Japan Must Uphold Its G7/8 Legacy as a Leader in Global Health
Kiyoshi Kurokawa, MD*1
1. G7/8 Summit meetings began in 1976, when the world’s six major advanced
economies met to discuss economics and macroeconomic initiatives. The topic of
Human Health first appeared at the 1979 annual meeting in Japan, the final
communiqué concluding; ‘We will place more emphasis on cooperation with
developing countries in overcoming hunger and malnutrition.’ Thereafter, ‘HumanHealth’, a truly global concern, became a substantive agenda item.*2
2. Health-related agenda topics were scarce until 1996, when the global HIV/AIDS
pandemic led to the creation of UNAIDS. Since then, HIV/AIDS has remained centralto Summit discussions.
3. Japan has been a proactive leader in Health at G7/8 Summits, from the 1997/98
Hashimoto Initiative, through the Okinawa Infectious Disease Initiative, to its initial
proposal in 2000 that led to creation of the Global Fund to fight HIV/AIDS, Malaria
and Tuberculosis. Japan’s Health leadership in G7/8 Summits has focused on
capacity building and improving national health infrastructure, as exemplified bythe 2008 ‘Health Systems Strengthening’ initiative.
4. International commitment to global health is manifest in the UN’s Sustainable
Development activities, originating in the 1992 Earth Summit in Brazil, and theMillennium Development Goals (MDG) in 2000. The Rio+10 Summit (2002) andRio+20 (2012) re-emphasized the impacts - beneficial and detrimental - ofGlobalization.
5. The international Pharmaceutical industry has also played a major part in
improving global public health, Merck’s original drug donation of Ivermectin totackle River Blindness in 1987 being followed by subsequent drug donation
initiatives from several major pharmaceutical manufacturers.
6. The new paradigm of international, multi-faceted mobilisation to improve global
health was further advanced by the appearance of the Bill & Melinda Gates

Foundation (BMGF) in 2000, together with GAVI and many other new programs,
including the President's Emergency Plan For AIDS Relief (PEPFAR) in 2003. TheBMGF represented new leadership, creating and expanding multidisciplinary
partnerships with NGOs, countries, academia and industry (e.g. the Grand
Challenges Canada (2010) and the Japan’s Global Health Innovation Technology(GHIT) Fund (2013)).
7. Connectivity and access to the Internet have become increasingly easier andcheaper, raising awareness of Globalization among sider sectors of the generalpublic and changing the policy-making process - multi-stakeholders becoming
engaged, not just national and international government entities. Transparency his
also now of critical importance in all governance and accountability.
8. Resource-poor, disease-endemic countries and affected communities have also
made significant health interventions, which often reflect those responsible forJapan’s post-war Health Miracle. Modern technology is informing and empowering
virtually all communities, who can now take advantage of social networking andother enabling systems to help directly address their own health needs.
9. The bursting of the ’Bubble’ economies in Japan in 1990, elsewhere in Asia in 1997,
and then Wall Street in 2008, confirmed that economic and industrial paradigms
are changing, driving the world toward so-called ‘Post-capitalism.’ The
income/wealth gap, within and between nations, continues to widen, while mass
production and massive consumerism increases, and the world population
burgeons, resulting in human societies with clearly unsustainable foundations.
10. Shifting world economic power has seen the 2008 launch of the G20, emergence of
the BRICS group, and two new major Development Banks. Now, single events
resonate globally, as evidenced by the 9.11 disaster in 2001, the iPhone appearance
in 2007, and the Arab Spring in 2010, which expedited the disappearance or failureof nations in North Africa and the Middle East, causing refugees to flood into EU
countries creating unforeseen and complicated emergencies.
11. Worldwide, multi-partner, integrated measures against HIV/AIDS, Malaria andTuberculosis have progressed significantly since 2000, proving that concerted,
multi-stakeholder health interventions can conquer intractable diseases. But globalhealth problems are dynamic, forever evolving, and so need constant attention
from world leaders.
12. As health and poverty are central to today’s inherently unstable Globalization
process, improving human health is a major global challenge that will benefit allmankind. This is endorsed by the fact that, in 2005, Japan introduced a special
Hideyo Noguchi Prize, devoted to global health with a focus on Africa, to add toThailand’s existing Prince Mahidol Prize. Furthermore, new premier international
Medical Science awards (e.g. Lasker and Gairdner Prizes) are devoted to the newcategories of ‘Public Health Service’ and ‘Global Health’, respectively. In addition,
the 2015 Nobel Prize in Physiology and Medicine was awarded to Satoshi Omura
and William Campbell for the discovery of Ivermectin (>250 million people taking
free tablets annually to eradicate river blindness and elephantiasis), and to Youyou
Tu for her discovery of artemisinin (firstline antimalarial that has helped halve
deaths from the disease).
13. In addition to bilateral ODA and funding from multilateral agencies (e.g. the UN,World Bank) novel forms of private-public-partnership have appeared, nationallyand internationally, with the BMGF is playing a major role in this respect.
14. For 20 years, existing and emerging health challenges, including ageing, polio andflu epidemics, have received significant G7/8 consideration. Recent Summits havecontinued to address infectious diseases, including epidemics of dengue and Ebola,
antimicrobial resistance (AMR), aging societies and healthy aging, dementia, andvaccination programs (e.g. final steps for polio eradication).
15. The Japanese Government must try its best to maintain its credibility and its legacy
on Health at the G7 Summit at Ise-Shima, May, 2016. It should lead the discussion
on items such as Universal Health Coverage, Aging and Dementia. Further,
epidemics and AMR both natural and intentional, are real global risks withadvancing urbanization and increasing human traffic across national andcontinental boundaries.
16. The promises to fight devastating diseases and to procure the necessary financial
resources must be executed in the face of major challenges, including the sluggish
economy and huge sovereign debts. Innovative financial mechanisms, such asthose employed by GAVI (about twenty percent of its funding comes from nationalbonds of UK, France, Italy, Norway, Australia, Spain, the Netherlands, Sweden andSouth Africa), may provide a new model for utilizing national bonds as a criticalsource of funding for protecting health and human security. Japan must uphold its
commitments made at the G7/8 Summits and continue to strive to be a leader inglobal health.

Footnotes;
1. Kiyoshi Kurokawa, MD, <www.kiyoshikurokawa.com/en/>
Chair of Health and Global Policy Institute, <www.hpgi.org/en/>
Chair of Global Innovation Technology Technology, <www.ghitfund.org/en/>
Adjunct Professor and Principal Investigator of Global Health Innovation Policy
Program at Graduate Institute of Policy Studies,
http://www3.grips.ac.jp/~GHIPP/en/about/
2. Footnote; Primary data source of this report is the G8 Research Group of the Munk
School of Global Affairs, University of Toronto at<http://www.g8.utoronto.ca/conclusions/index.html>

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