アンカーリンク用
Basic Policy
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: Research and development of innovative pharmaceutical products and strengthening healthcare infrastructure.
In "Research and Development of Innovative pharmaceutical products," we are actively engaged in the research and development of drugs for NCDs (noncommunicable diseases), including cancer, for which medical needs have yet to be met and for rare diseases. In addition, we are strengthening our efforts to provide new drugs to patients around the world in the United States and Europe in addition to the Asian region where we already have our own sales network.
In the area of "strengthening healthcare infrastructure," we are working on medium- to long-term initiatives to train medical personnel and improve the medical environment in low- and middle-income countries through partnerships with NPOs, NGOs, public institutions, pharmaceutical companies, and other organizations.
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
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.
In addition, we continue to examine applicability of our patented compounds to Neglected Tropical Diseases (NTDs) and other diseases in the aforementioned countries (use of the existing patent pool, the provision of voluntary licenses to generics manufacturers, etc.).
In the situation of a public health national emergency, such as a pandemic, etc., we understand that the compulsory right will be granted as one of the options. We also understand that the compulsory right will be granted in accordance with Article 31-2 of the TRIPS Agreement (the Agreement on Trade-Related Aspects of Intellectual Property Rights) in order to export pharmaceuticals to countries with insufficient or no capacity to manufacture pharmaceuticals. We will consider licensing patents flexibly and appropriately on a case-by-case basis. In order to improve access to pharmaceuticals, granting the compulsory right alone cannot resolve the fundamental problems. We consider that comprehensive activities are necessary, including activities that include the correction of economic discrepancies, training of healthcare professionals, and development of the healthcare system, healthcare infrastructure, and drug supply system.
- https://www.un.org/development/desa/dpad/least-developed-country-category.html
- https://data.worldbank.org/income-level/low-income
- https://data.worldbank.org/income-level/lower-middle-income
Promotion Management System
We set the improvement of access to healthcare as one of the themes included in the materiality "respect for human rights" and the Board of Directors and the Management Meeting are managing targets and progress (Please click here for detail). In addition, in terms of implementation, the Sustainability Promotion Committee, consisting of members of each division, mainly promotes implementation under management by the Sustainability Strategy Meeting.
Examples of Innovative pharmaceutical products R & D Initiatives
Efforts made against rare diseases
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 July31, 2024)
Product name | Therapeutic indication* | Date designated as an orphan drug | Development Status |
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OPDIVO intravenous infusion | Malignant melanoma | June 17, 2013 | Approved |
Hodgkin lymphoma | March 16, 2016 | Approved | |
Malignant pleural mesothelioma | December 1, 2017 | Approved | |
Cancer of unknown primary | March 11, 2021 | Approved | |
Malignant mesothelioma (excluding malignant pleural mesothelioma) | February 22, 2023 | Approved | |
Unresectable advanced or recurrent epithelial skin malignancies | May 23, 2023 | Approved | |
Demser Capsules | Improvement of catecholamine excess and various symptoms in pheochromocytoma | May 25, 2015 | Approved |
Kyprolis for intravenous infusion | Relapsed or refractory multiple myeloma | August 20, 2015 | Approved |
Onoact for intravenous infusion | Life-threatening refractory and emergent cardiac arrhythmias: ventricular fibrillation and hemodynamically unstable ventricular tachycardia | August 24, 2016 | Approved |
Mektovi Tablets | NRAS or BRAFV600 mutation-positive malignant melanoma | December 4, 2013 | Approved |
Braftovi Capsules | BRAFV600 mutation-positive malignant melanoma | December 4, 2013 | Approved |
Velexbru Tablets | Primary central nervous system lymphoma | August 20, 2019 | Approved |
Waldenström's macroglobulinemia, Lymphoplasmacytic lymphoma | November 19, 2019 | Approved |
- Anticipated indications or diseases on the designation
Efforts to obtain approval for pediatric use
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 July31, 2024)
Product name | Therapeutic indication | Status |
---|---|---|
Onon Dry Syrup | Bronchial asthma, allergic rhinitis | Approved |
Emend Capsules | Digestive symptoms (nausea, vomiting) resulting from the administration of antineoplastic agents (cisplatin, etc.) (including the delayed phase) | Approved |
Proemend for intravenous injection | Digestive symptoms (nausea, vomiting) resulting from the administration of antineoplastic agents (cisplatin, etc.) (including the delayed phase) | Approved |
Orencia for intravenous infusion | Active polyarticular juvenile idiopathic arthritis | Approved |
Demser Capsules | Improvement of status of catecholamine excess secretion in patients with pheochromocytoma | Approved |
OPDIVO intravenous infusion | Relapsed or refractory classical Hodgkin lymphoma | Approved |
Onoact for intravenous infusion | Tachyarrhythmia (supraventricular tachycardia, atrial fibrillation and atrial flutter) in patients with low cardiac function | Approved |
Efforts to Strengthen the Medical Environment
– Capacity Building –
There are still countries and regions in the world where the healthcare infrastructure is immature and many people who cannot access necessary healthcare are left behind. We are working to support NGOs to strengthen the healthcare infrastructure in these regions (local capacity building: Building a healthcare infrastructure where healthcare can be delivered continuously by local capabilities).
