Even today as we see remarkable developments in the medical field, there are many diseases against which no effective treatment exists. Also, in low- and lower middle-income countries, there are many people who have difficulty receiving necessary medical care due to various reasons such as inadequate medical infrastructure and poverty. Under the corporate philosophy “Dedicated to the Fight against Disease and Pain,” we aim to improve access to healthcare by pursuing these goals: the development of innovative pharmaceutical products, improvement of medical infrastructure, and establishment of partnerships with outside parties. We currently sell our pharmaceutical products ourselves in Japan, South Korea, and Taiwan; in Asia, including Japan, we will make efforts for improving access to healthcare including the treatment of rare diseases. In regions other than Asia, we will make efforts to provide pharmaceuticals with the help of our partner companies. We will also work on supporting medium- to long-term activities to strengthen medical systems by means such as medical education and the development of medical infrastructure through partnerships with NPOs and the Global Health Innovative Technology Fund.

The Direction of our efforts

• Promotion of research and development for measures against diseases for which patients’ medical needs are not yet met, rare diseases, and intractable diseases
• Local medical education, training of medical personnel, improvement of medical supplies in countries and regions where medical infrastructure is not fully developed
• Strengthening the medical system through partnerships with external parties

Our Policies on Intellectual Property Rights and on Patents in Countries with Limited Access to Healthcare

We strive to continually develop innovative drugs through appropriate protection and use of various types of intellectual property generated during the course of drug development, while at the same time respecting intellectual property rights owned by third parties. In some countries, people have difficulty access to healthcare due to economic reasons. To deliver our innovative drugs to more patients worldwide, we will neither apply for nor enforce patent rights in Least Developed Countries defined by the United Nations^*1 and Low Income Countries defined by the World Bank^*2. We also will not file patent applications or enforce rights in Lower Middle Income Countries defined by the World Bank^*3 with the exception of some countries.

• Least Developed Countries defined by the United Nations: https://www.un.org/development/desa/dpad/least-developed-country-category.html
• Low Income Countries defined by the World Bank: https://data.worldbank.org/income-level/low-income
• Lower-middle Income Countries defined by the World Bank: https://data.worldbank.org/income-level/lower-middle-income

Promotion Management System

The management team oversees the directions for the improvement of access to healthcare and the details of the efforts.
New efforts associated with access to healthcare will be deliberated on and approved by the CSR Committee, chaired by the Corporate Executive Officer / Head of Corporate Communications. Its activities are periodically reported to the Management Meeting which is chaired by the CEO.

Efforts to obtain approval for pediatric use

Working on the treatment of rare diseases is important so as to improve access to healthcare. We make the following efforts to develop and provide pharmaceuticals for rare diseases.

(As of July 26, 2021)

In addition, Opdivo is designated as a target item under the Priority Assessment Designation System, specified by the Ministry of Health, Labour and Welfare, that targets bile duct cancer.

Efforts to obtain approval for children

Medication evaluated appropriately for children should be used for pediatric patients. Aiming to improve pediatric patients’ access to healthcare products, we are working on the flexible approval for children as follows.

(As of July 26, 2021)

Efforts Made against Intractable Diseases

Together with Keio University, Kochi University, the National Institute of Biomedical Innovation, Health and Nutrition, Mitsubishi Tanabe Pharma Corporation, and Daiichi Sankyo Co., Ltd., we established the Immune-mediated Inflammatory Diseases Consortium for Drug Development for the purpose of drug development research targeting intractable immuno inflammatory diseases in May 2018. It is expected that the achievements of this consortium will lead to the creation of next-generation pharmaceuticals with high utility against intractable immunoinflammatory diseases and also enable the provision of new treatment options for patients and healthcare professionals.

ONO SWITCH Project

As an initiative to promote both medical system support and work style reform, we started ONO SWITCH Project in August 2018. Under this initiative, donations are made to medical-related NPOs/NGOs using the money saved by reducing overtime payments through work style reform. The project aims to contribute to the promotion of work style reform and healthcare, and people’s health around the world, thereby further promoting our corporate philosophy “Dedicated to the Fight against Disease and Pain."

