Antimicrobial Resistance: Plans for Korea and Beyond 27th Management Board Meeting Joint Programming Initiative on Antimicrobial Resistance Antimicrobial Resistance: Plans for Korea and Beyond Jaesang Kim Kyeong Kyu Kim Director, Next Generation Biotechnology National Research Foundation of Korea Ministry of Science and ICT Professor & Director Institute for Antimicrobial Resistance Research & Therapeutics Sungkyunkwan University, Korea

National Research Foundation of Korea Partner to Ministry of Science and ICT Supporting research efforts in Science and Technology With an annual budget near 4 billion EURO

Bio & Medical Technology Development Program Goal Aims to acquire core fundamental technologies in the field of biomedical engineering and to develop strategies for application in actual healthcare 2017 Budget 2017 Total Budget in 2017: 263 billion KWon 200 million EURO

NRF and JPIAMR, a brief history National Action plan on Antimicrobial Resistance (Aug. 2016) Adoption of AMR as priority issue by NRF (Jan. 2017) Adoption of AMR as international cooperation topic (Jan. 2017) Exploration during General Assembly of Glopid-R (Mar. 2017) New R&D projects launched (Aug. 2017) NRF presentation at the 6th KOR-EU S&T Cooperation Committee Meeting (Sep. 2017) Letter of Interest in joining JPIAMR (Jan. 2018) 27th Management Board Meeting (Feb. 26, 2018)

The Current Situation in Korea A very high DDD of 31.7 in 2014 MRSA very common (> 60% of S. aureus) A very high ratio of Vancomycin-resistant E. faecium Resistance to fluoroquinolone extremely high among chicken enterococci (79.7%; Denmark 6%) Resistance to Sulpha drugs extremely high among chicken enterococci (9.1%; Denmark 2%) year Major H 2nd tier H Local H Conval H 2007(%) 26.0 15.5 5.0 20.5 2014(%) 36.5 22.1 24.7 49.1

How we began to fight back

Multi-agency effort for One Health Korean Centers for Disease Control and Prevention; Health Insurance Review and Assessment; Ministry of Health and Welfare; Ministry for Food, Agriculture, Forestry and Fisheries; Ministry of Oceans and Fisheries; Ministry of Food and Drugs Safety; Ministry of Science and ICT; Ministry of Strategy and Finance; Ministry of Interior; Ministry of Foreign Affairs Promote the prudent use of antimicrobial medicines Prevent the spread of antimicrobial resistance Strengthen the surveillance system Improve public awareness Strengthen research and development Enhance international collaboration

Role of NRF and Ministry of Science and ICT A new R&D fund for fighting AMR Coordinating role in government-wide R&D planning, evaluation and budgeting for AMR Focus on basic research of AMR - Understanding pathogenic mechanisms - Identification of novel targets - Development of novel strategy and reagents Global networking and collaboration for AMR - Sharing the knowledge and experience - Increased awareness of AMR - Improved policy making and implementing - Efficient research and development

Sungkyunkwan University, Korea (IAMRT-SKKU, Korea) Institute for AMR Research and Therapeutics Sungkyunkwan University, Korea (IAMRT-SKKU, Korea) GLOPID-R WHO International AMR research groups JPIAMR International AMR Research Network National AMR Research Network ESKAPE(E. coli, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter spp., Pseudomonas aeruginosa, Enterococcus spp.) JPIAMR Joint Programming Initiative on Antimicrobial Resistance Korean Centers for Disease Control and Prevention Research on Multi-drug Resistant Bacteria Mechanism-Based Approach Agent-based Approach Korea Health Industry Development Institute Research on Multi-drug Resistant Bacteria Korea National Institute of Health National Research Foundation (Ministry of Science and ICT, Korea) Ministry of Health and Welfare

IAMRT-SKKU, Korea Goal Mission Plan The institute aims to understand the principle of antibiotic resistance and to develop novel antimicrobial therapeutics. Mission Conveying breakthrough research on AMR and providing a practical solution to AMR in conjunction with international communities working on AMR. Bringing in all relevant research activities carried out by various ministries and agencies in Korea under one umbrella leading to coordination not just within Korea but also with the rest of the world. Plan Hosting an international workshop or conference on AMR research. Building a national AMR research network in Korea. Participating in JPIARM activities as a regular member country. Connecting Korean AMR researchers with JPIAMR for the international collaboration. Initiating the international collaboration and idea exchange in Asia (propose) ESKAPE(E. coli, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter spp., Pseudomonas aeruginosa, Enterococcus spp.) JPIAMR Joint Programming Initiative on Antimicrobial Resistance

Research projects supported by NRF Mechanism-based approaches Targeting the master virulence regulating signals for controlling multidrug resistant bacteria. Identification of novel virulence and resistance factors from the clinically isolated drug-resistance pathogens by applying the multiplex approaches. Anti-superberg strategy targeting the key functionalities and components of the bacterial cell membrane. Agent-based approaches Structure-based development of inhibitors targeting the class B carbapenemase. Development of peptide and peptido-mimetic potentiators for repositioning drugs against drug-resistant bacteria ESKAPE(E. coli, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter spp., Pseudomonas aeruginosa, Enterococcus spp.) JPIAMR Joint Programming Initiative on Antimicrobial Resistance