairs and JICA.
25 Cloud Funding: To raise funds through the Internet from an indefinite number of people
26 Vaccine Bonds: Bonds issued by IFFIm (International Finance Facility for Immunization) which is a multilateraldevelopment organization proposed by the Government of the United Kingdom and was established in 2006 inorder to smoothly raise funds for immunization and support Gavi, the Vaccine Alliance. The funds raised byissuing the bonds are used for the dissemination of immunization and strengthening of medical systems indeveloping countries through Gavi, the Vaccine Alliance. It has raised 3.85 billion US dollars since theirestablishment in the international capital market. The nine contributory countries are, the UK, France, Italy, Spain,
the Netherlands, Sweden, Norway, South Africa, and Australia. Incidentally, Japanese securities companies issued
bonds in 2008 and the total sales up to bonds issued in March 2013 were 125 billion yen.

13

(5)-5 Promotion of supporting measures to tackle AMR for the achievement of WHO global
action plan on AMR○

The "Global action plan on AMR" adopted at the May 2015 World Health Assembly
urges the Member States to formulate national action plans within two years and reporton progress. The government will support the strengthening of this commitment so as toenable WHO and OIE 27 to promote international efforts to tackle AMR, and actively
promote international cooperation in surveillance, infection prevention and management
for antimicrobial resistance specifically in Asia, based on the "National Action Plan on
AMR" formulated in March, 2016. 【The Ministry of Foreign Affairs, the Ministry of
Education, Culture, Sports, Science and Technology, the Ministry of Health, Labour andWelfare, and the Ministry of Agriculture, Forestry and Fisheries】

2. Project for developing and dispatching human resources to take charge of measures totackle international infectious diseases(1) Establishment of the "Registration System of Human Resources against International
Infectious Diseases" 28○

Registration of member candidates to the Japan Disaster Relief (JDR) Infectious
Diseases Response Team, to be dispatched to countries where infectious diseases occuror spread, in order to strengthen Japan's personnel assistance to tackle emerging
infectious diseases will be promoted; and the Ministry of Health, Labour and Welfare
will promptly discuss measures for enhancement of human resource development andinformation gathering to start efforts at the early stage while obtaining cooperation with
relevant ministries and agencies such as the Cabinet Secretariat, the Ministry of Foreign
Affairs, and the Ministry of Education, Culture, Sports, Science and Technology. This is
to develop and secure human resources for global health (human resources for policy
and human resources for technology) covering a wide range of fields including
infectious diseases who are expected to take an active role in international institutions.
After that, the government and agencies will recommend relevant persons to register
under each mechanism collectively called the "Registration System of Human Resource
against International Infectious Diseases" and share information, aiming at the registrantof 500 members 29 by FY 2020. 【The Cabinet Secretariat, the Ministry of Foreign

27

The World Organization for Animal Health (OIE for short): Intergovernmental organization for the purpose of
improving the world's animal health, which was started in Paris, France, with the signatures of 28 countries in
1924. 180 countries and regions acceded to it as of May 2015, and Japan acceded in January 28, 1930.
28 Generic term for the registration mechanisms of Japan Disaster Relief Team (JDR) Infectious Diseases Response
Team, and measures on strengthening development and collecting information on international health humanresource in wide fields including infectious diseases in the Ministry of Health, Labour and Welfare. Members areto be registered in each system separately and the systems are to be maintained respectively.
29 The breakdown of 500 is 200 team members registered under the "Japan Disaster Relief Team (JDR) Infectious

14

Affairs, the Ministry of Education, Culture, Sports, Science and Technology, and theMinistry of Health, Labour and Welfare】(2) Developing human resources to tackle international infectious diseases○

The Japan Disaster Relief Team (JDR) Infectious Diseases Response Team and theMinistry of Health, Labour and Welfare will clarify aptitude required for each fields suchas clinical medicine, epidemiology, examination and diagnosis, logistics, management,
and global health policy in order to develop human resources and information gathering,and the government and agencies will develop an effective human resource development
program in cooperation with relevant organizations (National Center for Global Healthand Medicine (NCGM), National Institute of Infectious Diseases, and JICA) including
cross-sectional perspectives, implement trainings systematically, and promote the humanresource development for infectious diseases control at universities. 【The Cabinet
Secretariat, the Ministry of Foreign Affairs, the Ministry of Education, Culture, Sports,
Science and Technology, and the Ministry of Health, Labour and Welfare】○

As part of the training, practical training overseas is conducted by utilizing overseas
dispatch organizations in the "Infectious Disease Emergency Specialist Training
Program" 30 by the Ministry of Health, Labour and Welfare and the "Field Epidemiology
Training Program (FETP-J)" 31 by the National Institute of Infectious Diseases, andR&D sites in Asian and African countries of the "Japan Initiative for Global Research
Network on Infectious Disease (J-GRID)" 32 managed by AMED. 【The Ministry of
Education, Culture, Sports, Science and Technology and the Ministry of Health, Labour

Diseases Response Team" and 300 people developed and collected as political human resources in international
health human resources in wide fields including infectious diseases, who can be dispatched to international
institutions. 138 people currently have applied to the "Japan Disaster Relief Team (JDR) Infectious Diseases
Response Team" (as of December 22, 2015). The number of Japanese staff in WHO is 43 people (as of December
31, 2014), the number of Japanese staff involved in international health in other international institutions (PanAmerican Health Organization (PAHO), Joint United Nations Programme on HIV/AIDS (UNAIDS), UNDP,UNFPA, UNICEF, World Bank (WB)) is about 60, and the number of Japanese staff in overseas research sites inthe third period of J-GRID (FY 2015 to FY 2019) is 41 people.
30 Program for developing specialists on infectious disease crisis management, which was established by the
Ministry of Health, Labour and Welfare in FY 2015.
31 Field Epidemiology Training Program: It was established in the National Institute of Infectious Diseases in 1999
for the purpose of developing field epidemiologists to become the core to promptly search for infectious diseasecrisis management cases and take appropriate action, and establishing a nationwide network. It includes two-year
practical training for doctors and veterinarians involved in countering infectious diseases and people engaged inregional health including measures to tackle infectious diseases in nation and prefectures, which the 17th trainees
are currently taking and whose total number of graduates is 64 people.
32 A program for the purpose of promoting epidemiology research projects and fundamental research on diagnostic
agents for pathogens of infectious diseases which spread in each region; developing new technology which
contributes to prevention for infection control and diagnostic agents; and developing advanced experts by utilizing
overseas research sites developed in Asia and Africa (9 sites in 9 countries: China, Vietnam, Indonesia, Zambia,
Myanmar, Philippines, Thailand, India, and Ghana).

15and Welfare】○

Issues concerning the team’s activities will be discussed by the advisory committee
and technical committee for the Infectious Diseases Response Team and induction
course on general international emergency response and skill-up course according tofields of expertise for registered members will be implemented in order to develop the
dispatch system of Japan Disaster Relief Team (JDR) Infectious Diseases Response
Team. 【The Ministry of Foreign Affairs】○

The government will discuss expansion of training and continuous measures forretaining skills after the completion of training in order to equip medical officers, etc. of
the Japan Self-Defense Forces with increased specialized knowledge to cope with
infectious diseases and improve their skills. 【The Ministry of Defense】(3) Dispatching human resources to tackle international infectious diseases○

The government will carry forward preparation so as to smoothly dispatch personnel
in response to the outbreak or spread of infectious diseases under the framework of"Japan Disaster Relief Team (JDR) Infectious Diseases Response Team". Moreover, theMinistry of Health, Labour and Welfare will promptly discuss and implement themechanism for the strengthening of development and information collection, and thereby
promote the dispatch of international health human resources (political and technicalhuman resources) in wide areas including infectious diseases, who are expected to takean active role in international institutions. 【The Ministry of Foreign Affairs and theMinistry of Health, Labour and Welfare】○