—Project name and concept—

Save the World by our work style ImprovemenT and CHange
The project name also expresses switching working styles, switching the funds obtained through work style reform to donations, and switching in the process of reviewing our working styles.

• We have been working on the realization of work style reform since 2014. To promote work style reform on a company-wide scale, we appoint a promotion committee member in each department. The committee members conduct various activities in their respective departments to raise awareness and encourage employees to improve their work efficiency and take paid holidays. Thanks to these efforts, in FY2019, the average monthly overtime hours per employee decreased by 2.3 hours and the paid leave acquisition rate increased by 24.7% compared to FY2014. (The amount raised in donations from ONO SWITCH Project is calculated based on the decrease in overtime payments compared to FY2014.)

We determine the recipients of the donation based on a questionnaire for all employees every year. In FY2020, we donated to the three NPOs described below, based on the results of FY2019. The activities planned for FY2021 utilizing this donation and local healthcare issues are as follows.

Partners （Activity area supported by our company）	Local healthcare issues	FY2021 plans
Japan Committee, Vaccines for the World’s Children （Bhutan）	Bhutan does not yet have the ability to prepare all the vaccines needed in their country, and some children die from vaccine-preventable infections. Also, there is not enough vaccine refrigerators to access the vaccine.	・Provision of DPT (diphtheria/pertussis/tetanus) vaccines for 53,500 people (100% elimination of the shortage of vaccines for two-year-old children) ・Provision of hepatitis B vaccines for 9,000 people(100% elimination of the shortage of vaccines for infants within 24 hours of birth) ・Provision of TD (tetanus/diphtheria) vaccines for 69,482 people（Pregnant women: 2 times during first pregnancy, then once per pregnancy. Children: Elimination of 56% of the shortage of 2 vaccinations） ・Provision of 5 vaccine refrigerators KPINumber of vaccines and vaccine refrigerators supplied
Japan Heart （Cambodia）	The Pol Pot regime (1970s) slaughtered 1/4 of the population, who were mainly intellectuals including doctors and teachers, and only a few 10s of doctors survived after the collapse of the administration. Subsequently, in order to solve the shortage of doctors, the government adopted a policy of having medical students graduate after 1 year and engage in medical care, and medical care collapsed because physicians who were inexperienced in both technique and knowledge undertook the tasks of medical care. The level of medical care in Cambodia is still lower than in surrounding countries, and there are few equipped medical institutions, and therefore the development of medical personnel is a major issue. Japan Heart Children's Medical Center, which was established by Japan Heart in 2016, provides medical care to the poor, free of charge, and also develops local medical personnel. Without this center, the poor in the community would not have access to advanced health care. The number of patients is increasing year by year, and this medical center is faced with a shortage of necessary medical devices and failures of existing devices.	Purchase of equipment for the early detection of neonatal jaundice and phototherapeutic devices for jaundicePurchase a new measuring instrument, because the bilirubin measurement equipment currently in use and necessary for the diagnosis of jaundice has broken down repeatedly. In addition, purchase the latest and most secure phototherapy equipment for treating jaundice. ·Enable the facilities for newborns (approximately 600 babies per year) born in hospitals located in the Ponnel District, Kandal Province, to provide screening tests for high bilirubin, and jaundice phototherapy early and safely. Enable treatment of newborns born in public hospitals in the same region who require respiratory support or body temperature management soon after birth. KPINumber of cases in which newborns requiring jaundice treatment were detected early and highly safe phototherapy was performed/ Number of treatments under appropriate body temperature control for newborns in need of body temperature management after birth. ・Provide training to local healthcare professional to ensure that they can treat newborns who need respiratory support or body temperature management soon after birth. KPINumber of local healthcare professionals who are able to provide adequate respiratory support and body temperature management for newborns
		Support for students who aim to become healthcare professionalsFor students who have demonstrated sufficient proficiency to proceed to a school of medicine or nursing, but have difficulty in entering school due to economic reasons of family, we help them learn and support them through a training period at the Japan Heart Children's Medical Center for 2 years after graduation. In FY2021, we are continuing our support for Cambodian nursing students, whom we have been supporting since FY2018. KPINursing students advancing to the fourth year
		Environmental improvement around Japan Heart Children's Medical Center (improvement of the sanitary environment during the rainy season)The garden around the medical center is not maintained, and puddles form during the rainy season every year. Water that remains for a long time leads to an outbreak of mosquitoes. In addition, the road becomes muddy, and the feet of the patients and their accompanying families become soiled easily, and the floor in the hospital also becomes soiled. To solve this problem, the sanitary environment around the hospital will be improved by creating a waterway to draw water from places where water tends to accumulate and direct it to a sewer, and by paving the gravel road in front of the hospital.
People's Hope Japan （Myanmar）	In rural areas of Myanmar, the maternal mortality rate and the newborn mortality rate are higher than in urban areas. As for the use of basic maternal and child health services, there are large regional disparities between urban and rural areas, and economic factors and access environments have major impact. In rural areas, approximately 2400 pregnant women (2017) and approximately 22,000 newborns (2018) have lost their precious lives in one year. It is reported that the major causes are the following three points: delay of awareness, access, and care. To prevent these, it is necessary to improve the knowledge and health behaviors of the residents as well as the environment and quality of services among health service providers and the capacity of health authorities to manage local health systems.	Skill monitoring of midwives and assistant midwives (second)Continuing from FY2020, we will conduct a second skill monitoring to measure the degree of establishment and improvement of the knowledge and skills learned in clinical practice. We also plan to conduct training of committee members for maternal and child health promotion according to local needs. KPIPerform skill monitoring using assessment sheet
		Training after graduation of midwives and refreshment training of assistant midwivesWe will conduct the training which was scheduled for FY2020 as soon as the local environment is prepared. KPIConduct the training (3-5-day training programs in cooperation with the local health authorities) This may be changed to more emergency assistance, depending on the situation and changes in Myanmar after February 2021