Under the "ONO SWITCH Project" that was implemented from FY2018 to FY2021, we have provided support in Cambodia, Myanmar, Bangladesh, and Bhutan for the training of local healthcare personnel, educating local citizens on diseases, and assisting with scarce healthcare facilities and supplies (for more details, see "ONO SWITCH Project (FY2018 to FY2022)" on this page below). We have achieved steady results in strengthening healthcare infrastructure through the activities of the NGOs and NPOs that we supported under this project.
In consideration of the lessons learned from this project, we started a new healthcare access improvement project, the "ONO Bridge Project," in FY2022.
With the new project, and not only through financial support necessary for NGO measures, we will also increase the social recognition of issues related to access to healthcare, have our employees participate in volunteer activities, take measures for collaboration using our know-how, etc. At the same time, we will increase the input of non-financial capital into the project and thereby maximize our social impact and strengthen our human resources, etc. For example, we will increase employee understanding, empathy, and desire to take on the challenge of resolving issues related to healthcare access and we aim to disseminate the mission statement and to increase engagement in the association thereto. In addition, we consider this project as to be an opportunity to broaden our understanding of patients and healthcare issues around the world and thereby aim to support our growth strategy
- Our thoughts on the project name:
- To serve as a bridge between healthcare and patients.As the hope of patients for the future,we aim to create a society where people who need healthcare and people who want to deliver healthcare are connected and overcome the healthcare access gap.
In this project, we first started the two programs below with the NGOs with which we collaborate. Through the programs, we not only contribute to the financial support necessary for NGO measures but we will also increase the social recognition of issues related to healthcare access and take measures for collaboration using our know-how, among other things.
Myanmar: Maternal and child health service improvement program
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- Partner
- Specified Nonprofit corporation People's Hope Japan (hereinafter referred to as "PHJ")
To address the issue of maternal mortality in Myanmar, we will work with PHJ to train maternal and child health care promoters in an aim to help local residents understand the risks of childbirth, strengthen local health service networks that connect local residents and midwives, and to improve access to maternal and child health care services for pregnant and nursing mothers.
Please see below for details of our activities
Corresponding SDGs
- 3.1
- By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births
Issues related to healthcare access in Myanmar and PHJ's activities
The maternal mortality rate in Myanmar is considered to be 250/100,000 live births (source: UNICEF, The State of the World's Children 2021). There is a big gap from the goal: "SDGs 3.1: By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births." One of the causes is childbirth without assistance from healthcare professionals. In addition, the causes include a shortage of healthcare professionals, a shortage of appropriate devices at medical institutions, barriers to physical access, traditions of at-home childbirth, lack of community understanding of the risks associated with childbirth, etc. In addition, this issue is more significant in rural areas and there are differences in access to healthcare even within Myanmar.
Maternal mortality ratio(Per 100,000 live births)
PHJ has engaged with this issue in Tatkone Township, Nay Pyi Taw Union Territory for approximately six years starting in 2014 and achieved results in promoting the use of maternal and child health services in rural areas. PHJ has been expanding the effective models obtained from this activity into Lewe Township Nay Pyi Taw Union Territory since 2020 (we have supported part of this activity).
- Source: Extracted from PHJ Annual Report 2022
PHJ aims to increase four indicators (pregnancy check up rate, rate of proportion of births attended by medical practitioners, institutional births rate, and postpartum checkups rate) for which the use rate is particularly low in rural areas.
Percentage of maternal and child health services accessed in the target area (before the start of the program)
Programs that ONO supports
[Target area]
Target area: Lewe Township, Nay Pyi Taw
[Support period]
From FY2022 to FY2024
[Issues, measures, targets]
- Issues
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- Lack of local people's knowledge of the risks of childbirth: Lack of appropriate knowledge of the risks associated with childbirth, such as hypertension due to pregnancy, postpartum bleeding, etc. leads to delays in identifying danger signs during pregnancy or at the time of childbirth and in deciding to see a hospital.