The government will implement simulation training hypothesizing the spread of
infectious diseases in addition to the induction course and the skill-up course, andprocurement, storage, maintenance, management and review of material and equipment
by JICA in order to develop the dispatch system of the Japan Disaster Relief (JDR)
Infectious Diseases Response Team, and share information and exchange views withWHO having expertise and network concerning infectious diseases in order to secure thesafety of the team's activities and appropriate content thereof. 【The Ministry of Foreign
Affairs】○

A contract with a private company offering emergency transport service including
16

transport of patients to safe places including Japan will be aimed to be concluded by thesecond quarter in FY 2016 when the preparation of the full-fledged dispatch of the
Infectious Diseases Response Team is scheduled to be complete, in order to minimize
members' health damage and secure the safety of their lives in case of a member of the"Japan Disaster Relief (JDR) Infectious Diseases Response Team" is affected with
infectious diseases during the team’s activity. 【The Ministry of Foreign Affairs】○

The Japan Self-Defense Force Unit will transport necessary personnel, materials andequipment, and others to overseas regions upon consultation between the Ministry ofForeign Affairs and the Ministry of Defense and under cooperation with relevant
ministries and agencies such as the Ministry of Health, Labour and Welfare and theMinistry of Foreign Affairs in order to support the activities of the Japan Disaster Relief(JDR) Infectious Diseases Response Team, if such transport cannot be performed byutilizing civilian assets and other alternatives are not available. 【The Cabinet Secretariat,
the Ministry of Foreign Affairs, the Ministry of Health, Labour and Welfare, and theMinistry of Defense】(4) Supporting career path of human resources to tackle emerging infectious diseases○

The Ministry of Health, Labour and Welfare will continuously collect and provide
information and analyze the current state on international institutions which can be adispatch destination, positions of relevant organizations in Japan, and necessary
capabilities under cooperation with relevant ministries and agencies such as the Ministryof Foreign Affairs and the Ministry of Education, Culture, Sports, Science andTechnology from the perspective of supporting career path for international healthhuman resources (political and technical human resources) in wide fields including
infectious diseases, who are expected to take an active role in international institutions;and attempt matching between the human resources and relevant organizations in Japanby utilizing this information. 【The Ministry of Foreign Affairs, the Ministry of
Education, Culture, Sports, Science and Technology, and the Ministry of Health, Labourand Welfare】

3. Project for strengthening crisis management system of infectious diseases(1) Strengthening of the testing system and promotion of operations involved in prevention
and treatment for high-risk pathogens led by National Institute of Infectious Diseases
with BSL4 facilities○

The government will basically conduct verification testing involved in Type I
17

infectious diseases such as Ebola Virus Disease, strengthen the testing function andpromote the operations involved in prevention and treatment in the National Institute of
Infectious Diseases. 【The Ministry of Health, Labour and Welfare】○

The government will develop a system which enables specimen testing to be promptly
performed in regional public health laboratories and quarantine stations and strengthen
the nationwide testing system involved in Type I infectious diseases in order to preparein the case that Type I infectious diseases such as Ebola Virus Disease occurred in Japan.
In strengthening the testing system, the government will create and make a standard
manual well known, implement training based upon it, construct a network by regional
block, and gradually strengthen the systems of public testing organizations. 【TheMinistry of Health, Labour and Welfare】(2) Strengthening of collection, analysis, evaluation, and provision of information on
infectious disease overseas○

In order to strengthen the Capacity of the National Institute of Infectious Diseases tocollect, analyze and evaluate information, the Government will centralize and manage
necessary information from international institutions including WHO, US CDC 33, publichealth organizations in other countries, Japanese overseas establishments, anddomestic/foreign media; and develop a system for analyzing and evaluating thisinformation in a prompt and appropriate manner through utilizing relevant programs.
【The Ministry of Foreign Affairs and the Ministry of Health, Labour and Welfare】○

In order to strengthen information collection related to public health in affected foreigncountries of infectious diseases, the Government will start a training program at the
National Institute of Infectious Diseases for medical attachés 34 of overseas
establishments to acquire expertise on infectious diseases. 【The Ministry of Foreign
Affairs and the Ministry of Health, Labour and Welfare】○

The Ministry of Foreign Affairs, the Ministry of Health, Labour and Welfare, and the
National Institute of Infectious Diseases will structure mechanism of coordination so as
to appropriately issue the travel advice/warnings on infectious diseases to Japanese33

34

Centers for Disease Control and Prevention
They are mainly engaged in medical affairs, taking care of the health of the members and their families inoverseas establishments and providing relevant information to Japanese nationals overseas that follows research on
medical conditions of the mandated country. (Out of a total of 97 such establishments, medical attaches are placedin 95 of these as of January 2016.)

18

nationals overseas, and perform risk communication through health safety lectures 35. If
necessary, medical experts/doctors will be sent to give these lectures. 【The Ministry ofForeign Affairs and the Ministry of Health, Labour and Welfare】(3) Securing intellectuals involved in infectious diseases and scaling up risk communication○

The government will select each intellectual for Ebola Virus Disease and infectious
diseases for their response in the light of future international situations, develop a system
to enable technical consultations to be held in a prompt and smooth manner if domestic
measures or international response are necessary in the future, and thereby scale up risk
communication in the Government of Japan. 36 【The Cabinet Secretariat, the Ministry ofForeign Affairs, and the Ministry of Health, Labour and Welfare】

4. Project for promoting research system of infectious diseases(1) Forming an infectious disease research center○

The government will strengthen the Japanese infectious disease research function
through measures including providing necessary support in light of the discussion andarrangement status in Nagasaki University in forming an infectious disease research
center with BSL4 facilities as the core under utmost consideration to secure safety,
equipped with the latest equipment to enable analysis of pathogens, animal experiments,
the development of treatment methods and vaccines, and other R&D activities, so as toimprove the basic research capacity involved in infectious diseases in domestic
universities and other research institutes and develop and secure human resources who
are acquainted with the handling of high-risk pathogens. 【The Cabinet Secretariat, theMinistry of Education, Culture, Sports, Science and Technology, and the Ministry of
Health, Labour and Welfare】○

The government will establish a council consisting of relevant ministries and agencies,and relevant municipalities and universities in the Cabinet Secretariat within TY 2016,
and promote support measures necessary for forming the above infectious diseaseresearch center with BSL 4 facilities as the core through discussion and arrangement
including the following matters. 【The Cabinet Secretariat, the Ministry of Education,
Culture, Sports, Science and Technology, and the Ministry of Health, Labour and35

It provides information on the accurate knowledge of prevention measures from the medical perspective toJapanese nationals overseas who live with fear of infectious diseases.
36 Regarding "novel influenza" prescribed under Article 2 (i) of Act on Special Measures against Novel Influenza(Act No. 31 of 2012), comments shall be invited from persons with relevant knowledge and experience such as
persons with expertise involved in infectious diseases under the same Act when a basic guideline is formulated,and "the intellectuals' meeting for measures to tackle novel influenza" has been set up.