Targets and progress of partners in FY2020

Partner （Activity area supported by our company）	FY2020 plans	FY2020 progress
Japan Committee, Vaccines for the World’s Children （Bhutan）	Provide DPT vaccines for 50,000 people, hepatitis B vaccines for 8,000 people, and 5 vaccine refrigerators. KPINumber of vaccines and refrigerators provided	・DPT vaccines for 50,000 people were provided. (100% elimination of the shortage of vaccines for two-year-old children) ・Hepatitis B vaccines for 8,000 people were provided. (100% elimination of the shortage of vaccines for infants within 24 hours of birth) ・Five vaccine refrigerators were provided and are still in use.

Vaccine support in Bhutan

Partners （Activity area supported by our company）	FY2020 plans	FY2020 progress
Japan Heart （Cambodia）	Provide accurate and high-quality tests to all patients who need testing with the newly installed CBC measuring device.Continue to achieve zero deaths from dengue fever at Japan Heart Children's Medical Center. (as per last year), by treating patients in a timely manner. CBC measuring device refers to an automated blood cell analyzer or automated blood cell counter which measures red blood cells, white blood cells, platelets, etc. in blood. KPIPercentage of patients whose blood test results were promptly reflected in their treatment out of all dengue patients at the center	Accurate and high-quality tests were able to be provided to all patients who needed testing with the installed CBC measuring device. ・All dengue patients were treated at the center in a timely manner. There were zero deaths from dengue fever at the center, and the KPI was achieved at 100%. (As of March 31, 2021)
	Support for students who aim to become healthcare professionals.Continue support for a Cambodian nursing student whom we have supported since FY2018.	Students completed the first semester of the third year. ・Attended classes mainly online. ・Since the hospital practical training, which is part of school curriculum, has been stopped due to the prevention of coronavirus infection, they have studied at Japan Heart Children's Medical Center.
	Prevention of dengue feverConduct awareness-raising activities for residents of the area where Japan Heart Children’s Medical Center is located to prevent an epidemic of dengue fever, which occurs every year. (Especially for families with children. All of the deaths from dengue fever in Cambodia in 2019 involved children.) • Before the start of the dengue fever epidemic season (October 2020), Japan Heart Children’s Medical Center will distribute awareness-raising materials and disseminate information via social media to raise awareness of dengue prevention and early detection to suppress any dengue epidemic KPINumber of people who received awareness-raising materials (target: 4,000 people) Number of times awareness-raising posts were viewed on social media (target: 20,000 people) Infectious diseases such as dengue fever are said to increase as global warming progresses. We also support this program from our perspective on climate change.	Between June 2020 and January 2021, awareness-raising activities were conducted regarding the prevention of mosquito bites, typical symptoms of dengue fever, and early diagnosis. ・Awareness-raising materials (leaflets) about dengue fever were distributed at Japan Heart Children’s Medical Center, health centers visited by Japan Heart, and their surroundings, and were received by 4,000 people. ・Awareness-raising messages about dengue fever were posted 6 times on Facebook, and 22,708 people read the posts.