- Difficulty accessing health services: There are significant differences in the use status of maternal and child health services between urban areas and rural areas. The network between local people and health services, such as midwives, etc., is insufficient.
- Measures
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- This program trains maternal and child health promoters, monitors their activities, provides instructions, and provides re-training six months later.
- "Maternal and child health promoters" are volunteers. After they complete a two-day training session specified by the Ministry of Health, they provide health education and visit pregnant women in their homes, and they serve as a bridge between local people and health services under the supervision and instruction of a midwife. After the training, they cooperate with midwives and auxiliary midwives and collect information on pregnant women, postpartum women, and children below the age of 5 in their villages, visit pregnant women in their homes, support vaccination by midwives, prepare reports, and more.
- Targets
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- Train new maternal and child health promoters: 600 promoters by FY2024
- Provide re-training to trained maternal and child health promoters: 300 promoters by FY2024
One maternal and child health promoter will be assigned per five pregnant women to all villages (178 villages) based on the approximate number of childbirths in one year.
Activity status in FY2023
In FY2023, 425 maternal and child health promoters were trained (in 108 villages), which made a total of 607 promoters in combination with the previous project, the ONO SWITCH project. In addition, maternal and child health promoters are not selected by PHJ. Midwives, auxiliary midwives, and representatives of each village, etc. have mainly selected women who are trusted by villagers and are "expected to be a promoter." PHJ meets every single woman selected individually, explains the role of promoters and their specific activities, and confirms the consent of the woman.
After maternal and child health care promoters were trained, regular meetings of local medical personnel were held with midwives, auxiliary midwives, and maternal and child health care promoters from the villages where the promoters began their activities in attendance, and annual implementation plans for health education by midwives were formulated at 40 of the 45 rural health facilities in the township. Based on the plan, health education in villages started in January 2023, and a total of 477 health education sessions were conducted in FY2023.
[Progress of the program]
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FY2022 progress | FY2023 progress | Status |
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Cambodia: Program to Improve Access to Advanced Pediatric Medical care
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- Partner
- Specified Nonprofit corporation Japan Heart
(hereinafter referred to as "JH")
In response to the shortage of medical personnel and knowledge in Cambodia and issues related to accessing medical care in rural areas (economic strength, infrastructure, and local customs), we work with Japan Heart to improve access to medical care for local residents, including pediatric cancer patients, by training medical professionals, educating patients, and providing support to medical facilities through programs.
Please see below for details of our activities
Corresponding SDGs
- 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
- 3.8
- Achieve universal health coverage (UHC), including financial risk protection, access to quality essential health-care services and access to safe, effective, quality, and affordable essential medicines and vaccines for all
- 3.c
- Substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries, especially in least developed countries and small island developing States
Issues related to Access to Healthcare in Cambodia and Activities of Japan Heart
- Name of the hospital
- Japan Heart Children's Medical Center (JHCMC)
- Year constructed
- 2016: JHCMC built
2018: JHCMC Expansion (increase in pediatric oncology beds) - Number of staffs
- 131 (as of March., 2024)
- Number of beds
- 94 beds (Adult: 39 beds/ Pediatric: 55 beds)
- Diagnosis and treatment department
- Internal medicine, Pediatrics, Obstetrics & Gynecology, Pediatric Hematology & Oncology, Pediatric Surgery
- Performance
- Provide medical care: Adult 20132, Pediatric 3,859
Hospitalization: Adult 947, Pediatric 268
Surgery: Adult 1,022, Pediatric 275
The United Nations World Health Organization (WHO) has indicated that 80% of patients with pediatric cancer survive in high-income countries, while the percentage of patients who achieve remission in low- and middle-income countries is below 30%*.
Survival rate of pediatric cancer
Many pediatric patients who cannot access advanced medical care have also been left behind in Cambodia.
A major cause is the shortage of medical institutions and healthcare professions that can provide advanced medical care. In particular, due to the impact of history, including the slaughter and civil war that occurred in the past in Cambodia, skilled medical care professionals who train the next-generation of medical care professionals are in short supply and issues related to healthcare access may remain in the future. In addition, the lack of economic power of people in the community, hospital visitation habits, and trust in healthcare are barriers to accessing healthcare.
Japan Heart opened the Japan Heart Children's Medical Center independently in the Ponnel District, Kandal Province, Cambodia, which provides advanced medical care for free to patients with pediatric cancer and other diseases. In addition, Japan Heart also trains local healthcare professionals through its activities. The Medical Center also engages in building the local healthcare system in the Ponnel District and provides free mobile medical services in the district.
