JICA has many people from various backgrounds who are tackling international issues with clear-cut passion in their respective fields. This new series, “People Taking on International Challenges,” focuses on the passion of these people. The first article in this series features Hisakazu Hiraoka, who has been taking on the challenge of combating infectious diseases for many years.
December 27 is the International Day for Epidemic Preparedness established by the United Nations. It was newly established in 2020 to recognize once again the need for preparedness against epidemics (infectious diseases) in the wake of the global outbreak of new coronavirus infections.
Hisakazu Hiraoka of JICA’s Human Development Division, who has worked for many years on infectious disease countermeasures in developing countries, says, “Infectious diseases will follow us as long as human beings exist. In other words, it is important to be aware that infectious disease outbreaks are a possibility, not a question of whether or not they will occur, and to be prepared for them in the same way that one is prepared for earthquakes.
We asked Mr. Hiraoka about the current state of infectious disease countermeasures in developing countries and what is needed to prepare for the next pandemic.
Hisakazu Hiraoka is currently in charge of JICA’s overall new coronavirus-related measures as the Deputy Director of the Office for the Promotion of Cooperation in Coping with New Coronavirus Infectious Diseases. His desk is lined with a variety of goods related to infectious diseases as well as his favorite insects.
Work that creates the “foundation” of people’s health
In Japan, preventive measures against infectious diseases, such as hand washing, wearing masks, and vaccination, were widespread in society even before the Corona disaster. However, in many developing countries, such practices have not taken root, and combined with the difficulty of securing clean drinking water, many infectious disease outbreaks still occur today.
Mr. Hiraoka’s job is to establish and strengthen the overall healthcare system in these countries, including measures against infectious diseases. He works with local administrators to build a foundation for protecting the lives and health of the people in those countries.
The actual activities on the ground are carried out by specialists dispatched from Japan, but we are in charge of managing the project as a whole, as well as connecting the relationship with those in Japan. Sometimes we talk with local administrative officials and laboratory technicians, and sometimes we visit medical facilities to understand what is really needed in each country, and to consider what kind of cooperation we should provide.
Ms. Hiraoka says she has always loved biology in general, and from there she became interested in viruses, bacteria, and parasites. After studying health science and nursing at university, she joined JICA, where she worked mainly in the health and medical field in Southeast and South Asian countries such as the Philippines, Indonesia, Bangladesh, and Sri Lanka.
When he was the section chief in charge of the Africa region, he traveled to Ghana, Sierra Leone, and other countries, and has visited more than 20 countries so far. Before becoming a Corona disaster, he used to visit the region approximately once every two months, but he often visited the same countries repeatedly, some more than 20 times.
In the Philippines, where tuberculosis (TB) was widespread, the National TB Research Institute was established in 2002 with Japanese assistance. Today, the institute is producing human resources who are contributing to the prevention of tuberculosis. The photo was taken at the opening ceremony.
The more prevention progresses, the more difficult and frustrating it becomes.
Mr. Hiraoka was seconded to the World Health Organization (WHO) for two years starting at the age of 26. She worked at the Western Pacific Regional Office in Manila, Philippines, where she was particularly involved in the promotion of child immunization.
Vaccinations are very effective in preventing infectious diseases and are free of charge. On the other hand, however, in some countries and regions, vaccines are not delivered to the places where people live, or even if they are delivered, they are not brought to the children, which often makes it difficult to promote vaccination.
It is especially important to approach mothers to get their children vaccinated. This is why Papua New Guinea is conducting an annual vaccination campaign. They call on residents to gather in a square and create a bit of a festive atmosphere to bring their children.
Mr. Hiraoka recalls that it was a very valuable experience for him to see and hear the actual efforts and innovations of people in the field. However, he also notes that the more widespread the use of vaccination and other countermeasures becomes, the more the threat of disease itself becomes invisible, which is a difficult aspect of infectious disease countermeasures.
So you end up thinking, “Why should I bother getting vaccinated when there is no one else around who is in trouble anymore? The more infections subside, the less visible the preventive effect of vaccines becomes. That is why I feel it is necessary to keep telling people how effective they are. Besides, I also want to tell people that if they continue to take measures, ‘someday the threat will (possibly) disappear.'”