19

Welfare】(i) Concrete utilization measures of BSL4 facilities (fundamental R&D of humanresources on pathogens and epidemiology related to infectious diseases, R&D for
creating medicines, and desirable network, coordination and cooperation)(ii) Desirable function and operation methods of BSL4 facilities○

The government will strengthen the functions of testing and inspection, prevention,and treatment of BSL4 facilities and develop human resources necessary for operations
and management of BSL4 facilities through training of management systems related to
infectious diseases and facility arrangement/maintenance in the National Institute of
Infectious Diseases. 【The Ministry of Health, Labour and Welfare】(2) Promotion of R&D involved in infectious diseases of high-risk pathogens○

The government will steadily promote R&D involved in infectious diseases including
pathogens of Type I infectious diseases under continuous and seamless research support
from basic research through to practical application by AMED based on "The Plan for
Promotion of Medical Research and Development" (approved by the Headquarters for
Healthcare Policy on July 22, 2014). Thereby, the government will promote on ascientific basis, connect the research results with the development of therapeutic drugs,
diagnostic drugs, and vaccines, promote international joint research, and develop humanresources for research institutes such as universities. 【The Cabinet Secretariat, theMinistry of Education, Culture, Sports, Science and Technology, and the Ministry of
Health, Labour and Welfare】

5. Project for strengthening the domestic ability to address infectious diseases(1) Promotion of measures to tackle AMR○

In December 2015, the "Antimicrobial Resistance Review Meeting" was establishedand held under the Promotion Team in order to promote comprehensive measures totackle AMR. In the meeting, the government will carry forward discussions on
cross-sectorial efforts in the areas of medical care, livestock production and aquaculture,and food safety from the perspective of One Health, 37 and formulate the"National
Action Plan on AMR" by March 2016 to strengthen measures to tackle AMR. 【TheCabinet Secretariat, the Cabinet Office, the Ministry of Foreign Affairs, the Ministry of
Education, Culture, Sports, Science and Technology, the Ministry of Health, Labour and37

One Health: Concept of integrally promoting several fields such as health of human and animals and environment
under one policy.

20

Welfare, and the Ministry of Agriculture, Forestry and Fisheries】○

The National Institute of Infectious Diseases will strengthen the systems of Japan
Nosocomial Infections Surveillance (JANIS) 38 involved in antimicrobial resistantbacteria and analysis of pathogens, and construct a system that comprehensively bears
the infectious disease control function involved in measures to tackle antimicrobial
resistant bacteria in cooperation with NCGM. 【The Ministry of Health, Labour andWelfare】(2) Strengthening of systems of relevant organizations in Japan(2)-1 Strengthening of systems and functions of quarantine stations and municipalities○

The government will develop personnel systems and strengthen necessary quarantine
functions by systematically developing a waiting room for suspects affected with
infectious diseases (depressurized room), air-conditioning systems, devices including athermograph for detecting a person's fever, in order to respond to the outbreak ofinfectious diseases in foreign countries and the increase of foreign travelers to Japan inquarantine stations. Moreover, it will strengthen functions through the development of
human resources also in municipalities, public health centers, and regional public healthlaboratories. 【The Ministry of Health, Labour and Welfare】(2)-2 Strengthening of systems and functions of designated medical institutions for
specified infectious diseases○

The government will continue to aid the operations of designated medical institutions
for Type I and Type II infectious diseases, and promote elimination of cases where
prefectures 39 have not yet established designated medical institutions for Type I
infectious diseases, in order to take appropriate action in outbreak of infectious diseases
in Japan. 【The Ministry of Health, Labour and Welfare】○

The government will strengthen the functions in designated medical institutions for
specified infectious diseases by systematically reinforcing equipment so as to giveintensive care to critical patients with Ebola Virus Disease in the light of response of38

Japan Nosocomial Infections Surveillance (JANIS): System for the purpose of grasping the overview of
nosocomial infections in Japan and returning useful information on measures to tackle nosocomial infections to
medical fields, through the investigation of outbreak situation of nosocomial infections in medical institutions,separation conditions of antimicrobial resistant bacteria, and the outbreak situation of infectious diseases byantimicrobial resistant bacteria
39 They were established in 47 sites in Japan and not established in Akita Prefecture, Miyagi Prefecture, Ishikawa
Prefecture, Kagawa Prefecture, Ehime Prefecture, and Kagoshima Prefecture (as of January 2016).

21

medical institutions overseas to patients with Ebola Virus Disease. 【The Ministry of
Health, Labour and Welfare】○

The government will develop a system necessary for promoting measures to tackle
AMR in medical fields including the appropriate use of antimicrobial agents in NCGM,
which is one of designated medical institutions for specified infectious diseases, anddevelop a system capable of continuously offering the Infectious diseases Response
Service (IRS) 40, in which staffs in the center are dispatched as experts based on therequest of domestic medical institutions at the time of spread of Ebola Virus Disease and
MERS. 【The Ministry of Health, Labour and Welfare】(2)-3 Develop a structure for enhancing capabilities in response to infectious diseases in theJapan Self-Defense Forces○

The government will aim at the designation of the National Defense Medical College
and the Self-Defense Forces Central Hospital as designated medical institutions for TypeI infectious diseases at the earliest possible time in light of the self-contained treatment
and clinical education for technical human resources, and enhance a framework to
respond to infectious diseases in the National Defense Medical College and Self-Defense
Forces Central Hospital, etc. 【The Ministry of Defense】

IV. Individual Sectorial Measures
In addition to the measures of III, Prior Projects, the Government of Japan will steadily
promote various kinds of measures in fields such as promotion of international cooperation,
development of domestic testing and research systems, the strengthening of the foundationof human resources involved in measures to tackle infectious diseases, and strengthening
the domestic measures on infection prevention and the safety measures for Japanesenationals overseas, based on the Basic Guideline as follows.
Moreover, regarding the recent spread of Zika Virus Disease in Latin America, theGovernment of Japan will promptly take appropriate measures according to the recent
situation under cooperation among relevant ministries and agencies through the Relevant
Ministries and Agencies Meeting. 41
40

Infectious disease Response Service (IRS): It is a service in which experts are dispatched based on the request of
medical institutions or municipalities at the time of spread of Ebola Virus Disease and MERS, and is conducted as
research operations in NCGM.
41 In the Cabinet Order Partially Revising the Order for Enforcement of Act on the Prevention of Infectious Diseases
and Medical Care for Patients Suffering from Infectious Diseases and the Order for Enforcement of Quarantine Act(Cabinet Order No. 41 of February 5, 2016), Zika Virus Disease was placed at Class IV infectious disease on
Infectious Disease Act and quarantinable infectious diseases on Quarantine Act, for which measures were
strengthened.

22

1. Promoting international cooperation(1) Strengthening of cooperation with international institutions etc. for emergency response(1)-1 Providing support for securing and strengthening the implementation of IHR 42 of
WHO and strengthening the base of GOARN 43○

Supporting developing countries as to the implementation International HealthRegulations (IHR) of WHO is essential from the perspective of preventing the outbreakof future public health crisis from changing as to its spread; and therefore theGovernment of Japan will continue to encourage developing countries to secure andstrengthen its implementation of IHR through promotion of support to WHO etc. 【TheMinistry of Foreign Affairs and the Ministry of Health, Labour and Welfare】○

The government will strengthen the implementation system of training before dispatch
and communication systems in ordinary times through the promotion of support to the"Measure Operations to tackle Infectious Diseases" by WHO, in order to promptly
respond to the outbreak of infectious disease crisis in GOARN. 【The Ministry of Health,Labour and Welfare】(1)-2 Dealing with the Catastrophe Containment and Relief Trust of the International
Monetary Fund (IMF)○

IMF immediately provides grant aid through the Catastrophe Containment and Relief(CCR) Trust 44 of the IMF in order to allocate it to the Member State's debt to IMF
which reaches repayment deadline within two years after the outbreak of the catastrophe,
and the Government of Japan will contribute to efforts by IMF. 【The Ministry of
Finance】(1)-3 Cooperation and policy dialogues with implementing agencies such as UNDP,
UNICEF, and UNFPA○

Regarding the United Nations Development Programme (UNDP), United Nations
Children's Fund (UNICEF), and United Nations Population Fund (UNFPA), the42International Health Regulations (IHR): International regulation based on Article 21 of the WHO Charter. It
prescribes fulfillment of the construction and maintenance of the ability to discover, evaluate and report aphenomenon of infectious diseases to Member States (194 countries as of January 2016).
43 Global Outbreak Alert and Response Network (GOARN): The global alert and response network on the outbreakof infectious diseases is an international framework of measures to tackle infectious diseases led by WHO. It is
operated for the purpose of collecting information on infected persons, sending out important information, andproviding technical support for response in the early stage in affected countries, in which National Institute of
Infectious Diseases has participated in Japan.
44 It is for the purpose of slowing down the worsening of the macroeconomy in the Member State with severe
economic stagnation due to pandemic.

