Japan will preside over the G7 Hiroshima Summit and lead discussions on various issues facing the international community. Taking this opportunity, this series will consider the current status and future challenges of important issues facing the international community, as well as Japan’s contribution and JICA’s cooperation. The theme of the second session is “Global Health Care. Three years have passed since the unprecedented pandemic caused by the new coronavirus infection. In order to prepare for the next infectious disease, we will consider the global healthcare system required in the post coronavirus era.
Challenges posed to the world by the new coronavirus pandemic
The pandemic of novel coronavirus infections that struck the world has had a tremendous impact on the international community: according to the World Health Organization (WHO), as of April 2023, 762.27 million people worldwide have been infected and 6.89 million people have died.
In terms of the threat of infectious diseases, there have been global outbreaks of SARS (severe acute respiratory syndrome) and Ebola hemorrhagic fever. Each time, the strengthening of countermeasures in each country and the framework for international cooperation have been reviewed mainly by international organizations and national governments. However, the new coronavirus infection that spread so quickly in both developing and developed countries was an unprecedented infectious disease that far exceeded the countermeasures and assumptions made through past efforts.
In order to build a strong society that can respond to new infectious disease outbreaks and health crises, it is essential to first strengthen health systems and prepare for public health crises at the national level. At the same time, it is also necessary to respond to infectious diseases that spread at once by monitoring and reporting infectious diseases at the international level beyond national borders, mobilizing funds when infectious diseases spread, and ensuring access to vaccines. The new coronavirus infection has made it clear to the world that it is necessary to take a two-sided approach, one at the international level and the other at the national level.
The United Nations has urged that “No one is safe, until everyone is safe. No one is safe until everyone is safe.” Without the safety of one’s own country, there is no safety for the entire world, and without the safety of the entire world, there is no safety for one’s own country.
Japan Announces “Global Health Strategy,” Demonstrating its Determination to Contribute to the World
Learning from the lessons of the new coronavirus infection and preparing for the next crisis, the Japanese government launched the “Global Health Strategy,” which was announced in May 2022, with the following two policy goals and a commitment to Japan’s active contribution to global healthcare.
Contribute to building and strengthening the global health architecture to enhance prevention, preparedness, and response to public health crises such as infectious disease pandemics.
Achieve robust, equitable, and sustainable universal health coverage (UHC) required in the post-Corona era through strengthening health systems in each country.
This strategy is truly a response to both international and country-level challenges. the first policy goal, global health architecture, refers to the state of affairs, including the mechanisms and organizations that address global health issues. This includes setting norms for pandemics, mobilizing funds in the event of an infectious disease outbreak, and research and development, manufacturing technology transfer, and distribution for equitable access to medicines and vaccines.
The second policy goal, UHC, is to ensure that all people have access to adequate quality health care services, as needed, without suffering economic hardship. To achieve this goal, various efforts are needed, such as improving the skills of healthcare workers, strengthening the capacity of communities, and securing financial resources. It is also essential to build a system that is resilient to crises such as pandemics, guarantee equitable access, and ensure sustainable health financing that can respond to changes in society and needs.
Japan, which achieved universal health coverage in 1961, has long been a leader in international discussions and initiatives in the field of global health, and since the late 1990s has taken advantage of the G7 to play a leading role in combating infectious diseases, strengthening health systems, and promoting UHC and leadership in the international arena.
In addition, the trust and network with developing countries that JICA has built through its long years of cooperation is a major strength that supports Japan’s leadership. Aiming to improve services such as maternal and child health care and infectious disease control, and to strengthen the overall health system through administrative capacity and human resource development, JICA has provided detailed support from the policy and institutional level to on-site service improvement, while respecting the ownership of the partner country. Through the accumulation of this support, we have built trusting relationships and networks with developing countries.
Preparedness in peacetime is essential. Reaffirmed in response to new coronavirus infection
To respond to public health crises, it is essential to be prepared in times of peace. The response to the new coronavirus infection reaffirmed the importance of such preparedness, and the results of JICA’s cooperation were tangible.
In this pandemic, while the autonomous response by developing countries themselves was remarkable, many of the partner organizations that JICA has supported so far played a central role,” said Ken Ito, Deputy Director General and Head of Health Group 1 of the Human Development Division. Kenichi Ito, Deputy Director General and Head of Health Group 1 of the Human Development Division, said, “This pandemic has been a great success, and many of the partner organizations that JICA has supported have played a central role.
