Global Health andtheThe 2008 G8 Toya-ko Summit Process& Experiences of Civil Society

Africa Japan Forum

Japan AIDS and Society Association

We underline the need for partner countries to work towardsustainable and equitable financing of health systems. We also
welcome the efforts of the providing for health initiative as well as
the International Health Partnership and the Catalytic Initiative.
We reiterate our commitment to continue efforts, to work towards
the goals of providing at least a projected US$ 60billion over 5
years, to fight infectious diseases and strengthen health. Some
t i
ill
id
dditi
l
f
h lth
t

Survival Kit

TABLE OF CONTENTS
Preface: Civil Society and the G8 Process: Why We Advocate

1Part I: Global Health Outcomes from the Toya-ko Summit
1. Greatest Potential: Accountability
2. Lack of Progress in Other Areas of Global Health
3. Using the Results of the Toya-ko Summit

2
2
2
2

Part II: G8 Pledges for Global Health
１．Introduction
２．Pledges in Toya-ko Summit
３．Pledges in the Past G8 Summits

5
5
5
7

Part III: HIV/AIDS and Global Health – G8 Guidebook
1. The G8 Process
2. The General Flow of the G8 Process
3. Creation of Civil Society Networks in Host G8 Country for the G8 Process
4. Global Health as an Agenda Item
5. Media and Civil Society
6. Towards the G8 Summit: Initial Phase (January - February 2008)(1) Overview(2) Sherpa Meeting(3) The World Economic Forum(4) G8 Health Experts Meetings(5) Global Health Summit
7. Towards the G8 Summit: Mid-Phase （March – April 2008）(1) Overview(2) TICAD Ministerial Meeting(3) G8 Ministerial Meetings(4) Africa Partnership Forum
8. G8 Summit Process: Civil G8 Dialogue
9. Towards the G8 Summit:: Final Phase (May – June 2008)(1) Overview(2) Meeting between the Chair of the G8 and Int’l NGOs
(3) The Final Stretch
10．G8 Summit: International Media Center
11．G8 Summit: The Alternative Summit

17
17
18
20
21
22
23
23
23
24
25
26
27
27
27
28
29
30
31
31
32
32
33
35

Epilogue: Civil Society and the G8 Process: Creation of an Insitutuional Memory

36

Reference (Contents: to page 38)

37
Acknowledgements

We would like to express our gratitude to all those who supported us in the completion of thisresource book. We would especially like to thank the Open Society Institute and the 2008 Japan
G8 Summit NGO Forum.

PREFACE: CIVIL SOCIETY AND THE G8 PROCESS: WHY WE ADVOCATE5

Preface: Civil Society and the G8Process: Why We Advocate

healthcare are ensured for all. Civil society involved in theG8 understands that despite wanting to bring an end to
the G8, they cannot stop them from meeting. However,what civil society can do is to ensure that their voices and

The G8 Summit is yet another example of a world
increasingly divided between have and have nots, of aworld where those with hard power attempts to decide thefate of the rest of the world without the full participation of
those who will be most affected by their decision and/or
indecisions.

does not have been divided between have and have nots
and the world does not have to be run in the directions of
those with money or military might. Whenever andwherever gatherings or events take place where thosethat are most affected by the decisions and policies madeat these places are unheard, civil society has always
stood at the forefront of pressing for participation andpressing for the policies and issues that benefit the mostvulnerable and the most voiceless of the world.

everyone, and pushing for participation in the G8 process
and holding the G8 countries accountable to theircommitments.

boundries of country borders, religion, race, language etc.
to come in solidarity to demand a more just world in which
economicdevelopment,

accesscriticisms of the G8 by providing alternatives andresources to issues that will best serve the people thosemost affected by their indecisions and/or indecisions.
A commitment is made under the presumption that it willable kept, but when it comes to the G8 leaders making its
commitments, it has proven over and over thatcommitments are merely just words. The G8 has failed tokeep what is presumptively supposed to be kept. Thus ascivil society, we have worked and will continue to work toensure that the commitments that are supposed to be

Civil Society involved in the G8 process has shattered the

security,

have done so by going beyond the battle between G8 vs.