23

government will collect information and exchange views to strengthen futurecooperation in the health field at opportunities such as strategy dialogues between Japanand UNDP, policy meetings between Japan and UNICEF, and policy meetings between
Japan and UNFPA, respectively. 【The Ministry of Foreign Affairs】(2) Health systems strengthened in developing countries to prevent outbreak and spread of
infectious diseases(2)-1 Promotion of UHC and health system strengthening leveraging development
cooperation○

Under the situation in which issues facing developing countries are diverse, as are
their economic conditions and prerequisite health systems, it is important to support
self-help efforts by partner countries and offer cooperation aimed at self-reliant
development. Therefore, the government will organically combine technical cooperation,
government loan and grant aid to reflect the partner countries' situation and implement
these modalities in a timely and flexible manner while taking note of the possibilities ofcooperation with other donors (including international institutions addressing specificdiseases) and private sectors. 【The Ministry of Foreign Affairs and the Ministry of
Finance】○

The government will proceed in dispatching experts for direct support anddevelopment of human resources in each field according to the implementation stage ofmeasures for strengthening health systems in each country, and actively disseminate
Japanese expertise. 【The Ministry of Health, Labour and Welfare】○

The government will promote the of health systems strengthened in developing
countries through cooperation with international institutions including the Global Fundand other donors. 【The Ministry of Foreign Affairs and the Ministry of Health, Labourand Welfare】○

The government will provide support to developing countries for the implementationof IHR, including ones through a framework of the Global Health Security Agenda(GHSA) 45. Moreover, the government will provide support to developing countries to

45

Global Health Security Agenda (GHSA) is an initiating to strengthen the existing framework of WHO related to
public health crisis (IHR: International Health Regulations) in cooperation with other countries and international
institutions such as WHO, FAO (Food and Agriculture Organization of the United Nations), and OIE (World
Organization for Animal Health) for the purpose of improving the ability of measures to tackle infectious diseases
in the world. It is a multi-country framework established in February 2014, which was led by the US. Japan has
selected seven countries of Vietnam, Philippines, Myanmar, Kenya, Ghana, Senegal, and Zambia as supporting24

ensure its implementation of IHR through development of systems and human resourcesin the Noguchi Memorial Institute for Medical Research 46, which Japan has supported sofar. 【The Ministry of Foreign Affairs and the Ministry of Health, Labour and Welfare】○

The government will promote support to the World Bank to contribute to UHC throughthe Japan Trust Fund of World Bank in light of the results of Joint Japan-World BankUHC Research 47. 【The Ministry of Finance】(2)-2 Emergency assistance and support for the recovery of health systems after outbreak ofinfectious diseases○

The government will support the affected country’s emergency response, develop
human resources, provide medical supplies, and construct a health information systemthrough provision of emergency grant aid, emergency relief goods, funds and materials
to international institutions, and personnel assistance including dispatch of experts, andthereby recover the health systems which failed to function properly due to the spread of
infectious diseases and prevent the outbreak and spread of future infectious diseases bystrengthening health system in affected countries. 【The Ministry of Foreign Affairs】

2. Developing testing and research systems for high-risk pathogens involved in infectious
diseases in Japan(1) Strengthening the testing system at the National Institute of Infectious Diseases○

The government will promote active information disclosure and communication withlocal communities and strengthen the situation which ensuressafe and stable

operations involved in testing, treatment, and prevention in BSL4 facilities, by
establishing a strict management system of BSL4 facilities in the National Institute of
Infectious Diseases and regularly holding communication meetings consisting ofresidents' associations, academics, local municipalities and fire brigades, public healthcenters, the National Institute of Infectious Diseases, and the Ministry of Health, Labourand Welfare to safely operate facilities in an open and transparent manner. 【Thecountries for the present.
Noguchi Memorial Institute for Medical Research: It was the main institute for medical research in Ghana, which
was set up in 1979 (expanded in 2000) by Japanese grant aid (a total of 3.26 billion yen) and was named after Dr.
Hideyo Noguchi, who had been engaged in yellow fever research in Ghana and passed away due to the disease.
Japan has offered technical cooperation to the institute for more than 30 years and contributed to development of
human resources in the medical research field in Ghana.
47 "Joint Japan-World Bank UHC Research": It was conducted for the purpose of sharing Japanese experiences andexpertise related to UHC to developing countries and discussing the applicability to efforts for each country's UHC
on the occasion of the 50th anniversary in 2011, after the achievement of UHC in 1961. Researched countries are
11 countries of Japan, Bangladesh, Brazil, Ethiopia, France, Ghana, Indonesia, Peru, Thailand, Turkey, andVietnam.
46

25

Ministry of Health, Labour and Welfare】(2) Further discussion how to designate BSL 4 facilities in Japan○The government will discuss the necessity of further developing BSL4 facilities
considering regional balances, and function division and cooperation between facilities
as well as promoting establishment and development of BSL4 facilities in Japan through"Project for strengthening crisis management system of infectious diseases" and "Projectfor promoting research system of infectious diseases". 【The Cabinet Secretariat, theMinistry of Education, Culture, Sports, Science and Technology, and the Ministry of
Health, Labour and Welfare】

3. Developing the base of Japanese human resources involved in measures to tackle
infectious diseases who take an active role in the international community
The Government of Japan will promote the development of human resources by thefollowing Infectious Disease Emergency Specialist Training Program in addition toefforts in the above mentioned "Project for developing and dispatching human resources
to respond to international infectious diseases".
○

The government will continuously develop nearly five experts on infectious diseasecrisis management every year, who have clinical and epidemiological knowledge related
to infectious diseases, the ability to respond to public health, the international adjustment
ability, and comprehensive expertise and abilities, through the Infectious Disease
Emergency Specialist (IDES) Training Program which was initiated from April 2015.
【The Ministry of Health, Labour and Welfare】○

The government will promptly and appropriately grasp the actual conditions anddiagnose the cause for the outbreak and spread of infectious diseases, and continuously
develop field epidemiologists who can contribute to maintenance and improvement ofhigh-quality infectious disease surveillance system in ordinary times, through FETP-J by
the National Institute of Infectious Diseases. 【The Ministry of Health, Labour andWelfare】

4. Strengthening domestic measures on infection prevention and the safety measures forJapanese nationals overseas(1) Promoting provision of information on infectious diseases in Japan to the populace○