Partners （Activity area supported by our company）	FY2020 plans	FY2020 progress
Future Code （Bangladesh）	PCR testing equipment for detecting the novel coronavirus or X-ray equipment to the new hospital. KPIIn the case of PCR testing equipment, conduct 50 PCR tests a day, of which at least 10% should be given to the poor.)	Due to the influence of novel coronavirus, the national regulations are strict, and the construction of a new hospital is behind schedule. After the lifting of the restrictions, donation of PCR testing equipment is planned in line with the opening of the new hospital.
	Conduct health checkups at orphanages and hygiene education at orphanages and elementary and junior high schools. KPINumber of participants in hygiene education sessions: 50 (number of times sessions are conducted: at least once a year)	・Hygiene education on correct handwashing was provided to 70 children in an orphanage in December 2020. ・Health checkups and hygiene improvement education were provided to 46 children in an orphanage in January 2021. ・Health checkups and hygiene improvement education were provided to 31 children in an orphanage in March 2021.

Partners （Activity area supported by our company）	FY2020 plans	FY2020 progress
People's Hope Japan （Myanmar）	Conduct training and monitor the skills for all midwives (83 people) and assistant midwives (55 people) in Lewe Township of Nay Pyi Taw Union Territory. KPI•One-time skill monitoring using the assessment sheet • One-time training (a 3-5 day training program), in cooperation with the local health authorities By synergy with the above and other measures(enhancement of knowledge and improvement of health behaviors of pregnant women, recognition of danger signs and prompt action to receive medical treatment, and development and proper allocation of volunteers that connect residents and health facilities) promoted by the NPO, we aim to enable mothers and children to use appropriate health services (pregnancy checkup, delivery assistance by medical staff, in-home delivery, and postpartum checkup).	Skill monitoring for midwives and assistant midwivesSkill monitoring was conducted for all midwives (80 people) and assistant midwives (41 people). The staff of the health authorities and the regional health centers acted as an instructor of the skill monitoring and confirmed the skills of each midwife regarding maternity checkups, delivery assistance, and newborn infant care, based on assessment sheets. The results confirmed that midwives need to strengthen efforts to improve their knowledge and skills of delivery assistance, and assistant midwives need to strengthen their efforts to improve their knowledge and skills of maternity checkups. Training for midwives and assistant midwivesThe training was scheduled to be held in February and March 2021, but it has been suspended due to a sudden change of the situation in Myanmar since February 2021. Safety of local staff and business personnel is the top priority, and the training will be provided in FY2021, as soon as the environment is prepared Some midwives and assistant midwives take maternity leave, etc, and the number of trainees has been changed from the originally planned number.

For the results attained prior to FY2019, please see here.（292KB）

Participation in the Global Health Innovative Technology Fund

We became a member company of the Global Health Innovative Technology Fund (GHIT Fund) in 2018. The GHIT Fund is an international, not-profit organization that invests in the development of new drugs that are less marketable, including drugs for the treatment of malaria, tuberculosis, and neglected tropical diseases, as well as vaccines and diagnostics. Funding is provided by the Japanese government, the Bill & Melinda Gates Foundation, the Welcome Trust, and Japanese and foreign private companies. In order to reduce the health disparities between developed countries and low- and middle-income countries, the therapeutic agents, vaccines, and diagnostic agents developed through the GHIT Fund’s investments are priced according to the “No Gain, No Loss” principle. We sympathize the initiatives and policy, and we contribute to the funding of the GHIT Fund. Through participation in the GHIT Fund, we will strengthen the establishment of partnerships aiming to improve access to healthcare in low- and middle-income countries.