Throughout this G8 process, civil society went beyond justYet, Civil Society has proven over and over that the world

food

the voices of those who they represent are heard. Theytokept, as the word commitment suggest, are kept.
Civil society advocacy from both the developed and thedeveloping country towards the G8 is necessary in orderto create a more just world.

A New Year’s Card sent to Prime Minister Fukuda in January 2008

2

PART I：GLOBAL HEALTH OUTCOMES FROM THE TOYA-KO SUMMIT 果------------------------------

G8 summit failed to make progress on other issues within

１．Greatest Potential: Accountability

the global health agenda that would answer to thePART I：GLOBAL HEALTH OUTCOMESFROM THE TOYA-KO SUMMIT

expectations of Civil Society.
Three outcome documents on global health from the 2008
G8 Summit:(1) G8Communiqué:Paragraphs

The outcomes for Global Health from the July 2008

Development

45-46

(2

and

Africa.

pages)

See:

http://www.g8summit.go.jp/eng/doc/doc080714__en.h

Toya-ko G8 Summit was far from the modest progress

tml

some have expected. But one positive outcome of thisSummit was the establishment of a follow up mechanism(2) Toya-ko Framework for Action on Global health: The

to monitor our progress on meeting our commitments

outcome document of the G8 Health Experts with

(2008 G8 Communiqué: Development and Africa), whichassistance from associated international organizations

will show G8 implementation of past commitments toand private interest groups and foundations. The G8

ensure accountability. Thus meaning, the following will

Health Experts held several meetings throughout the

take into effect:

G8(1) Global Health will be an agenda item of the G8, atleast until 2010.
(2) Each G8 country will be responsible for creating a
as

their

(individual

country’s’)review.

(Matrices:

Actiontackling the three major infectious diseases was created.
(See:
http://www.g-8.de/nn_92452/Content/EN/Artikel/__g8-su
mmit/2007-10-31-g8-gesundheitsbericht.html)

GlobalHealth.

See:

df

pdf)

report which reviews what each G8 country has done inon

http://www.g8summit.go.jp/doc/pdf/0708_09_02_en.p

http://www.g8summit.go.jp/doc/pdf/0708_09_02_en.

commitments. At the 2006 St. Petersburg G8 Summit, aSee:

come as an attachment to the Toya-ko Framework forSeeevery year, despite failing to work towards achieving pastprocess.

each G8 counties for global health. The matrices

financial

The trend of the G8 has been to make new commitments

makingMatrices: the matrices contains past contributions ofcontribution for global health. This will be subjectedtopolicy(3) Toya-ko Framework for Action on Global Healthmatrix on the fulfillment of past G8 commitments, as
well

Summithttp://www.g8summit.go.jp/doc/pdf/0708_09_en.pdf

The greatest area of concern of this G8 Summit on the
progress in global health is the lack of financial
commitments. As a result, there are no guarantees thatthe political commitments made in the G8 Communiqué
will be kept nor met. Furthermore, the Toya-ko Framework
for Action, despite its name, is a package of generalrecommendation on health policies, rather than concrete
actions and directions for the attainment of global healthgoals.

Germany, the chair of the 2007 G8 Summit presented a-------------------

report on the financial contribution for the three infectious

3.Using the Results of the Toya-ko Summit

diseases reported by each G8 country. The follow up
mechanism constructed at the 2008 Toya-ko Summit
includes, in addition to the three infectious diseases, allglobal health issues such as health system strengthening.
Furthermore, the G8 countries have ensured that thisprocess will continue until 2010------------------2．Lack of Progress in other Global Health
TopicsThere was disappointment among the Civil Society as the(1)

Using the Opportunities

The greatest opportunity gained during the Toya-ko
Summit is the follow-up mechanism. The G8 leaders haveagreed to establish a follow-up mechanism to monitor
their progress on meeting the commitments. Thus Civil
Society must use this opportunity provided by thisfollow-up mechanism, and to advocate for the G8 for theattainment of its past commitments. In order to ensurethat the follow-up mechanism will be used to ensureaccounatibily, it is important for Civil Society to do thePART I：GLOBAL HEALTH OUTCOMES FROM THE TOYA-KO SUMMIT3
actions, plans and contributions for the attainment offollowing:these goals were lacking. Of this, on HIV/AIDS, there area) Evaluation of the matrices

few things that must be pointed out:

The matrices that came out of the 2008 G8 Summit will bea) Creation of a concrete financial contribution plan

revised every year, and as to the existing commitments offor the attainment of Universal Access by 2010

the G8, the G8 has agreed to evaluate how much andwhat kind of contribution each country has provided

According to UNAIDS, in 2009 USD 30 Billion, in 2010

towards its attainment. Thus meaning that these matrices

USD 40 Billion will be needed for the attainment ofwill become the baseline for measuring the accounatibily

Universal Access by 2010. Yet, at this summit, the G8 hasof G8 countries.

made a commitment for 60 Billion for infectious diseases
and health strengthening within five years; far from what

It is important to examine the format and contents of thewould be necessary to achieve Universal Access by 2010.

matrices, which will be the baseline, point out areas that(http://data.unaids.org/pub/Report/2007/20070925_advoc

are false or lacking, and then call for revisions to ensure

acy_grne2_en.pdf)

that the matrices will be comprehensive and easily
understood.

We must work to ensure the creation of a concrete
financial contribution plan for the attainment of Universalb) Independent review of the performance of each G8

Access in lieu of the 2009 G8 Summit in Italy.

countryb) Creation of a concrete financial contribution plan
The attached matrices created by the G8 are the fruits offor the attainment of goals set at the Heiligendamm

compromises among the G8 countries. No matter theSummitamount of proposals and recommendations made by Civil
Society, there will always be points which are insufficient

At the 2007 G8 Summit in Heiligendamm Summit, the G8

and lacking. The civil society should use the information

leaders have made the following commitments concerningon these matrices to bring focus to the performance of

HIV/AIDS:

each G8 country.
¾
Currently, the attached matrices which contain the

Financial contribution necessary to attain Universal
Access to PMTCT by 2010

contribution of each G8 country to the three infectious
diseases are broad contribution amounts and not¾

A long term and predictable financial contribution

accordingly to each issue within the global health agenda.

based on ambitious but realistic demand based

As for the past commitments, it is only a list of what eachfinancial targets for the Global Fund to Fight AIDS,

country has accomplished, and does not contain

TB and Malaria.

information on the contributions of each G8 country for theattainmentofacertaingoals.

Furthermore,the¾

In Africa, within the next few years to:contribution amount is not aligned in currency and・

Have 5 million PLWHA on ARVs

includes other features that are not user friendly. On these・Prevent 24 million new HIV/AIDS infections

points, as Civil Society, we must call on revision, and・Care for 24 million affected by HIV/AIDS,

using the independent review of the matrices, we will

including the 10 million children orphaned byensure that the G8 countries are held accountable for
their commitments.

AIDS
・Realize Universal Access to PMTCT.

(2) On pursuing issues that were lacking at the G8

The financial contribution severely undermines what the

Toya-ko Summit

G8 countries should be contributing, yet to even to ensure
this commitment, a concrete action and financial plan will

2010 is a milestone for the attainment of the Millennium

be necessary. (See page 15)

Development Goals, the deadline for the attainment of
Universal Declaration for treatment, care and prevention(3) The necessity of increasing cooperation andto HIV/AIDS and furthermore, the deadline for the Abuja

strengthening coordination among Civil Society

target on Malaria. At the 2008 G8 Summit in Toya-ko,

Organizations involved in the G8 process.

34PART I：GLOBAL HEALTH OUTCOMES FROM THE TOYA-KO SUMMIT 果
in this issue.
Throughout the G8 Summit and the policy process for
global health, Civil Society of each G8 country must havec)

On travel restriction of PLWHA: France pushed forcooperation

easing or abolishing the travel restrictions, as well asmechanism and must be prepared to provide resourceful

Japan. However, the United States and Russia

response to issues that comes up. The reason for theaggressively pushed against this.

aneffective

information

sharingandfollowing is as follows:d)

The character of Toya-ko Framework for action on

For the 2008 G8 summit, the Japanese Government has

Global Health: Japan has worked to ensure that theheld the G8 Health Experts meeting three times sincecharacter of the Framework for Action is similar to the

Feburary, and concluding the results of the meetings incharacter of the G8 communique. However, Italy and

the Toya-ko Framework for Action on Global Health.