The government will increase the variety of tools such as a media and social
networking service for providing domestic infectious disease information including26

measures to be taken in the case where the infection of Type I infectious diseases isconfirmed, and promote effective provision corresponding to people's diverse lifestyles
by expanding the targets of mail magazines. 【The Ministry of Health, Labour andWelfare】(2) Improving response capability of relevant organizations including quarantine stations
and securing responses in the situation where an infection (including a suspected
infection) has been confirmed in Japan○The government will improve the response capability of relevant organizations by thefollowing measures in addition to "Strengthening systems of relevant organizations inJapan" in the "Project for strengthening the domestic ability to address infectious
diseases"(i) The government will conduct training on infectious diseases every tax year, such astransferring training for patients infected with Ebola Virus Disease in cooperation with
relevant organizations, and testing technical training for learning the latest knowledge
and testing methodology involved in inspection in quarantine stations. 【The Ministryof Health, Labour and Welfare】(ii) The government will make the National Institute of Infectious Diseases appropriately
conduct active epidemiological investigation (including contact investigation) by
utilizing FETP-J, in preparation for domestic cases of the outbreak of Ebola Virus
Disease and MERS in several municipalities. 【The Ministry of Health, Labour andWelfare】(iii) In municipalities and designated medical institutions for specified infectious
diseases, the government will continuously conduct training and training meetings to
respond to the outbreak of infectious diseases including transferring training ofpatients infected with Ebola Virus Disease in cooperation between relevantorganizations. 【The Ministry of Health, Labour and Welfare】(iv) The Police will actively participate in measures or training under cooperation with
relevant organizations and continue to implement various types of training including
training for detaching/attaching materials and equipment for infection protection, andcheck and maintain necessary materials and equipment. 【The National Police
Agency】(v) The Fire and Disaster Management Agency will make each fire service ensure theimplementation of standard precautions to all sick and injured people, and disseminate
the basic measures in the fire service in the cases of contact with the sick and injured
people who are suspected to be infected with infectious diseases. Moreover, it will27

promote efforts for the construction of cooperation systems between fire services andpublic health centers in the regions where the systems of public health centers are notsufficiently developed regarding the transfer of infected patients. 【The Fire andDisaster Management Agency】(vi) The Ministry of Land, Infrastructure, Transport and Tourism will participate in the
training implemented by quarantine stations, and take appropriate actions according tothe outbreak situation of infectious diseases such as information provision to the
populace, adjustment with concerned operators in charge of transfer of specimens andpatients, and provision of necessary cooperation, if emerging infectious diseases
occurred including suspected issues of Ebola Virus Disease. 【The Ministry of Land,
Infrastructure, Transport and Tourism】(vii) The Ministry of the Environment will investigate and discuss a disposal manual of
infectious waste generated from medical institutions for review in cooperation with
relevant organizations, and will ensure the disposal of infectious waste based on the
manual. Moreover, it will revise the manual in FY 2016 so as to include issues incurrent conditions. 【The Ministry of the Environment】(3) Developing policies for responses to Viral Hemorrhagic Fever at administrative
agencies.

○

The government will create the "Guideline of administrative measures against Viral
Hemorrhagic Fever" 48, obtain cooperation of medical relevant organizations, and urge
administrative agencies (quarantine stations, municipalities, public health centers, andregional public health laboratories) to take actions in a prompt and appropriate manner.
【The Ministry of Health, Labour and Welfare】(4) Ensuring the provision of timely and appropriate information/warnings on infectious
diseases to Japanese nationals overseas○

The Ministry of Foreign Affairs will issue “travel advice and warning”, “region-widesafety information”, and “spot safety information” through Overseas Safety HP
according to the situation of the outbreak of infectious diseases, in order to provide
timely and appropriate information/warnings to Japanese nationals overseas. 【The48

The "Guideline of administrative measures against Viral Hemorrhagic Fever" is a guideline on the administrative
response for strengthening measures to prevent the outbreak and spread of infectious diseases in anticipation forthe possibility of outbreak of internationalinfectious diseases. It describes administrative measure systems, transferof patients, the collection and transportation of specimens, medical systems (treatment policy in medical
institutions), active epidemiologic investigation, disinfection, and methods of public relations and information
provision about Viral Hemorrhagic Fever (Crimean-Congo hemorrhagic fever, South American hemorrhagic fever,Lassa fever, Marburg hemorrhagic fever, Ebola hemorrhagic fever).

28

Ministry of Foreign Affairs】○

Overseas establishments will collect information on the prevalent infectious diseases
from authorities and relevant organizations in the region under their jurisdiction andpromptly report to the ministry. They are also to provide timely and appropriate
information warnings to the Japanese nationals overseas through their homepages andconsular e-mails. 【The Ministry of Foreign Affairs】○

The Ministry of Foreign Affairs and the Ministry of Health, Labour and Welfare willclosely work together and cooperate in sharing information from overseas establishments
and the IHR framework, and utilize this for safety measures for Japanese nationals
overseas and domestic measures on infection prevention inside Japan. 【The Ministry ofForeign Affairs and the Ministry of Health, Labour and Welfare】(5) Strengthening safety measures such as medical evacuation in case of infection ofJapanese nationals overseas○

If Japanese nationals overseas were to be infected, relevant ministries and agencies
will cooperate and develop a support system in overseas establishments so that thenational will be provided with the best medical treatment taking into account the doctor’s
diagnosis and the request of the patient/family regardless of the method; the cure in theaffected country or the medical evacuation to a third country/Japan. 【The Cabinet
Secretariat, the Ministry of Foreign Affairs, and the Ministry of Health, Labour andWelfare】○

Before crisis the government will collect information regarding measures on infectious
diseases by relevant country, and private airlines and crisis management companies andconstruct cooperative relationships with them through overseas establishments, in orderto ensure their prompt cooperation and support once the medical evacuation to a third
country/Japan is considered to be the best method of treatment taking into accountmedical diagnosis and request from the patient/family. In addition, the government will
strengthen response through coordination of the relevant ministries and agencies andother methods to including the medical evacuation by the aircraft of the Japan
Self-Defense Forces in case there are no other alternative nor civil aircraft available.
【The Cabinet Secretariat, the Ministry of Foreign Affairs, the Ministry of Health,Labour and Welfare, and the Ministry of Defense】

29

V. Promotion of Measures based on this Basic Plan
The Promotion Team will follow up the progress situation of measures
based on this Action Plan every tax year, report the situation to the Ministerial
Meeting if necessary, and take necessary actions such as revision of the Action
Plan based on the results.
Concluded30

(Annex)"The Action Plan for Strengthening Measures on Emerging Infectious Diseases" Progress Schedule Chart

In the Guideline, concrete efforts and targets each tax year from 2015 to 2020 are listed for individual efforts of 5 prior projects (measures) and 67 individual sectorial
measures.
Further, the efforts of the Guideline are promoted for aiming to achieve goals to "end the epidemics of AIDS, tuberculosis, malaria, and neglected tropical diseases(NTDs)" and "eradicate preventable death of infants" in "2030 Agenda for Sustainable Development (SDGs)" adopted in UN development Summit, by FY 2030, in
addition to targets for each effort.

<Prior Projects (Measures)>1. Project for strengthening measures on emerging infectious diseases in developing countries
Measures

Ministry(1) Lead the reinforcement of a
new framework for Global
Health Governance

The Cabinet
Secretariat,
the Ministryof Foreign
Affairs, theMinistry of
Finance,andtheMinistry of
Health,Labour andWelfare(TY) 2015
ProposeJapan's view of
the new
framework for
Global Health
Governance(GHG) at G7
Health Experts'
Meeting

2016
Leadinternational
discussion as G7
Presidency toshare a vie on thebasic concept ofdesirable GHG

2017

2018

2019

2020

・Continuous contribution to GHG
・Implementation of emergency support under the framework of GHG in thecase of infectious disease crisis

1

Target○ Construction of
the improved
framework for
Global Health
GovernanceMeasures

Ministry(2) Contributing to theconstruction of expeditious
finance mechanisms for
emergencies through thejoint efforts of theContingency Fund for
Emergency of WHO and thePandemic Emergency
Financing Facility (PEF) of
World BankThe Cabinet
Secretariat,
the Ministryof Foreign
Affairs, theMinistry of
Finance,andtheMinistry of
Health,Labour andWelfare(TY) 2015

2016

2017

2018

2019

2020

Japan makes a contribution to discussion
between both organizations so as to makesmooth the adjustment between WHO andWorld Bank. for complementary constructionof CFE and PEF without duplication

Japan makes an active contribution to WHO's strengthening of emergency responses through support to the CFE and makes
appropriate contribution to PEF.