For example, smallpox, once feared as a “deadly disease,” has been dramatically reduced through the spread of vaccines, and in May 1980, the WHO declared the disease eradicated. At present, polio, which is also vaccine-preventable, and Guinea worm, a parasitic infection that can be prevented by a safe water supply, are on the verge of eradication.
At a vaccination campaign in Papua New Guinea. The accumulation of such activities will one day lead to the eradication of infectious diseases.
Shedding Light on “Neglected Infections”
However, Mr. Hiraoka points out that it is not easy to truly reduce the number of infections to zero. Not only are there cases where the threat has diminished or there are no noticeable symptoms due to widespread prevention, but there are also serious life-threatening infectious diseases for which adequate measures have not yet been taken.
The WHO has designated 20 infectious diseases as Neglected Tropical Diseases (NTDs). Although some of these diseases are believed to be controllable with proper prevention and treatment, the development of vaccines and medicines has not progressed well because they occur only in very limited areas of the world, especially in developing countries.
In Bangladesh, Hiraoka took on one of these “neglected tropical diseases. Visceral leishmaniasis. As the name implies, it affects the internal organs and can lead to death. Although it is estimated that more than 50,000 people are infected annually, the fact that the disease is caused by insects that are found in close proximity to people in their daily lives, in addition to the fact that the area is limited, has made it difficult to take countermeasures.
Therefore, in collaboration with the University of Tokyo and local research institutions, we first investigated what kind of people were infected, and supported research on how mosquito nets could be used to keep the insects away, as well as the development of simple diagnostic methods. We cooperated in a country-wide effort to eliminate the threat in areas where the infection is spreading.
I would say that strengthening our efforts as a country is exactly where JICA comes in. Many of the local officials have been working with JICA for many years, and they understand our methods and ways of thinking so well that they sometimes lecture other officials about Japan’s experience and initiatives. They may know what we are doing better than we do in Japan (laughs).”
Mr. Hiraoka inspecting a hospital in Bangladesh. By visiting the site of medical care, he is able to determine what cooperation is truly needed.
Infectious diseases are like earthquakes. It will surely come one day.”
Hiraoka says he became interested in infectious diseases after learning about AIDS when he was in high school, but the pandemic of the new coronavirus infection “didn’t really surprise me,” he says. He says he was not particularly surprised by the pandemic of the new coronavirus, because he knew that “as long as humans exist, it will happen someday. In fact, in some ways, he says, he was “waiting for it.
Humanity has experienced several pandemics, including the Spanish flu that broke out 100 years ago and cholera that spread from India to the rest of the world, including Japan, in the 1800s. In Japan, many infectious diseases, such as smallpox and measles, have spread and subsided, and then spread and subsided again …….
It is just like an earthquake. Although it is impossible to predict exactly when, where, and what kind of earthquake will occur, it is no longer a matter of course that it will “happen. In the same way, Hiraoka says, infectious disease outbreaks are “bound to happen” as long as human beings exist, and it is important not to neglect preparations for the next infectious disease.
The experience with the coronary disaster gave us experience in prevention and countermeasures.” At the same time, we must have learned that infectious diseases are never just a health care problem. We have seen that it is not only health that is threatened, but also the economy, society, and education, which in turn leads to poverty. I believe it is an experience for the future that this has happened in Japan and other developed countries as well.”
I hope that this pandemic will be an opportunity for people in a wide range of fields to have an “infectious disease mindset” so that more knowledge, technology, and countermeasures against infectious diseases can be applied.
Hiraoka laughs, saying, “Parasites, for example, are such interesting organisms that I don’t really want to take action against them (as long as they don’t do anything bad).” He says that microorganisms (viruses, bacteria, parasites, etc.), whose ecology has evolved despite human resistance since time immemorial, stir his interest in them as life forms.
Hisakazu Hiraoka
In 2000, she joined JICA, where she was mainly involved in technical and financial cooperation in the field of healthcare. From 2003 to 2005, she was seconded to WHO as a Technical Officer, Expanded Immunization Programme Division, Department of Infectious Disease Control, Western Pacific Regional Office. 2015 to 2017, she was seconded to Nagasaki University as an Associate Professor, Graduate School of Tropical Medicine and Global Health. From 2020, he will serve as Deputy Director of the Office of Cooperation and Promotion of Countermeasures against Infectious Diseases of New Strains of Coronavirus.
© Source JICA
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