Canada intervened to making the Framework nothing

Within this process, on various issues stakeholders ofmore then a document to hand over to the G8each G8 country faced off with each other, and theleaders.

Framework for Action is a result of compromises madeamong the participants of each country. Due to the

As stated previously, the G8 countries have different

difference each country has on the various issues, thestances on different issues, and compromises becomecontent is lacking in many areas. The following arenecessary for every issue that was is on the table. Thus,

examples of the conflicted views/positions of the G8creating ambitious and innovative commitments became

countries.

almost impossible. At an early stage, Civil Society groupsof each country gathered information on the position eacha)On the deadline for the 60 Billion commitment madeof their respective governments will hold on certain issues.

atSummit: The

Then, with the cooperation of civil society groups inGovernment of the UK pushed for three years (bydifferent countries, reacted to their countries’ positions2010), however, the German Government pushed forthrough advocacy and campaigning. These kinds ofeight years. Other European countries and Canadapressure and positive interventions from civil society

remained passive on this issue.

helped prevent the G8 governments from making easy

the

2007

Heiligendamm

G8

compromises and made sure the governments areb)

On reproductive health and improvement of maternal

forward-moving in their decisions and/or commitments.

health: The Japanese government pushed for theThus, it is necessary to create a greater mechanism forinclusion of these issues, however even though theinformation sharing and a mechanism for cooperation in

US government showed some understanding, they

advocacy among civil society of the world.

kept their tradition of not getting their hands too deep

Closing Celemony of the People’s Summit 2008

PART II

5

G8 PLEDGES FOR GLOBAL HEALTHPART II
G8 Pledges for Global Health
Beginning in 2000, the G8 set global issues such as
global health, as one of the major agenda items of the G8.
This is a far growth from the time the G8 was originally the"G6", a forum on economic coordination of capitalist
developed countries.
What kind of pledges has the G8 made on global healthissues in the past? The following is the lists of G8 pledges
on global health:(1) Toya-ko G8 summit(2) Past G8 Summit (1980's-2004 and 2005, 2006,
2007)

2. Pledges in Toya-ko Summit＜Pledges in Toya-ko Summit Leaders Declaration＞
Issue

Paragraph

Discription

HealthGeneral45・

Financing

46(a)

・

HealthSystemStrengthening

46(b)

・

Maternal,
Newborn andChild Health

46(c)

・

HIV/AIDS

45
46(g)

・

・

・

・
Malaria

46(d)

・

Other
Infectious
Diseases

46(e)
46(f)

・
・

(G8) also agreed to establish a follow-up mechanism tomonitor our progress on meeting our commitments.
(G8 leaders) welcome the report submitted by our healthexperts along with its attached matrices… to ensureaccountability. ("Toya-ko Framework of Action") includes
the principles for action, and actions to be taken on health,drawing on the expertise of international institutions.
We reiterate our commitment to continue efforts, to work
towards the goals of providing at least a projected
US$ 60billion over 5 years, to fight infectious diseases andstrengthen health. Some countries will provide additional
resources for health systems including water.
The G8 members will work towards increasing healthworkforce coverage towards the WHO threshold of 2.3
health workers per 1000 people
We will also supports efforts by partner countries andrelevant stakeholders, such as GHWA, in developing
robust health workforceplans and establishing specific,
country-led milestones as well as for enhanced monitoringand evaluation, especially for formulating effective healthpolicies. (...) We take note of the Kampala Declaration andagenda...
G8 members are determined to honor in full their specificcommitments to fight infectious diseases, namely malaria,
TB, polio and working towards the goal of universal accessto HIV/AIDS prevention, treatment and care by 2010.
G8 members are determined to honor in full their specificcommitments to fight infectious diseases, namely malaria,
tuberculosis, polio and working towards the goal ofuniversal access to HIV/AIDS prevention, treatment andcare by 2010.
review travel restrictions for HIV positive people with aview to facilitating travel and we are committed to follow
this issue.
expand access to LLITNs, with a view to providing 100
million nets through bilateral and multilateral assistance…
by the end of 2010
we will meet our previous commitments to maintain or
increase financial contributions to support the Global Polio
Eradication Initiative
we will be able to reach at least 75% of the people affectedby certain major NTDs… With sustained action for 3-5
years, this would enable a very significant reduction of thecurrent burden with the elimination of some of these
diseases.