Target○ The constructionof expeditious
financemechanisms for
emergencies
through the joint
efforts of theContingency Fundof WHO and PEF
of World Bank,
making acontribution toeach effort

Support to CFE(3) Setting up a public-private
partnership platform
involved in measures totackle infectious diseases indeveloping
countries(provisional name)

The Cabinet
Secretariat,
the Ministryof Foreign
Affairs, andthe Ministryof Health,Labour andWelfareSetting up a public-private
partnership platform

・Collection and analysis of information such as health needs in developing countries
・Discussion and adjustment involved in availability and effective provision methods of
medicines, and desirable cooperation of relevant organizations
・Implementation of the discussed and adjusted issues by relevant organizations

2○ Effective provisionof materials andequipment such as
medicines, diagnostic
agents, vaccines, andprotective supplies todeveloping countries,
and development ofdelivery systems of
medicines

Measures

Ministry(4) Promotion of prompt andsmooth supply of medicines
to developing countries

The Cabinet
Secretariat,
the Ministryof Foreign
Affairs, andthe Ministryof Health,Labour andWelfare(TY) 2015

2016

2017

2018

2019

2020

Promotion of international deployment of a series of products and technologies from diagnosis to treatment
Providing Asian regulatory officials with Japan's knowledge and side effect information of medicines for infectious
diseases developed in Japan, by Asia Training Center for Pharmaceuticals and Medical Devices Regulatory Affairs
Preparation of the system through which the "Development Promotion Team" immediately provides support if a medicine
is required for emergent development, and implementation of support by the team in an emergency(5) The strengthening of measures
to tackle infectious diseases indeveloping countries bystrengthening cooperation withinternational institutions(5)-1 Support for measures totackle the three major
infectious diseases
through the Global Fund(5)-2 Support for vaccination
activities by Gavi, theVaccine Alliance

The
Ministry ofForeign
Affairs

The
Ministry ofForeign
Affairs

Promotion of measures to tackle three major infectious diseases and strengthening of systems for health through support to the
Global Fund

Promotion of support to vaccination programs

3

Target○ Development of asmooth supply
system for
medicines indeveloping
countries○ Development of apromotion systemfor development inan emergency○ Realizing
prevention,
treatment, andcare for the threemajor infectious
diseases, andstrengthening
systems for healthin developing
countries○ Dissemination ofpentavalentvaccine, yellow
fever and measles
vaccines, and new
vaccines.
Strengthening
health systems toeffectively
disseminate
vaccination
・The number oflives saved by
Gavi activities:
7.1 million people(2014) → morethan 12 million
people (by2020)

Measures

Ministry(5)-3 Promotion ofdevelopment of
new drugs throughthe Global HealthInnovative
Technology Fund
(GHIT) and others

The Ministry ofForeign Affairs, theMinistryof
Education, Culture,
Sports, Science andTechnology, and theMinistry of Health,Labour and Welfare(TY) 2015

2016

2017

2018

2019

2020

Promotion of research and development of medicines for NTDs by promoting public-private partnership through support to
the GHIT Fund

Promotion of international joint research that contributes to development of medicines by SATREPS managed by AMED(5)-4 Promotion ofnational assistanceby utilizing crowd
funding(5)-5 Promotion of
supporting
measures to tackle
antimicrobial
resistance (AMR)
for achievement of
the WHO global
action plan on
AMR

TheCabinetSecretariat,
theMinistry of Foreign
Affairs, and theMinistry of Health,Labour and Welfare
The Ministry ofForeign Affairs, theMinistryof
Education, Culture,
Sports, Science andTechnology,
theMinistry of Health,Labour and Welfare,and the Ministry ofAgriculture, Forestry
and Fisheries

Support to system design forthe launch of crowd funding○ Support to andpromotion of crowd
funding

Promotion of international cooperation in surveillance, infection prevention and management for
antimicrobial resistance

Formulation of"Action Plan"

Hosting the
Asia-Pacific
Ministerial
Meeting on AMR(in April)

2. Project for developing and dispatching human resources who take charge of measures to tackle international infectious diseases(1) Establishment of"Registration System
for Human Resource
to tackle International
Infectious Diseases"

The
CabinetSecretariat,
theMinistry of Foreign
Affairs, the Ministryof
Education,
Culture,Sports,ScienceandTechnology, and theMinistry of Health,Labour and Welfare

Target○ Research anddevelopment of
medicines for NTDs,
Tuberculosis andMalaria fordeveloping countries
・The conduct of
nonclinicalstudy/clinical trials,
and a target forcompletion for
medicines fordeveloping countriesof 20 trials by TY
2017

System development forstrengthening thedevelopment andinformation collection ofhuman resources

Promotion of registration of human resources to be dispatched to international
institutions in addition to registration to the JDR Infectious Diseases Response Team

4

○ Promotinginternational
cooperation for
AMR
・It is separately
prescribed in the
Action Plan

○ Securing international
health human resourcesin broad fields including
infectious diseases whoare expected to take anactive role ininternational institutions
・The number ofregistrants to the"Registration System of
Human Resource totackle International
Infectious Diseases":
500 people by FY 2020

Measures

Ministry(2) Developing human resource
against international
infectious diseases

The Cabinet
Secretariat,
the Ministryof Foreign
Affairs, theMinistry of
Education,
Culture,Sports,Science andTechnology,
the Ministryof Health,Labour andWelfare, andthe Ministryof Defense(TY) 2015

2016

2017

2018

2019

・Clarification of necessary
suitability
・Development of human resource
development program including
cross-sectorial perspectives

Implementation of training by human resource program

Discussion of practical training
by utilizing international dispatchorganizations and research anddevelopment centers overseas

Implementation of practical training

2020

Discussion of issues and implementation of training for the JDR Infectious Diseases Response Team
(The first Induction Course is conducted in the fourth quarter of FY2015 and the Skill-up Course is conducted in the second quarter of FY2016)

Discussion oftraining expansion
for medical
officers of theJapan Self-Defense
Forces

Implementation and improvement of expanded training
Discussion oncontinuous measuresfor keeping skills after
completion of training

Improvement of continuous measures for retaining skills

Promotion of human resource development involved in infectious diseases in universities(3) Dispatching human resource
to tackle international
infectious diseases

The Cabinet
Secretariat,
the Ministryof Foreign
Affairs, theMinistry of
Health,Labour andWelfare, andthe Ministryof Defense

・Development of dispatch
systems of the JDR Infectious
Diseases Response Team・Introduction of materials andequipment
・Aiming to conclude a contract
with a private company offering
emergency transport service for
medical evacuation of membersin the JDR Infectious Diseases
Response Team

Discussion on the mechanism
for strengthening development
and information collection by
the Ministry of Health, Labourand Welfare

・Maintaining the dispatch systems of the JDR Infectious Diseases Response Team・Storage, maintenance, management, and review of materials and equipment to be delivered

Implementation of the strengthening of development and information collection by the Ministryof Health, Labour and Welfare

5

Target○ Development of
human
resources invarious fields
such as clinical,
epidemiology,
testing anddiagnosis,
logistics,
management,
andinternational
health policy,
who areregistered in the"Registration
System of
Human
Resource
againstInternational
Infectious
Diseases"○ Maintaining thesystem topromptly
dispatch theteam under theframework of the
Infectious
Diseases
Response Teamin response to
the outbreak andspread ofinfectious
diseases○ Promotion ofhuman resource
dispatch tointernational
institutions

Measures

Ministry(4) Supporting career
paths of humanresource to tackle
international
infectious diseases

The
MinistryofForeign Affairs, theMinistry of Education,
Culture,Sports,ScienceandTechnology, and theMinistry of Health,Labour and Welfare(TY) 2015

2016

2017

Discussion on concrete
support measures formatching

2018

2019

2020

Implementation of support by matching

Implementation of information collection/provision and analyses of the current state on positions in international institutions anddomestic relevant organizations and necessary capabilities

3. Project for strengthening crisis management system of infectious diseases(1) Strengthening of testing
systems and promotion ofoperations involved inprevention and treatment
for high-risk pathogens
led by National Instituteof Infectious Diseases
with BSL4 facilities(2) Strengthening ofcollection, analysis,
evaluation, and provisionof information on
infectious diseases
overseas