Kenichi Ito, Deputy Director of Human Development Department and General Manager of Health Group 1
In Ghana, the Hideyo Noguchi Memorial Institute for Medical Research (Noguchi Lab) was in operation 24 hours a day when the new coronavirus infection first spread. It was responsible for up to 80% of PCR testing in the country and also supported the establishment of PCR testing facilities in 40 locations in the country. In Kenya, the Central Institute of Medical Research (KEMRI) conducted half of the country’s PCR tests at peak times. In Vietnam, Cho Lai Hospital in the southern region received the first patients in the country and provided technical guidance to 25 hospitals in the southern region on patient care and nosocomial infection control.
The Noguchi Memorial Medical Research Institute, which operated day and night and was responsible for 80% of PCR testing in Ghana.
Even before the pandemic of novel coronavirus infection in Africa, “third-country training,” in which these institutions take the lead in assisting neighboring countries, has also been conducted. Noguchi Lab and KEMRI have provided training to West African countries and East African countries, respectively, to improve the techniques and skills of laboratory staff and to strengthen networks in the target countries. Since the recent pandemic, KEMRI has made significant contributions to the inspection systems in each country, including the addition of content related to testing for new coronavirus infections.
Noguchi Institute has also been working with regional frameworks, such as the African Center for Disease Prevention and Control (African CDC), which was established in 2016 to play a leading role in Africa in the wake of the Ebola pandemic, sending lecturers to the third country training conducted last year at Noguchi Institute.
Help achieve UHC tailored to each country
Infectious diseases are not the only global health challenge. JICA is promoting cooperation tailored to each region and country, with Senegal being a particularly successful example. Mr. Ito explains the background behind this.
In order to realize UHC, it is essential to proceed with the two pillars of providing and expanding quality services and strengthening the health care security system, in which society shares the burden of health care costs. In Senegal, we are cooperating on each of these two pillars and encouraging dialogue between the Ministry of Health and the Ministry of Finance, as it is difficult for the Ministry of Health alone to make the effort to secure financial resources.”
Strong government commitment has also been a tailwind, with the number of poor community health insurance enrollees in Senegal increasing from 185,000 in 2015 to 1.14 million in 2019. This support for achieving UHC is also being extended to Kenya, Egypt, and other countries.
Strengthening Cooperation on a Regional Basis at the Global Level
Strengthening regional frameworks is important to complement unilateral efforts and enable more rapid and appropriate assistance to vulnerable countries. In Africa, the African CDC played an active role in procuring and distributing PPE (personal protective equipment) and vaccines in short supply during the pandemic, and in ASEAN, the ASEAN Center for Communicable Disease Control is being established to strengthen the region’s public health response to crises. Regional-based efforts could be linked in the future, for example, to the formation and strengthening of a global infectious disease surveillance and analysis network, thereby contributing to the enhancement of global health architecture.
The Noguchi Institute in Ghana and KEMRI in Kenya, which JICA has supported for many years in Africa, are positioned as hubs for surveillance and analysis of genetic information of pathogens in Africa as envisioned by the African CDC. In Central and South America, JICA is also working to develop human resources in the region, together with the Gorgas Institute in Panama, which supported the strengthening of surveillance and analysis of genetic information of pathogens in the wake of the new coronary disaster. In Asia, JICA has conducted an earlier online training course on public health crisis management for officials of health ministries and ASEAN Secretariat of each country who are expected to be involved in the future in the ASEAN Center for Infectious Disease Control, which will become the core of the region.
If we can promote rapid analysis and sharing of pathogen genome information in Asia, Africa, and Latin America with the international community, we can boost rapid vaccine and drug development, which is a challenge for strengthening global health acuteness. However, support by public organizations such as JICA is not enough. Currently, the formation and strengthening of international joint clinical research networks among industry, government, and academia, especially in Asia, is also underway for the rapid development of vaccines and therapeutics by Japanese pharmaceutical companies and others.
Japan’s contribution to global health in cooperation with the international community will lead to stability and peace in the international community as a whole through the promotion of health, while at the same time protecting the safety of Japan and its people. In the post-coronary era, now is the time for Japan and the international community to join hands and promote efforts to realize a society in which everyone can live in good health, through the cooperation of industry, government, and academia.
© Source JICA
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