Reference of Toya-ko
Framework
Paragraph 1 and 2

Paragraph 29

Paragraph 11-15

Paragraph 16-20

Paragraph 21

Paragraph 23
Paragraph 24, 25, 30

6PART II

G8 PLEDGES FOR GLOBAL HEALTH

Pledges in Toya-ko Framework for Action on Global Health
IssuesHealthGeneralFinancing

Paragraphs
1

HealthSystemStrengthening

13
14

Maternal,
Newborn andChild Health18

HIV/AIDS

21

TB

22

Malaria23

Other
Infectious
Diseases

24
25

30

Substances
the G8 Experts have produced this report, which outlines the current situation, theprinciples for action, and actions to be taken on health.
・ G8 also recognizes that for progress to be made on maternal, reproductive andchild health, and emerging and neglected health priorities, additional resources-from both domestic and international sources-are needed if the health MDGs are to
be achieved.
・ Polio eradication has urgend funding requirement for the next five years of at least
980 million USD・ measures such as "Treat, Train and Retain (TTR)" of health workers andtask-shifting between health workers should be encouraged.
・ The G8 encourages the WHO work on a voluntary code of practice regarding
international ethical recruitment of health workers.
・ …using maternal health indicators to help track and asses health systems
performance. G8 encourages further collaboration among stakeholders with the aimof standardizing health metrices to collect, analyse and evaluate health data forpolicy planning and evaluation.
・ (G8 Health Experts) recommend… increasing access to SBA bearing in the mind
the target agreed at the ICPD+5 in 1999, 90% of all births should be assisted byskilled attendants by 2015
・ The international community needs to continue to strengthen its efforst in scaling up
towards the goal of (UAby2010), including by meeting our pledges at Heiligendamm
to supprot life-saving ART through bilateral and multilateral efforts for approximately
5 millino people, to prevent 24 million new infections, and to care for 24 million
people, scale up coverage of programs for the PMTCT in Africa.
・ addressing sexual exploitation and gender-based violence remain critical. Support
for sexual and reproductive health should be made available and accessible toadlescents and to other highly vulnerable groups. Barriers of discrimination, stigma
and exclusion... should be eliminated.
・ The G8 supports ongoing work to review travel restrictions for HIV positive people
with a view to facilitating travel and we are commited to follow this issue.
・ The expansion of the Stop TB Strategy..is essential
・ The G8 must also strengthen surveillance and diagnostic systems for
MDR/XDR-TB as well as integrated collaborative approaches to address
co-infection of HIV and TB as recommended by WHO.
・ The G8 should continue to expand access to LLITN…IRS… ACT… IPT. G8 willcontinue to expand access to LLITN with a view to providing 100 million nets…
Continous vigilance and pre-emptive action should be supported to help manageand prevent resistance to ACT...
・ The incidence of polio is at its most geographically focused in history and we havethe opportunity to eradicate the disease if we intensify our efforts. The G8 will meetits previous commitments to maintain or increase financial contributions to support
the Global Polio Eradication Initiative, and encourage other public and private
donors to do the same. The G8 supports a strong commitment by polio-endemic
countries, and will work with them in the efforts to eradicate polio, bearing in mind
the World Health Assembly resolution urging poliomyelitis-affected countries toengage all levels of political and civil society in these efforts.
・ The G8 will work to support the control or elimination of (neglected tropical)
diseases listed by the WHO through such measures as research, diagnostics andtreatment, prevention, awareness-raising and enhancing access to safe water andsanitation. In this regard, by expanding health system coverage, alleviating poverty
and social exclusion as well as promoting adequate integrated public healthapproaches, including through the mass administration of drugs, we will be able toreach at least 75% of the people affected by certain major neglected tropicaldiseases in the most affected countries in Africa, Asia and Latin America, bearing in
mind the WHO Plan. With sustained action for 3-5 years, this would enable a verysignificant reduction of the current burden with the elimination of some of these
diseases.

