Japan has continued to show strong global health leadership since its G7 presidency in 2016
Japan was the fourth-largest donor to global health among members of the Organisation for Economic Co-operation and Development’s (OECD) Development Assistance Committee (DAC) in 2015 (the latest year for which complete data is available). In absolute terms Japan spent US$895 million on health ODA (in 2016 prices). Health ODA accounted for 5% of Japan’s total ODA in 2015, well below the DAC average (9%), which places it 19th in relative terms.
In 2015, Japan launched a new global health policy, the ‘Basic Design for Peace and Health (Global Health Cooperation)’, which focuses on universal health coverage (UHC) and on preparing health systems for public-health emergencies such as Ebola. Japan seeks to use its expertise (health staff, technology, pharmaceuticals, and medical equipment) to meet these objectives. However, unlike previous health strategies, the new policy does not include a timeframe and concrete funding commitment for health.
In line with the strategy, Japan agreed on a new action plan during a ministerial meeting to fight infectious diseases in 2016. The plan focuses on four issues: 1) strengthening international systems to fight against infectious diseases through the Global Fund to fight AIDS, Tuberculosis and Malaria (Global Fund), Gavi, the Vaccine Alliance (Gavi), and the Global Health Innovative Technology Fund (GHIT Fund); 2) developing domestic human resources in the infectious diseases field; 3) strengthening domestic research institutes; and 4) strengthening key domestic institutions dealing with infectious diseases. In support of the action plan, Japan pledged US$800 million to the Global Fund for the period 2017 to 2019, an increase of 46% over Japan’s previous pledge, and US$95 million to Gavi for the period 2016 to 2020.
Japan hosted the UHC Forum in December 2017, in collaboration with the World Health Organization, the World Bank, and UNICEF, the United Nations Children’s agency. The forum brought together government representatives and global health organizations with the goal of stimulating progress towards achieving UHC. At the meeting Japan pledged US$2.9 billion in development assistance to promote UHC world-wide, though it did not specify a precise time period nor recipients for the disbursement.
Health was one of three priority initiatives of Japan’s G7 presidency in 2016, alongside women’s empowerment and stabilization of the Middle East. Health-related discussions at the 2016 G7 summit focused on three areas: public health emergency response, promotion of UHC, and measures against anti-microbial resistance.
In 2015, Japan channeled 52% of its health ODA multilaterally, slightly below the DAC average (55%). The Global Fund was by far the largest recipient (41% of multilateral health ODA, or 21% of total health ODA). The remainder (48%) was channeled bilaterally.
Bilateral health ODA amounted to just 4% of Japan’s total bilateral ODA in 2016. Japan’s bilateral investments focus on health systems strengthening (HSS), which accounted for 35% of Japan’s bilateral health ODA in 2016. This is made up of health policy and administrative management (20%) and basic health infrastructure (15%). Other important areas of Japan’s health ODA are infectious disease control (21%), medical services (21%), and reproductive health care (10%).
The Ministry of Foreign Affairs ‘Global Health Division’ is in charge of strategy; Japan Agency for International Cooperation leads on implementation
Within the International Cooperation Bureau of Japan’s Ministry of Foreign Affairs, the ‘Global Health’ division within the ‘General Directorate for Global Issues’ is in charge of health-related issues. Within the Japan Agency for International Cooperation’s (JICA) the ‘Human Development’ department is responsible for implementation, alongside the different geographic departments.