Japan - Global health

Japan ranks among the top donors to global health in absolute terms and is increasing its contributions to health multilaterals

Japan was the fourth-largest donor to global health among members of the Organisation for Economic Co-operation and Development (OECD) Development Assistance Committee (DAC) in 2020. Japan spent US$1.9 billion on official development assistance (ODA) to health in 2020. Health ODA accounted for 10% of Japan’s total ODA in 2020, which is in-line with the DAC average and placed Japan in 13th place among other donors in relative terms. Japan’s health ODA almost doubled, increasing by 84% in 2020 from 2019’s US$1.0 billion. The uptick was mainly driven by Japan’s increased bilateral health ODA, which expanded by 177% from 2019 levels, largely due to COVID-19 related support.

Japan has been increasing its share of health ODA channeled through multilaterals, which accounted for 61% of health ODA in 2019. However, this figure dropped in 2020 and stood at 41% (DAC average: 44%). Conversely, Japan channeled 59% of its health ODA bilaterally in 2020, up from 39% in 2019. More than half (54%) of this was channeled as earmarked funding to multilaterals.

Japan prioritizes global health in its ODA policy framework, the ‘Development Cooperation Charter,’ with an emphasis on quality health care, infectious disease control, and universal health coverage (UHC). In May 2022, Japan finalized a new global health policy, which focuses on strengthening preparedness, prevention, and response to public health crises, including pandemics, and on achieving a more resilient, equitable, and sustainable UHC as the world copes with COVID-19 response. The policy also aims to increase Japan’s total health ODA and comes in the lead up to Japan’s G7 presidency in 2023.

Japan’s bilateral investments focus on infectious disease control and health systems strengthening (HSS), and efforts in these areas have increased in light of the effects of the COVID-19 crisis. COVID-19 control accounted for 68% of Japan’s bilateral health ODA in 2020, with infectious disease control coming in second (10%). Other important priorities include HSS-related areas, such as basic health infrastructure (7%), medical services (7%), and health policy and administrative management (3%). Given Japan’s recent response and commitments towards fighting the COVID-19 crisis, it is expected that the focus on infectious disease control will continue to grow.

Download
Download

In October of 2020, Japan released its health strategy for COVID-19 response in partner countries, 'Leave No One's Health Behind'. The strategy puts renewed emphasis on achieving UHC and prioritizes three pillars: 

  1. Supporting immediate COVID-19 response through strengthened capacity for health services, vaccines, diagnostics, and therapeutics;
  2. Advancing long-term health systems strengthening in partner countries; and 
  3. Promoting broader health security through support for sectors including water and sanitation, nutrition, education, and gender equality. 

The Japanese government has been supportive of the Access to Covid-19 Tools Accelerator (ACT-A), and by June 2022 had committed a total of US$1.7 billion to the ACT-A, including US$1.2 billion for its 2020-21 budget and US$538 million for its 2021-2022 budget. This total commitment includes US$1.5 billion provided to the Gavi COVAX facility to ensure equitable access to vaccines. It is important to note that not all ACT-A funding is reportable as ODA.

MOFA’s ‘Global Health Policy Division’ is in charge strategy; JICA leads on implementation

Within the International Cooperation Bureau of Japan’s Ministry of Foreign Affairs (MOFA), the Global Health Policy Division, led by Director Satoshi Ezoe, is in charge of health-related issues. Within the Japan Agency for International Cooperation (JICA), the Human Development Department, led by Senior Vice President Nobuko Kayashima, is responsible for implementation, alongside the different geographic departments.