PART II

G8 PLEDGES FOR GLOBAL HEALTH

3. Pledges in the past G8 Summits(1)G8 Pledges from 80’s to 2004
Year
and
Place
1985
Bonn
(Germany)
1986
Tokyo
(Japan)1987 Venice(Italy)1989
Paris(France)
1996
Lyon(France)

Contents
We shall continue to see to work with developing countries, so as to help them to fight hunger anddisease…
We pledge ourselves afresh to fight against hunger, disease..
Heads of State or Government and the representatives of the European Coummunity affirm that AIDS is
one of the biggest potential health problems in the world.
・ We take note of the creation of an International Ethics Committee on AIDS
・
・
・
・
・
・
・
・
・

1997
（US）

Denver

・
・

・

・
・

1998
Birmingham
(UK)

・
・
・
・

1999 Cologne

・
・
・
・
・

The goals of a new partnership for development should include improved health
The objective of this new partnership includes giving more explicit priority to sustainable
development and alleviation of poverty. This should mean adequate ODA funding of essential
sectors such as health...
(In relation to the new partnership) we emphasize the usefulness of indicators capable ofmeasuring progress toward development objectives in specific countries in areas such as
extremem poverty, infant, child and maternal mortality...
we endorse the creation and implementation mechanisms to aid in the prevention, detection,
surveillance and response to the emergence and re-emergence of communicable diseases.
we reiterate our call for the extension of all forms of cooperation in the realms of research,
prevention, accessible and affordable health care services and diagnostics in the treatment andcontrol of these diseases.
We pledge to support this effort (measures already undertaken in each of our countries toencourage scientific community in its search for remedies to these diseases) at the national level,
while at the same time promoting international cooperation among research teams in this field.
continue to extend various kinds of assisstance programs, in particular for the benefit of thecountries hardest hit by HIV/AIDS and other infectious diseases.
encourage cooperation among those of us who jointly conduct cooperatie projects with Africa, S
Asia, Latin America and the Carribean by transferring our expertise in regard to surveillance,
prevention, research, diagnosis, and treatment of these diseases.
continue to work to ensure that availability of safe and effective treatments for these all-too-often
diseases.
we strongly support the efforts of the WHO and UNAIDS.
we will work with African countries to ensure adequate and well-targeted assistance for thosecountries which have the greatest need and carry out the necessary broad based reforms. This
assisstance will include…environmental protection and human resource development, including
health and education of their people.
in the coming year, our governments will promote more effetive coordination of international
responses to outbreaks; promote development of a global surveillance network, building upon
exisitng nationa and regional surveillance systems; and help to build public health capacity toprevent, detect and control infectious diseases globally including efforts to explore the use ofregional stocks of essential vaccines, therapeutics, diagnostics and other materials.
we support the efforts of the WHO and the recent World Health Assembly resolutions regarding thequality of biological and pharmaceutical products.
we will work to provide the resources necessary to accelerate AIDS vaccine research, andtogether will enhance international scientific cooperation and collaboration.
we will work to assure that it (UNAIDS) has resources adequate to fulfill its mandate.
we will continue of efforts to reduce the global scourage of AIDS through vaccine development,
preventive programmes and appropriate therapy, and by our continued support for UNAIDS.
we welcome the French proposal for the 'Therapeutic Solidarity Initiative' and other proposals forteh preveniton and treatement of AIDS, and request our esperts to examine speedily the feasibilityof their implementation.
we support the new initiative to "Roll Back Malaria" to relieve the suffering experienced byhundreds of millions of people, and significantly reduce the death rate from malaria by 2010.
We reaffirm the need to continue efforts to combat AIDS at the national and international level
through a combined strategy of prevention, vaccine development and appropriate therapy.
We welcome and support the coordinating and catalytic role of the UNAIDS in the fight against
AIDS.
We call on co-sponsors and other partners to cooperate in the formulation of clear goals,
strategies and initiatives at botht eh global and regionel level.
We also pledge to continue our national and international efforts in the fight against infectious andparasitic diseases, such as malaria, polio and TB, and their drug-resistant forms.
we will continue to support the endeavors of the WHO and its initiatives "Roll Back Malaria" and"Stop TB". We call on the governments top adopt these recommended strategies.