The Ministryof
Health,LabourandWelfareStrengthening of testing functions in BSL4 facilities of the National Institute of Infectious Diseases
Discussion on system development ofpublic testing organizations

The Ministryof
Foreign
Affairs and theMinistryofHealth,LabourandWelfareDevelopment of systems for uniform
collection and management

Construction of centers and networks of public testing organizations

Strengthening of functions in the National Institute of Infectious Diseases

Development of systems foranalyzing and evaluating information
in a prompt and appropriate manner
Newly set
training
Construction ofcooperation
systems

Implementation of the training for medical attachés of overseas establishments
Strengthening of cooperation between the Ministry of Foreign Affairs, the Ministry of Health, Labour andWelfare, and the National Institute of Infectious Diseases
Dispatch of a medical specialist on infectious diseases involved in health safety lecture(3) Securing intellectuals
involved in infectious
diseases and scaling up
risk communication

The
CabinetSecretariat, theMinistryofForeign Affairs,
and the Ministryof
Health,LabourandWelfareConstruction of
consultation systems

Scaling up risk communication

6

Target○ Securing career
paths by matching
between the humanresource to tackle
international
infectious diseases
and domestic
relevantorganizations○ Strengthening anddevelopment of
nationwide testing
systems for Type I
infectious disease
・The number of
network 0 (FY 2015)→ 7 (FY 2020)○ Strengthening of
informationcollection of
infectious diseases
overseas anddevelopment ofsystems forappropriate risk
communication
・Development ofsystems capable ofresponding toemergencies invarious regions by
nearly 10 trained
medical attaches○ Development ofsystems capable ofholding technicalconsultations in a
prompt and smoothmanner for Ebola
Virus Disease andinfectious diseases
to be responded toin the light of futureinternationalsituation

4. Project for promoting research system of infectious diseases
Measures

Ministry(1) Forming an infectious
disease research center

The
CabinetSecretariat,
theMinistryof
Education,
Culture,Sports,ScienceandTechnology, andthe Ministry of
Health,Labourand Welfare(TY) 2015

2016

2017

2018

2019

2020

Implementation of necessary support in light of the discussion and arrangement status in Nagasaki University in forming an infectious
disease research center with BSL4 facilities as the core

Establishmentof a council

Discussion, adjustment and promotion of concrete utilization measures and support measures including
desirable functions and operation methods of BSL4 facilities

Target○ Forming an
infectious diseaseresearch centerwith BSL4
facilities as the
core

Strengthening the functions of testing and inspection in the National Institute of Infectious Diseases(2) Promotion of researchand development
involved in infectious
diseases of high-risk
pathogens

The
CabinetSecretariat,
theMinistryof
Education,
Culture,Sports,ScienceandTechnology, andthe Ministry of
Health,Labourand Welfare

Steady promotion of research and development involved in infectious diseases including pathogens of Type I infectious diseases
under research support by the Japan Agency for Medical Research and Development (AMED) based on "Plan for Promotion of
Medical Research and Development"

5. Project for strengthening domestic ability to address infectious diseases(1) Promotion of measures
to tackle AMR

The
CabinetSecretariat,
theCabinet Office, theMinistryofForeign
Affairs,
the Ministry of
Education,
Culture,Sports,ScienceandTechnology,
theMinistryofHealth,Labourand Welfare, andthe Ministry ofAgriculture,
Forestry
andFisheries

・Establishmentof review
meeting・Formulation of"Action Plan"

Implementation of measures based on the Action Plan
・Evaluation of progress and effectiveness of measures, and improvement of measures if necessary
・Grasping the current state and identifying issues involved in antimicrobial resistance for review of the Action Plan

Strengthening of systems of Japan Nosocomial Infections Surveillance (JANIS) by drug-resistant bacteria and analysis forpathogens, and construction of systems involved in comprehensive infectious disease control function in cooperation with the
National Center for Global Health and Medicine (NCGM), in the National Institute of Infectious Diseases

7○ Strengthening of
measures to tackle
infectious diseases
by connecting the
research resultswith thedevelopment oftherapeutic drugs,
diagnostic drugs,
and vaccines○ Strengthening of
measures totackle AMR
・It is separately
prescribed in the
Action PlanMeasures(2) Strengthening of systems of
relevant organizations inJapan(2)-1 Strengthening ofsystems and functionsof quarantine stations
and municipalities(2)-2 Strengthening ofsystems and functionsof designated medical
institutions for specified
infectious diseases

Ministry

The
Ministry of
Health,Labour andWelfareThe
Ministry of
Health,Labour andWelfare(TY) 2015

2016

2017

2018

2019

2020

Systematic development of equipment and devices in quarantine stations, municipalities, health centers, regional public health laboratories

Development of necessary human resource systems in quarantine stations

Assistance for operations of designated medical institutions for specified infectious diseases
Request of development and assistance to undeveloped prefectures
Development of systems of designated medical institutions for specified infectious diseases

Development of systems for promoting measures to tackle
AMR in National Center for Global Health and Medicine

Development of systems capable of dispatching experts
when an infection spreads in Japan, in the National Center
for Global Health and Medicine(2)-3 Establishing aframework to improve
the ability to address
infectious diseases in
the Japan Self-Defense
ForcesThe
Ministry of
DefensePromotion of measures to tackle AMR

Prompt dispatch of experts when an infection spread inJapan

The government will aim at the designation of the National Defense Medical College
and the Self-Defense Forces Central Hospital as designated medical institutions forType I infectious diseases on the earliest possible occasion
Enhance a framework to respond to infectious diseases in the National Defense Medical College and Self-Defense Forces Central
Hospital, etc.

8

Target○ Strengthening ofsystems andfunctions ofquarantine stations
and municipalities○ Strengthening ofsystems andfunctions ofdesignated medical
institutions for
specified infectious
diseases○ Development ofType I designatedmedical institutions
in all prefectures
・The number ofdeveloped
prefectures:
41 (TY 2015) → 47
(TY 2020)○ Strengthening ofdomestic
measures totackle AMR
・Separately
prescribed in the
Action Plan
○ Establishment ofsystems to improve
the ability toaddress infectious
diseases in theJapan SDF
・The number ofhospitals establishedby MOD as
designated medical
institutions for TypeI infectious diseases
2 hospitals by TY:
2018

<Individual Sectorial Measures>
1. Promoting international cooperation
Measures

Ministry(TY) 2015

2016

2017

2018

2019

2020

(1) Strengthening cooperation
with international institution
for emergency(1)-1 Securing
implementation andstrengthening IHR ofWHO

The Ministryof
Foreign
Affairs
andthe Ministryof
Health,LabourandWelfare(1)-1 Support forstrengthening the baseof GOARN

The Ministryof
Health,LabourandWelfare(1)-2 Dealing with theCatastrophe
Containment andRelief Trust of theInternational Monetary
Fund (IMF)

The Ministryof FinanceSupport for securing implementation and strengthening of International Health Regulations (IHR) through promotion of
support to WHO

Target○ Securing
implementationand strengtheningof IHR bydeveloping
countries○ Strengthening ofsystems so as tosmoothly dispatch
appropriate experts
in the outbreak ofinfectious diseasecrisisStrengthening the implementation system of training before dispatch and the communication system to contribute tostrengthening the foundation of GOARN through promotion of support to WHO○ Support toefforts of theCatastrophe
Containment
and Relief Trust

Suppressing the reduction of financial capabilities to measures to tackle infectious diseases due to the worsening of macro
economy, by immediately providing grants to IMF Member State in severe economic stagnation due to pandemic throughcontribution to efforts by CCR Trust○ Establishment ofsystems preventing
international
emergency due tothe spread of
infectious diseases○ Strengthening ofcooperation in
the health field(1)-3 Cooperation andpolicy dialogues with
implementing agencies
such as UNDP,
UNICEF, and UNFPAThe Ministryof
Foreign
Affairs