- In Japan there were 2.3 physicians per 1,000 people as of 2014, while in Cambodia, there were only 0.2 physicians per 1,000 people as of 2014. The number of general beds per 1,000 people is 13.1 beds in Japan, while it is only 0.9 beds in Cambodia in 2016*.
- For example, at the Japan Heart Children's Medical Center, the medical fees for one patient with pediatric cancer are approximately eight hundred thousand to one million yen. The average annual income in Cambodia is 1,625 US dollars (approximately two hundred and twenty thousand yen; 2021, World Bank survey). Therefore, the standard treatment for pediatric cancer cannot be covered by an average household in Cambodia*.
- There are only a few medical institutions that have a department specialized in pediatric oncology in Cambodia. In particular, the number of medical institutions that can provide expert treatment of pediatric solid tumors is very limited. Therefore, patients with pediatric solid tumors come to the Japan Heart Children's Medical Center from all over Cambodia.
- Source: Japan Heart "State of Pediatric Cancer"
Programs that ONO supports
[Target area]
Target area: Ponnel District, Kandal Province, Cambodia
In this program, we support the activities of "Japan Heart Children's Medical Center."
[Support period]
From FY2022 to FY2026
[Issues, measures, targets]
1. Training skilled healthcare professionals
- Issues
-
- In order for local healthcare professionals of Japan Heart Children's Medical Center to provide medical treatment without the support of Japanese staff and to train the next generation of healthcare professionals, it is necessary for them to accumulate more advanced and wider knowledge and experience. The Medical Center is one of the few facilities in Cambodia where healthcare professionals can experience advanced healthcare; however, clinical experience is limited at the Medical Center alone. In addition, the advanced healthcare that is provided at medical facilities and the environment in advanced countries cannot be acquired at the Medical Center.
- Local nurses of the Medical Center have insufficient knowledge and skills to provide advanced nursing care (e.g., caring for patients who are under postoperative ventilator management, etc.).
- The Medical Center has no local radiology technicians. Therefore, Japanese technicians are engaging in treatment, meaning that local technicians are not trained.
- Measures
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- Training physicians:
- Provide training at a medical institution in Japan (National Hospital Organization Okayama Medical Center) in order to learn advanced medical care for pediatric patients (5 months).
- Expand the scope of clinical experience by providing training at other medical institutions in Cambodia.
- Create opportunities to learn the latest knowledge, such as participation in international academic conference of cancer, etc.
- Training nurses:
- Provide clinical training for advanced healthcare mainly for postoperative management through training at other medical facilities in Cambodia.
- Create opportunities to learn the latest knowledge by participating in internal academic conference of cancer, etc.
- Employing local radiology technicians: Employ local radiology technicians.
- Training physicians:
- Targets
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- Training physicians:
- Training in Japan: 1 person
- Training at other medical facilities in Cambodia: 2 persons
- Participation in international academic conference of cancer: 5 persons
- Training nurses:
- Training at other medical facilities in Cambodia: 5 persons
- Participation in international academic conference of cancer: 5 persons
- Employing radiology technicians: 1 person
- Training physicians:
2. Improvement of access to healthcare in rural areas
- Issues
-
- There are public healthcare facilities, such as health centers, in rural areas in Ponnel District, Kandal Province and surrounding areas. However, the healthcare that can be provided is limited and patients do not regularly use the public healthcare facilities. In addition, there is a hospital with medical devices on site located at more than an hour’s drive away. Local people are not accustomed to visiting the hospital regularly and they do not fully trust medical care.
- Measures
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- Japan Heart Children's Medical Center will give free mobile medical service to rural areas in Ponnel District, Kandal Province and surrounding areas and continue to provide necessary healthcare mainly for internal diseases to both adults and children.
- Reflecting local issues, the free "mobile medical service " will be changed to "mobile surgery" in April 2024
- Japan Heart Children's Medical Center will give free mobile medical service to rural areas in Ponnel District, Kandal Province and surrounding areas and continue to provide necessary healthcare mainly for internal diseases to both adults and children.
- Targets
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- Free mobile medical service: Monthly (The service will be provided 51 times during the program period, from January 2023.)
- Activities were revised to the following goals from April 2024
- Free mobile surgery: Dispatched 8 times a year; Number of surgeries: 50 (together from FY2024 to the end of the program)
- Free mobile medical service: Monthly (The service will be provided 51 times during the program period, from January 2023.)
3. Enhancement of advanced medical devices
- Issues
-
- Japan Heart Children's Medical Center is one of few facilities that can provide advanced healthcare to pediatric patients in Cambodia; however, their medical devices are insufficient when compared with advanced countries.
