The strategic initiative“ Integrative Promotion of Nation-wide Infection Control - Vaccination and Epidemiology - ” is a proposal package for solving health-related social issues associated with infectious diseases. This proposal includes research and development (R&D) strategy to overcome infectious diseases, social implementation of those R&D results, and practical operations of measures whole related activities.
Occurrences of serious infectious diseases continue to be reported around the world. Although the mortality rate of infectious diseases has significantly dropped in Japan owing to the improvement of the accessibility to medical care, nutritional status, public sanitation and so on, Japanese people are still threaten by infectious diseases, such as influenza and tuberculosis. On the other hand, an infectious disease appearing in one country or region can now quickly spread around the world through the global, advanced transportation systems. Nowadays, the Japanese public is also facing emerging threats of artificial infection risk including misuse and dual-use of biological materials (biohazards, bioterrorism, etc.) which are keenly recognized at the global level but not in Japan. Countermeasures against such emerging threats are not effectively prepared in Japan. Considering these circumstances, Japanese nation is still vulnerable to infectious diseases. Therefore we propose accelerate development and industrialization of vaccines, practical operation of epidemiology against infectious diseases, and enhanced transmission of epidemic information.?It is also urgent to pursue measures underpinned by scientific knowledge and technology to minimize health problems associated with infectious diseases from a viewpoint of a long-term national strategy.
Based on the situations described above, the Center for Research and Development Strategy (CRDS) at Japan Science and Technology Agency (JST) investigated the current status and issues of R&D and social implementation for controlling infectious diseases in and outside of Japan, and had discussions with experts from industries, academia and government. In conclusion, we propose that the promotion package of following three disciplines for reducing risks associated with infectious diseases.
Strategic imperative 1: “Promotion of Research and Development” ???(vaccines and adjuvants, etc.)
Strategic imperative 2: “Establishment of Infectious Disease Epidemiology”???(collection and organization of domestic and overseas information, samples, etc.)
Strategic imperative 3: “Social Implementation” ???(analysis and distribution of information about infectious diseases, assessment of research results, and social implementation of measures against infection diseases that are supported by scientific evidence, etc.)
It is a globally-shared view that vaccines are an extremely important factor to protect not just individuals but the entire society against the threat of infectious diseases.4 In recent years, increasing attention has been paid to adjuvants, which are pharmacological agents and can activate the effect of vaccines, making vaccine administrations more efficiently and effectively. For Strategic imperative 1, collaboration should be made by industries, academia and the government to form a target-oriented R&D consortium with paying attention to dual-use problems (use of research results for military purposes). The consortium should facilitate the quick development of effective and safe vaccines and adjuvants for the infectious diseases that are identified as targets for R&D based on results of comprehensive survey of domestic and international epidemiological trend and social needs. It should also promote a research that takes interdisciplinary approaches, with an aim to create innovative seeds from a mid-to-long term perspective.
It is requires for strategic imperative 2 to provide various information needed for R&D and the social implementation of infection control. Academia and the government should promote strategic imperative 2 through the identification of transmission routes/hosts and collection of samples by academia as well as rapid and accurate infectious disease surveillance (investigations/ monitoring) by relevant governmental agencies. At the same time, the database infrastructure should be reconstructed through accumulation and compilation of the information about various infectious diseases.
For Strategic imperative 3, Academia and the government should promote streamlining and improving the information networks of academia and relevant governmental agencies, which distributes information related to infectious diseases both under normal and emergency conditions. Several issues should be clarified to build up the information networks, for examples, what is the best channel, what is the proper information content, who is the best distributor, and so on. Furthermore, collaborative efforts should be made across academia, industries, the government, etc. to carry out health technology assessment on vaccines, including medical, social and economic aspects.
In case of pandemic, immediate action to prevent further spreading is required. Therefore we propose focus on suppressing the pandemic in order to quickly develop the vaccine, produce it in sufficient quantities, and make it available to the public. In normal situations, it is important that each of above strategies are continuously pursued with a long-term perspective, and only if they are steadily implemented under normal conditions do they become capable of quickly responding to an emergency situation.
When developing a vaccine or adjuvant for a particular infectious disease, the time frame for Strategic imperative 1 may vary widely depending on the target disease, how much progress the research is making, and how great the potential threat of the disease (a pandemic) is or will be to the health of the Japanese people. For example, when a pandemic occurs, it is desired that the development process be completed within several weeks to several months. However, for a disease that can potentially cause a pandemic in the future, the development is expected to be completed within ten years, including the time required for the clinical study.
This initiative should contribute not only to mitigation of risk associated with infectious diseases in Japan but also to an innovation in Life Science field through the development and global launches of new vaccines and adjuvants that can meet medical needs in Japan and overseas. And more, this initiative accelerates enhancing infectious disease epidemiology, which serves fundamental information for R&D activities, as well as creating new interdisciplinary fields for vaccine R&D. Furthermore, this initiative also aims at establishing the frameworks capable of responding to a pandemic emergency by facilitating the quick development of a vaccine in Japan and supplying it to the public in sufficient quantities, which will help assure the safety of the nation.