Japan - Global health
At a glance
Japan ranks among the top donors to global health in absolute terms, but spends less in relation to other sectors
Japan was the fifth-largest donor to global health among members of Organisation for Economic Co-operation and Development (OECD) Development Assistance Committee (DAC) in 2016 (the latest year for which multilateral and bilateral data is available). Japan spent US$883 million on health ODA in 2016 (in 2018 prices), making it the fifth-largest donor in the OECD DAC in absolute terms. Health ODA accounted for 5% of Japan’s total ODA in 2016, which is below the DAC average (8%) and placed Japan in 18th in relative terms.
Bilateral ODA represented the majority of Japan’s health ODA in 2016, which at 52% was higher than the DAC average of 44%. Japan channeled the remaining 48% of its health ODA multilaterally, below the DAC average of 56%.
Priority countries for bilateral cooperation on health
In 2018, bilateral health ODA amounted to US$379 million, or 3% of Japan’s total bilateral ODA. This represents a slight decrease from 4% of bilateral ODA in 2016 and 2017.
Japan contributes to a variety of health multilaterals including:
- The Global Fund to Fight AIDS, Tuberculosis and Malaria, which was the largest multilateral recipient of health-related funds from Japan in 2018 (US$282 million). Japan contributed US$800 million to the Global Fund for the period 2017 to 2019 and pledged an additional US$840 million for the period 2020 to 2022.
- Gavi, the Vaccine Alliance, to which Japan contributed US$95 million for the period 2016 to 2020. Japan increased its pledge significantly to US$306 million for the 2021-2025 period.
- The United Nations Population Fund (UNFPA), with US$33 million in contributions in 2018 and US$114 million in total contributions since 2014.
- The Global Polio Eradication Initiative (GPEI), with a latest contribution of US$6 million in 2019 and total contributions of US$569 million since its inception in 1985.
Japan’s ODA for global health has remained relatively steady since 2014, and due to Japan’s ongoing commitments in the sector, it is expected that global health will continue to maintain a share of approximately 5% of Japan’s total ODA. Due to Japan’s increasing commitments to global health-related multilaterals, it is possible that the relative proportion of Japan’s multilateral health ODA may increase in relation to bilateral health ODA.
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). Building on this focus, 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 lead up to the G7 presidency, Japan launched a new global health policy, known as the ‘Basic Design for Peace and Health (Global Health Cooperation)’, which focuses on UHC and on preparing health systems for public health emergencies. However, unlike previous health strategies, the new policy did not include a timeframe or concrete funding commitment for health.
In line with the strategy, Japan also released its ‘Action Plan for Strengthening Measures on Emerging Infectious Diseases’ in 2016. The plan focuses on strengthening international systems through the Global Fund, Gavi, and the Global Health Innovative Technology Fund (GHIT Fund), and on strengthening domestic resources and research institutes dealing with infectious diseases.
Japan’s bilateral investments focus on health systems strengthening (HSS), in line with its focus on universal health coverage (UHC). HSS funding accounted for 30% of Japan’s bilateral health ODA in 2018, incorporating basic health infrastructure (16%) and health policy and administrative management (14%). Other important areas of Japan’s bilateral health ODA are infectious disease control (21%), medical services (20%), and reproductive health care (9%). Given Japan’s recent response and commitments towards fighting the COVID-19 crisis, it is expected that the focus on infectious disease control will grow.
As part of its focus on UHC, Japan hosted the UHC Forum in December 2017, in collaboration with the World Health Organization, the World Bank, and the United Nations Children’s Fund (UNICEF). At the meeting, former Prime Minister (PM) Abe pledged US$2.9 billion in development assistance to promote UHC worldwide, though it did not specify a precise time period nor recipients for the disbursement.
In addition to the PM’s initiatives, the Japanese Vice Minister of Finance for International Affairs, Yoshiki Takeuchi, has emphasized Japan’s commitment to UHC through partnerships with the World Bank. Japan has so far supported 33 projects on UHC promotion and pandemic preparation through Japan’s trust fund at the World Bank, with a cumulative financial value of US$21 million. In a speech at the World Bank in October 2019, Vice Minister Takeuchi shared Japan’s vision for global health partnerships with the World Bank, which will focus on sustainable health financing systems, health sector human resources, and partnerships with the private sector.
In 2020 Japan has contributed to the international response to COVID-19 and has announced funding for both preventing further spread and responding to the current medical situation. Of the details released by the government so far, funding that may be counted as ODA includes US$51 million in funding for WHO’s strategic preparedness and response plan and US$50 million to the Association of Southeast Asian Nations (ASEAN) to support the establishment of the ASEAN Center for Public Health Emergencies and Emerging Diseases and for the COVID-19 ASEAN Response Fund.
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.