The holding of dialogue and meetings once a year if possible, such as strategy dialogues between Japan and UNDP, policy
meetings between Japan and UNICEF, and policy meetings between Japan and UNFPA

9

Measures(2) Health systems
strengthened indeveloping countries toprevent outbreak andspread of infectious
diseases(2)-1 Health systems
strengthened andpromoting universal
health coverage (UHC)by utilizing
development
cooperation

Ministry

The Ministryof
Foreign
Affairs,
theMinistryofFinance, andthe Ministryof
Health,LabourandWelfare(TY) 2015

2016

2017

2018

2019

2020

In development cooperation for strengthening health systems and promoting UHC, technical cooperation, government loans, and grant aid areorganically combined to reflect the partner countries' situation according to economic conditions and the prerequisites of health systems in the
supported countries and operated in a timely and flexible manner, taking into account the possibilities of cooperation with other donors(including international institutions addressing specific diseases)

Direct support and development of human resources by dispatching experts in each field according to the implementing stage ofmeasures for strengthening health systems in each country
Promotion of support to contribute to UHC by World Bank through the Japan Trust Fund of the World Bank
Support for the implementation of IHR through a framework of the Global Health Security Agenda (GHSA).
Support for the implementation of IHR in developing countries through development of research centers and human resources in
the Noguchi Memorial Institute for Medical Research(2)-2 Emergency assistancein response to theoutbreak of infectious
diseases and support
for the recovery ofhealth systems

The Ministryof
Foreign
Affairs
andthe Ministryof
Health,LabourandWelfareThe following efforts implemented to provide emergency assistance in response to the outbreak of infectious diseases or recover the healthsystems
・Provision of emergency grant aid and emergency relief goods, as emergency assistance and funds and materials to international institutions
for the recovery of health systems
・Personnel assistance including the dispatch of expert human resources

Promotion of strengthening health systems in developing countries through collaboration with the Global Fund, otherinternational institutions and other donors

10

Target○ Strengthening ofhealth systems andpromotion of UHC○ Promotion of designof health systems
and development ofhealth humanresources for
low-income
countries andregions in Africa
・Supported countries
for IHR
implementation
including ones
through theframework of GHSA
7countries○ Development of
human resources,
provision of
medicines, andpromotion of healthinformation systemin the outbreak ofinfectious diseases

2. Developing testing and research systems for high-risk pathogens involved in infectious diseases in Japan(1）Development of thetesting system at the
National Institute of
Infectious Diseases

The
Ministry
Health, Labour
Welfareofand(2) Further considering
how to designate BSL
4 facilities in JapanThe Cabinet Secretariat, theMinistry of Education, Culture,
Sports,ScienceandTechnology, and the Ministryof Health, Labour and Welfare

Promotion of active information disclosure and communication with local communities by holding communication meetings

Further discussion on the necessity of development of BSL4 facilities○ Development of safe
and stable situation in
BSL4 facilities in the
National Institute of
Infectious Diseases○ Appropriate setting up
and development of
BSL4 facilities

3. Developing the base of Japanese human resources involved in measures to tackle infectious diseases who take an active role in the international community
Measures
Ministry(TY) 2015
2016
2017
2018
2019
2020
TargetPromoting human resources
development through the
Infectious Disease
Emergency Specialist
Training Program

The
Ministry of
Health,Labour andWelfare・Creation of IDES Training Program and implementation of training
・Promotion of human resources development by IDES Training Program and registration of human resources

・Registration of IDES Training Program graduates as an infectious disease
emergency specialist
・Gradual registration as a member of Infectious Diseases Response Team in
JICA

・Development of human resources by FETP-J

11○ Development of anexpert on infectious
disease crisis
management who has
clinical andepidemiologicalknowledge related to
infectious diseases,
the ability to respondto public health, theinternational
adjustment ability, andcomprehensive
expertise and abilities
・The registerednumber to JDR Teamin JICA from the
IDES Training
Program
20 people by TY
2020○ Development of field
epidemiologists
The number of
FETP-J graduates:
64 people (TY 2015)→ 100 people (TY2020)

4. Strengthening the domestic measures on infection prevention and the safety measures for Japanese nationals overseas(1) Promoting provision of
information on infectious
diseases in Japan to the
populace

The Ministry of
Health, Labourand Welfare(2) Improving response
capability of relevantorganizations including
quarantine stations andsecuring responses in thecase where an infection(including a suspected
infection) has been
confirmed in JapanThe
National
Police Agency, theFire and Disaster
Management
Agency,the
Ministry of Health,LabourandWelfare,the
Ministry of Land,
Infrastructure,
Transport
andTourism, and theMinistry of theEnvironment

Measures

Ministry(3) Developing policies forresponses to Viral
Hemorrhagic Fever atadministrative agencies.

The Ministryof
Health,LabourandWelfare(4) Ensuring the provision oftimely and appropriate
information and traveladvice/warning on infectious
diseases to Japanese nationals
overseas

The Ministry ofForeign Affairs
and the Ministryof
Health,LabourandWelfareUtilization of new media including SNS, and regular implementation of needs investigation of mail magazines to broaden
measures
Implementation of training in quarantine stations, municipalities, health centers, regional public health laboratories, anddesignated medical institutions for specified infectious diseases
Appropriate implementation of active epidemiological investigation by utilizing Field Epidemiology Training Program (FETP-J)
in the National Institute of Infectious Diseases
Making training and basic measures known in the National Police Agency, the Fire and Disaster Management Agency, and the Ministry of Land,
Infrastructure, Transport and Tourism

・Making the new manual known
・Investigation and discussion for further review of the manual・Investigation and discussion forrevision of an infectious waste disposal
manual and implementation of revision(TY) 2015

2016

2017

Creation of aguideline foradministrative
response

2018

2019

Making it known by training

Issuing of safety information on infectious diseases in a timely and appropriate manner

12

2020

○ Proper provision of
information on
infectious diseases inJapan○ Keeping necessary
response capabilities in
relevant organizations
・The frequency of
trainings in eachorganization
Once or more (TY 2014)→ Once or more
improved training peryear (TY 2020)・The figure for illegal
dumping or
inappropriate disposal of
infectious waste
0 (TY 2014) → 0 (TY2020)

Target○ Securing responses
by administrative
agencies in a
prompt andappropriate mannerin cases where
Viral Hemorrhagic
Fever occurred inJapan○ Provision of infectious
disease information to
Japanese nationals
overseas in a timely
and appropriatemanner(5) Strengthening safetymeasures such as medical
evacuation in case of
infection of Japanesenationals overseas

The Cabinet
Secretariat, theof
Ministry
Foreign
Affairs,
theMinistryofHealth,LabourandWelfare, andthe Ministry of
DefenseDiscussing the
deployment of medical
attaches in an emergency
situation such as theinfection of Japanesenationals overseas

Test deployment of
the medical attachés inan emergency situation

Full-scale deployment of medical attaches in an
emergency situation<Developing medical evacuation system >・Government will collect information on infectious diseases by relevant country and private airlines and crisis managementcompanies and construct a cooperative relationship with them through overseas establishments in order to ensure theirprompt cooperation and support once the medical evacuation to a third country/Japan is considered to be the best method oftreatment taking into account doctor's diagnosis and request from the patient/family.
・Government will strengthen response through coordination of the relevant ministries/agencies and other methods to including
the medical evacuation by the aircraft of the Japan Self-Defense Force in case there are no other alternative nor civil aircraft
available.

13○ Strengthening support
by the medical
attaches in overseas
establishments
・Development ofsystems capable ofresponding toemergencies in various
regions by nearly 10
medical attaches who
experienced various
trainings○ Maintaining medical
evacuation capability
overseas