Sumitomo Dainippon Pharma are committed to continuously addressing countermeasures on antimicrobial resistance (AMR) for lower-middle income countries including Vietnam until 2026 to improve appropriate use of antibacterial agents and medical environments with One Health approach (human, animal, and environment), and contribute to the realization of sustainable treatment of infectious diseases that benefits 96.2 million people.
October, 2020
Sumitomo Dainippon Pharma Co., Ltd.
| Issues to be solved | Antimicrobial resistance (AMR) |
| Product / Technology / Service | Promotion of appropriate prescribing and use of antibacterial agents based on susceptibility surveillance research |
| Approach | Scientific research, capacity building |
| Target country / area | Vietnam |
| Target year for achievement | 2026 |
| Scale of the business | 70M yen / year, implemented every other year in 2019 and 2021 |
| Partner | National Center for Global Health and Medicine (NCGM), local government and medical institutions |
| Relevant target of SDGs |
3.3 By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases
3.4 By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being
17.17 Encourage and promote effective public, public-private and civil society partnerships, building on the experience and resourcing strategies of partnerships |
Background
Sumitomo Dainippon Pharma Group has marketed carbapenem antibiotic meropenem in Southeast Asian countries, including Vietnam, since 2017. Meropenem is originally found and developed by Sumitomo Dainippon Pharma in 1995. WHO classifies meropenem into the Watch Group according to the WHO Model Lists of Essential Medicines (EML) and recommended to use as first- and second-line therapy for wide range infectious diseases and avoid the emergence of resistant bacteria.
In Vietnam known with the highest rates of resistance against antibacterial agents in Southeast Asia, many cases have been reported on the inadequate therapeutic efficacy by antibacterial agents, including meropenem at local medical institutions. We have also recognized the serious situation through our businesses.
Given such a background, we started the first susceptibility surveillance study in 2019 in collaboration with 10 major medical institutions in Vietnam. A detailed investigation was performed on the development of resistance against several antibacterial agents, including meropenem, mainly used for therapy of severe and intractable infectious diseases.
Purpose of the project
We aim to realize appropriate prescription and use of antibacterial agents and the control of nosocomial infection based on evidence obtained by our susceptibility surveillance study. Currently, we are making efforts to create a practical scheme and are planning to expand the scope of our activities with One Health approach (human, animal, and environment).
Detail of the Project (How can this project address global health challenges?)
Infection diseases are one of the most critical global health issues, directly affecting human lives and social activities, as observed for the COVID-19 pandemic, which has claimed many lives and significantly hindered economic activities worldwide. AMR infections are caused by drug-resistant bacteria that develop or spread through various factors, such as human and environmental factors and suggested to be addressed through two main measures. One is the development of new antibacterial agents, and the other is the prevention of the spread of AMR infections by the appropriate use of existing antibacterial drugs and control measures for nosocomial infections. We have worked on both measures by utilizing the knowledge accumulated for many years through the invention, development, manufacturing, and sales of meropenem. The present project is relevant to the latter measure.
Since the developmental stage of meropenem, we have had a concern about the deterioration of drug efficacy due to the possible future occurrence of AMR. We have promoted globally the activities for appropriate use of antibacterial agents and made efforts to improve medical environments mainly by taking preventive measures for infectious diseases (both of community and nosocomial infections) and raise public awareness since the launch of meropenem for more than 25 years. As an R & D pharmaceutical company, we believe it is our important mission to create medical environments in which all antibacterial agents, including existing ones, remain adequately effective as treatment options, besides being involved in the research and development of new antibacterial agents.
Our activities in Japan and relevant data accumulated since 1995 have been effectively taken over as a foundation for public measures for AMR, including PK-PD (*1)-based EBM (evidence-based antibacterial drug prescription) and the Japan Nosocomial Infections Surveillance (JANIS), and translated into medical treatments for infectious diseases in Japan. We believe that AMR issues cannot be resolved without long-term and comprehensive efforts by both the public and private sectors. We are implementing this project based on the belief that Japanese modern systems and mechanisms established through public-private partnerships should also be effective in Vietnam. Besides supporting the creation of scientific evidence through our susceptibility surveillance study, we will make comprehensive and multilevel efforts to promote changes in the behaviors and consciousness of all stakeholders involved in AMR issues and systematize sustainable public-private measures for AMR in collaboration with other stakeholders.
In 2019, we invested about 70 million yen in the project, relative to about 2 billion yen from the sales of meropenem in Vietnam. It is estimated that advances in medical and financial reforms (e.g., recommendation of generic or domestic products) by the government may have any impact on our business. However, we believe that continuity is essential for this project and plan to maintain the same level of investment at least in 2021.
Based on the evidence of our susceptibility surveillance study in 2019, the 10 participant institutions will promote activities for appropriate prescription and use of antibacterial agents. Because these institutions play an educational role in each local medical system in Vietnam, the project should improve skills, change behaviors, and raise awareness among local medical professionals, thereby providing organic ripple effects on relevant institutions.
(*1) Concept to design the optimal administration of an anti-microbial agent by evaluating its efficacy and safety in connection with pharmacokinetics (PK), which shows how an anti-microbial agent concentration changes within human body, and pharmacodynamics (PD). Timeline or milestones by the achievement of the commitment, KPI for monitoring activities
Currently, we are analyzing the latest rate of resistance against major antibacterial agents through our susceptibility surveillance study started in 2019. Based on the results, we plan to assess the resistance rates by region, institution, and infectious disease, examine possible countermeasures, and consider specific KPIs for activities to improve the rates of AMR. We will consider KPIs that match the local situation in the future. The current candidate KPIs are the temporal changes in the measured resistance rates, the numbers and understanding levels of participating doctors, nurses, and pharmacists specializing in infectious diseases, the share rates of collaborating private sectors in the industry, the numbers and understanding levels of community involved in educational activities, etc.
Precondition for achieving the commitment
We believe the project requires external funding as resources for continuous activities, cooperation with government ministries and agencies to establish systems rooted in the local culture, and other organizations and companies that also support measures for AMR locally, securement of specialized human resources, obtainment of government approval for implementing support activities, and cooperation with customs for the local transportation of support materials (such as medical equipment).
Role and responsibility of each partner
Local governments: Approval of activities, advice on activity planning
WHO/JICA: Advice and cooperation for social implementation of activities
International NGO/NPO: Information sharing and cooperation regarding local AMR activities
References
Sumitomo Dainippon Pharma Corporate website, “Contribution to Global Health”
https://www.ds-pharma.com/csr/global_health/contribution_to_global_health.html Contact information
Company: Sumitomo Dainippon Pharma Co., Ltd.
Person in charge: Megumi Maruyama, Global Health Officer
Telephone: +81-6-6203-5321 (head office)
editor：All contents including photos provided by Sumitomo Dainippon Pharma
