●Monkeypox
Alfonso J. Rodríguez-Morales
（President, Travel Medicine Committee, Pan American Association of Infectious Diseases, パナマ、President, Colombian Infectious Diseases Association, Pereira, コロンビア）

Discovered in 1958 in Denmark, monkeypox (MPX), a DNA-virus member of the Orthopoxvirus genus (Poxviridae family),has been causing disease in a wide variety of animals, particularly non-human primates(where it was initially identified) and terrestrial and arboreal rodents, but since1970 in humans in some regions of Africa. Although neglected for decades, global interest started in 2003, when the first outbreak due to MPX infection was reported in multiple states of the United States, associated with zoonotic transmission from prairie dogs (herbivorous burrowing ground squirrels from the genus Cynomys) that were in contact with the Gambian pouched rats (Cricetomys gambianus) and other animals (e.g. dormice); causing human disease, including children. After that, sporadic imported cases have been reported in multiple countries (e.g. United Kingdom).

But in May 2022, the report of imported and related cases started recognizing a new significant outbreak that rapidly affected numerous territories in Europe, North America and beyond. Up to September 2022, more than 67,000 cases have been confirmed in almost 100 countries that have not reported monkeypox before 2022 (nonendemic). During this outbreak, declared on July 23, 2022, as a Public Health Emergency of International Concern (PHEIC), by the World Health Organization (WHO), multiple changes in the understanding of the virus and the disease have become apparent. Now, the virus is classified into three clades, clade1 (formerly the Congo Basin or Central Africa clade), clade 2 (prior West African clade), and clade 3 (containing most genomes from the2017, 2018 and 2022 human outbreaks).

Another relevant aspect is the apparent change in clinical disease presentation. MPX is now considered an eruptive or ulcerative disease with significant presentation in the genital area, even discussed as a possible or potentially sexually transmitted infection. Although vaccines for MPX exist, these are not widely available and are recommended for high-risk groups, including the LGBTI community and some healthcare workers under occupational exposure risk.

In this conference, we will discuss a wide range of aspects, updating the situation and perspectives of this reemerging disease.

●Asian innovation in pharmaceutical and medical device industry-beyond tomorrow
Mihajlo (Michael) Jakovljevic
(UNESCO – The World Academy of Sciences (TWAS), Trieste, イタリア　Academia Europaea, Section of Clinical and Veterinary Science, London, イギリス)

The Asian region has passed a long and rocky road during the past several decades to establish itself as the second leading regional biotech market globally. China has become the second largest pharmaceutical market while Japan holds a strong second position as the global hub for medical devices development and innovation. Pharmaceutical expenditure continues to outpace real GDP growth in most of these　countries. The trend is likely to be continued for a decade ahead, driven by a myriad of actors ranging from aging populations, rapidly growing welfare and increased citizen　expectations raising demand for novel　medicines and technologies.

Satisfaction of these unmet needs in　terms of supply is coming from the large　multinational companies in wealthier among　these societies. Domestic born and largely　state-owned manufacturing industries　continue to play a crucial role in an array of　middle-income countries. Global biotech hub　of Singapore is hosting over 1.5 times more　headquarters of large pharmaceutical　companies than Beijing, Tokyo, Shanghai and　Hong Kong combined together. Japanese　Takeda, Astellas, Daiichi Sankyo and Otsuka　and Chinese Sinopharm, Guangzhou　Pharmaceuticals Corporation, SPH and　Yunnan Baiyao are now enlisted in leading　Top 25 pharmaceutical company rankings asper their annual net revenues in 2020–2021.Global industry landscape is evolving with　ever more Asian companies obtaining the　sharp innovative competitiveness leading　development of cutting-edge medical　technologies.

つづく