- There are issues where internal diseases (such as intussusception) cannot be diagnosed due to the absence of an X-ray fluoroscope or where there may be a greater burden on patients since a surgery requiring an X-ray fluoroscopy room is substituted with X-ray imaging machines.
- Measures
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- Introduce an X-ray fluoroscope.
- Targets
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- Purchase an X-ray fluoroscope and prepare an X-ray fluoroscopy room.
Progress in FY2023
1. Training skilled healthcare professionals
- Training physicians and nurses:
- Domestic training for physicians:
- A Cambodian physician received three months of clinical training at a medical institution in Cambodia. The content of the clinical training was mainly regarding anesthesia, and although there had been cases until now where physicians from Japan had visited Cambodia for anesthesia, now that this Cambodian physician is able to perform anesthesia procedures, more surgeries can be performed domestically.
- Participation in international academic conference of cancer by physicians and nurses:
- Two local physicians and one nurse of Japan Heart participated in the St. Jude-VIVA Forum on Pediatric Oncology in Singapore. This forum is a place where pediatric tumor specialists in Asia gather and share their know-how and implement networking to fill the gap between advanced countries and developing countries. At the Nursing Symposium, nurses of Japan Heart presented their activities. It became an opportunity for them to discuss their activities using their own words and they learned a lot and were stimulated by the exchanges with many healthcare professionals.
- Domestic training for physicians:
- Employing radiology technicians: Regarding the recruitment of local technicians, we are mainly using SNS to conduct our recruitment activities, which is mainstream in Cambodia, and reach out to educational institutions and other organizations. In Cambodia, there are only a limited number of educational institutions that train radiology technicians, and since there are so few human resources in that particular field, it is very difficult to recruit personnel. We will continue to promote recruitment activities using various methods and consider matters such as in-hospital staff training.
2. Improvement of access to healthcare in rural areas
- Free mobile medical services: Mobile medical service was conducted seven times in Ponnel District and the surrounding area (an area which is a three-hour drive from the Japan Heart Children's Medical Center) and provided free medical treatments to 522 local people. Lifestyle-related illness were found with many patients who came for medical examination. Diagnoses, such as diabetes, high blood pressure, and gastroenteritis, were given and therapeutic agents were prescribed. They were encouraged to continue visiting local medical institutions. In addition, it was found that knowledge on pediatric nutrition management is lacking. There are children with smaller bodies than usual. Nutritional guidance is also provided to their parents.
In addition, based on the activities up to FY2023, we have decided to change the content of our activities from the current "free mobile medical service " to "free mobile surgery" from FY2024 in order to better meet the needs of local communities. In our "free mobile surgery" service, staff from the Japan Heart Children's Medical Center (physicians, nurses, etc.) are dispatched for several days to public hospitals in rural areas that do not have surgical skills to provide surgery in cooperation with local staff in addition to carrying out their conventional medical treatment activities. This activity not only provides high quality medical care to local patients, but also helps to train local medical personnel.
3. Enhancement of advanced medical devices
- In FY2023, a surgical X-ray imaging device (C-arm) was introduced and installed in an X-ray-compatible operating room completed in FY2022.
In addition, we prepared equipment, conducted training, and otherwise put systems in place and began full-scale operation in January 2024. This has enabled us to provide medical care to patients who had previously been difficult to operate on due to the lack of equipment.
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Please see below for past access to healthcare projects
We engaged in the ONO SWITCH Project from FY2018 to FY2021 as an initiative to promote both medical system support and work style reform. Under this initiative, donations are made to the medical-related NPOs/NGOs mentioned below who use the money saved by reducing overtime payments through the promotion of our work style reform. The project aims to contribute to the promotion of work style reform, 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.
Please see the results for each fiscal year below.
Participation in Access Accelerated Initiatives
Since 2023, ONO has been participating in Access Accelerated, a global partnership that aims to improve access to non-communicable diseases (NCDs) prevention, treatment, and care in low- and lower-middle income countries.
Access Accelerated is an international initiative which was established at the World Economic Forum in 2017. Its member companies consist of more than 10 pharmaceutical companies in Japan, the United States and Europe. In partnership with organizations such as the World Bank Group, Access Accelerated is working to achieve one of the United Nations' Sustainable Development Goal (SDG) targets, namely “By 2030, reduce by one third premature mortality from NCDs through prevention and treatment and promote mental health and well-being” in low- and lower-middle income countries.
For more information on Access Accelerated activities, please visit the following website.
https://accessaccelerated.org/