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Assistant Minister Yamamoto, you have been involved in policy making in the field of global health (including countermeasures against AIDS) for quite a long time in the Ministry of Health, Labour and Welfare and Japan’s delegation to the UN. Please tell us about how you first came to be involved in this field.

I do not have a wealth of experience in the field of global health by any means. I first became in charge of HIV/AIDS in 1992 immediately after returning to the (former) Ministry of Health and Welfare from studying abroad in the U.S. After that, I handled the preparations and management for the 10th International AIDS Conference held in Yokohama, 1994, which was the first in Asia. At that time, I remember that therapeutics for HIV/AIDS were limited and that there was also strong discrimination and prejudice against people living with HIV. In that kind of environment, and in cooperation with healthcare professionals and researchers, NGOs, and patient groups around the world, I truly felt the power of solidarity as we tackled regional challenges with a global viewpoint. These challenges included developing theapeutics and guaranteeing equal access; education for prevention; protecting the human rights of patients, those are living with HIV/AIDS, and sexual minorities; and providing support for children orphaned by AIDS.

I was reunited with these friends ten years later, when I was serving in the UN delegation in New York. Even now, these friends still help me with various situations. And today, I oversee global health in my position as Assistant Minister for Global Health and Health Industry Strategy, Minister’s Secretariat, Ministry of Health, Labour and Welfare.

The GHIT Fund is Japan’s first initiative specializing in global health R&D. GHIT’s main role is to invest in the development of products for infectious diseases prevalent in developing countries. As you know, such infectious diseases and tropical diseases are not much of a problem in Japan; what was the Ministry of Health, Labour and Welfare’s rationale for contributing funds to GHIT? Why is investing in Global Health R&D important for Japan?

Japan’s pharmaceutical industry possesses technology and capabilities for developing new drugs on the same level as the U.S. and EU. Therefore, we have great expectations for this industry as one which will be important for Japan’s economic growth. We see improving the environment for drug discovery and development as directly related to strengthening our international competitiveness.

In the field of global health, on the other hand, the research and development (R&D) for Neglected Tropical Diseases (NTDs), tuberculosis, and malaria which are mainly prevalent in developing countries, is not being sufficiently done due to a lack of demand in developed countries. Even when medical products have been developed, the disparity in access to those tools has been a challenge.

Therefore, by leveraging Japan’s excellent R&D technologies and capabilities and promoting public-private partnerships to develop drugs meant for developing countries as well as supporting their supply, we aim to grow and expand Japan’s pharmaceutical industry. The return we see is revitalization of the domestic economy through providing the underlying support for expanding Japan’s pharmaceutical industry overseas. This is why we invested in GHIT.

Furthermore, health is essential to people's fundamental happiness and a foundation of prosperous countries. Indeed, Japan, which has experienced numerous health challenges, should proactively contribute to global health and play a leading role in this arena.

What kind of impact do you think the GHIT’s establishment has had on Japan’s global health R&D sector?

There are two distinctive features of GHIT to point out here. First, the collaboration between Japan and overseas organizations is a prerequisite when conducting R&D. Second, GHIT targets NTDs, which are still a global health challenge, despite the fact that they are not prevalent in Japan. Such a partnership approach and substantive focus make GHIT’s funding scheme completely different from other funding schemes for R&D in Japan. By leveraging this new platform, I think we have been able to demonstrate at home and abroad that Japanese pharmaceutical companies, research organizations, and universities possess technologies and capabilities which can not only contribute to the nation’s health, but to global health as well.

Based on these successful experiences, I am hoping that many companies and research organizations in Japan become motivated to help address the challenges of global health, and this will lead to further advancing Japan’s global health R&D.

Over the next five years, what kinds of roles will GHIT need to play in order to promote innovation in Japan?

GHIT’s pipeline currently has several drug and vaccine candidates in late-stage clinical trials. Over the next five years, we need to deliver these products as tangible results to people suffering from NTDs, tuberculosis, and malaria. In order to do so, we can utilize existing systems such as the Japanese orphan drugs/ medical devices designation system and clinical trial consultations offered by the Pharmaceuticals and Medical Devices Agency (PMDA), which is Japan’s regulatory authority, for more efficient and swift clinical development. At the same time, we need to work even more closely with the United Nations Development Program’s “Access and Delivery Partnership”, which Japan contributes to along with GHIT. Additionally, capacity building and system strengthening must be done in low- and middle-income countries to improve delivery on the ground.

I believe that we can continue to build trust between GHIT and stakeholders and advance Japan’s innovation through accumulating concrete results step by step. For example, by further expanding the results up to this point, and taking Japan’s pharmaceutical technology and capabilities from the bench to clinical settings where patients are suffering from infectious diseases.

The affiliations and positions listed in this interview are at the time of publication of the interview in 2017.