Frank Tu Ngo highlights Japan’s leadership in mitigating one of today’s most urgent global health challenges, antimicrobial resistance (AMR). By capitalising on its political influence, funding, expertise, and diplomatic positioning, Japan is driving global efforts against AMR
Antimicrobial or drug resistance is a pressing global health crisis. It occurs when bacteria, viruses, fungi, and parasites stop responding to medicines, making infections difficult — sometimes impossible — to treat. If left unchecked, AMR could cause up to 10 million deaths annually by 2050 and reduce global GDP by $3.4 trillion every year by 2030, posing an even greater threat than Covid-19. Indeed, the WHO lists AMR as one of the top global health threats in the 21st century.
If left unchecked, AMR could cause up to 10 million deaths annually by 2050, posing an even greater threat than Covid-19
That’s why, in 2015, the WHO adopted a Global Action Plan on AMR, calling on all member states to develop national action plans within two years. Japan responded in 2016 with its first National Action Plan, aligning with WHO’s five goals while adding a sixth: 'Strengthen Japan’s Leadership for Global Policies on Antimicrobial Resistance'.
Nearly a decade later, we can assess how Japan advanced this goal, and what impact it has had on global AMR policy.
Japan’s leadership is most visible in major multilateral forums. Since 2016, it has chaired the G7 twice (Ise-Shima 2016; Hiroshima 2023) and hosted the G20 Osaka Summit in 2019. These presidencies gave Japan the chance to shape agendas, draft communiqués, and coordinate messaging. Each time, AMR was highlighted as a key global health challenge.
Taking into account ever-expanding global economic integration, especially in the Asia Pacific region, Japan is all the more responsible for addressing the threat of antimicrobial resistance as countries develop their own national action plans
Former Prime Minister Shinzo Abe hints at Japan’s leading role in his article for The Lancet ahead of the Ise-Shima G7 in 2016
Indeed, the 2016 G7 Leaders’ Declaration and the accompanying Vision for Global Health explicitly identified AMR as one of four global health priorities. Leaders also pledged support for the UN High-Level Meeting on AMR, among other key events.
Later in 2016, the UN General Assembly held its first-ever High-Level Meeting on AMR — only the fourth time in history a health issue had been given such prominence. Japan’s agenda-setting power at high-level fora helped foster global momentum and collaboration to address AMR.
Japan is a major financial supporter of AMR research and development. Between 2017 and 2025, it contributed around $125 million to developing new antimicrobials, making it the top funder in Asia.
It has also provided around $9 million to leading international initiatives such as GARDP (a Geneva-based nonprofit launched by the WHO) and CARB-X (a US-based nonprofit led by Boston University). Both organisations are central players in the AMR landscape.
Beyond funding, Japan holds seats on the boards of key AMR multilaterals, such as the Global AMR Research & Development (R&D) Hub — a G20 initiative launched under Germany’s 2017 presidency. As a voting board member, Japan provides political support, legitimacy, and strategic guidance, shaping global AMR priorities and strategies.
Japan also offers policy leadership and technical expertise. Within the G7, it is one of only three countries, alongside Germany and the UK, to have fully implemented a pull incentive strategy, not just a pilot. Pull incentives are financial or policy mechanisms that reward medicine developers for bringing new antimicrobials successfully to market. Experts regard these incentives as essential for making AMR development financially viable while safeguarding the public interest.
Japan is one of only three G7 countries to fully implement a pull incentive strategy that rewards developers for bringing new antimicrobials to market
Japan’s experience in implementing such strategies is therefore of high interest to the AMR community. For instance, in the Global AMR R&D Hub's Pull Incentives Working Group, Japanese policy-makers share insights that inform other countries' policies and practices. Several Hub officials have noted that government representatives are often curious and eager to learn more about Japan’s approaches, and the processes behind its policies.
Finally, Japan acts as a diplomat, connecting global stakeholders. For seven consecutive years, it has hosted the Tokyo AMR One Health Conference — a ministerial forum that brings together Asia-Pacific governments, international organisations, and funders to address AMR. The conference enables many Asian nations, particularly low- and middle-income countries, to exchange expertise, foster collaborations, and access funding.
In February 2025, the 7th Tokyo AMR Conference convened 170 representatives from 29 countries, as well as international organisations including the WHO, UNEP, FAO, and WOAH. The Director of the Global AMR R&D Hub was also among the invited speakers, and participated in working groups. This underscores Japan’s capacity to convene global leaders and align agendas across regions. Its economic and diplomatic influence plays a crucial role in strengthening international collaboration.
Moreover, in some multilateral forums, Japan is often one of the few Asian voices. For instance, within the Global AMR R&D Hub, only Japan and China represent Asia. Japan’s regional expertise and presence in international arenas strengthens its role as a bridge between regional perspectives and global strategies.
Globally, public health budgets are under increasing pressure. Governments are expected to do more with fewer resources. Meanwhile, rising geopolitical tensions have made international cooperation more difficult, limiting the much-needed support for global health challenges like AMR. Amid these pressures, Japan’s leadership is vital.
Japan plays a significant and multilayered role in the global response to antimicrobial resistance — both domestically and internationally
Lesley Ogilvie, Director, Global AMR R&D Hub
Indeed, Japan is proving that while AMR is accelerating, Tokyo isn’t merely following — it’s setting the pace.