78PART II
2000(Japan)G8 PLEDGES FOR GLOBAL HEALTH

Okinawa

2001 Genoa(Italy)We also agree to give special attention to three issues - ...health... as a spur to growth.
z(Commit to) mobilising the instruments and resources of the international community to support andreinforce the efforts of these countries to combat and overcome these challenges（HIV/AIDS Pandemic,
slow growth), with particular priority on promoting equitable distribution of the benefits of growth throughsound social policies, including regarding health and education.
z
we have agreed to: Implement an ambitious plan on infectious diseases, notably HIV/AIDS, malaria andtuberculosis (TB)z
We... commit ourselves to working in strengthened partnership with governments, the WHO and other
IOs, industry (notably pharmaceutical companies), academic institutions, NGOs and other relevant actors
in CS to deliver three critical UN targets: （１） Reduce the number of HIV/AIDS-infected young people by
25% by 2010; （２）Reduce TB deaths and prevalence of the disease by 50% by 2010; （３）Reduce theburden of disease associated with malaria by 50% by 2010.
z
In order to achieve this ambitious agenda our partnership must aim to cover:◎ - Mobilising additional resources ourselves, and calling on the MDBs to expand their own assistanceto the maximum extent possible;◎ - Giving priority to the development of equitable and effective health systems, expanded
immunisation, nutrition and micro-nutrients and the prevention and treatment of infectious
diseases;◎ - Promoting political leadership through enhanced high-level dialogue designed to raise publicawareness in the affected countries;◎ - Committing to support innovative partnerships, including with the NGOs, the private sector andmultilateral organisations;◎ - Working to make existing cost-effective interventions, including key drugs, vaccines, treatments
and preventive measures more universally available and affordable in developing countries;◎ - Addressing the complex issue of access to medicines in developing countries, and assessing
obstacles being faced by developing countries in that regard;◎ - Strengthening co-operation in the area of basic research and development on new drugs, vaccinesand other international public health goods.
z
We note with encouragement new commitments in these areas. We strongly welcome the World Bank's
commitment to triple International Development Association (IDA) financing for HIV/AIDS, malaria, and
TB. We also welcome the announcements to expand assistance in this area made by bilateral donors.
z
We will convene a conference in the autumn this year in Japan to deliver agreement on a new strategy toharness our commitments. We will take stock of progress at the Genoa Summit next year and will also
work with the UN to organise a conference in 2001 focusing on strategies to facilitate access to AIDS
treatment and care.
z
Our partnership will support the key themes of the New African Initiative, including:¾
Human development, by investing in health and education, and tackling HIV/AIDS, TB and malaria,
including through the Global AIDS and Health Fundz
we have launched with the UN Secretary-General a new Global Fund to fight HIV/AIDS, malaria andtuberculosis. We have committed $1.3 billion. The Fund will be a public-private partnership and we call onother countries, the private sector, foundations, and academic institutions to join with their own
contributions - financially, in kind and through shared expertise. We welcome the further commitments
already made amounting to some $500 million.
z
The Fund will promote an integrated approach emphasising prevention in a continuum of treatment andcare. It will operate according to principles of proven scientific and medical effectiveness, rapid resource
transfer, low transaction costs, and light governance with a strong focus on outcomes. We hope that theexistence of the Fund will promote improved co-ordination among donors and provide further incentives
for private sector research and development. It will offer additional financing consistent with existing
programmes, to be integrated into the national health plans of partner countries. The engagement ofdeveloping countries in the purpose and operation of the Fund will be crucial to ensure ownership andcommitment to results. Local partners, including NGOs, and international agencies, will be instrumental in
the successful operation of the Fund.
z
Strong national health systems will continue to play a key role in the delivery of effective prevention,
treatment and care and in improving access to essential health services and commodities without
discrimination…We welcome the steps taken by the pharmaceutical industry to make drugs more
affordable. In the context of the new Global Fund, we will work with the pharmaceutical industry and withaffected countries to facilitate the broadest possible provision of drugs in an affordable and medicallyeffective manner. We welcome ongoing discussion in the WTO on the use of relevant provisions in theTrade-Related Intellectual Property Rights (TRIPs) agreement. We recognise the appropriateness ofaffected countries using the flexibility afforded by that agreement to ensure that drugs are available totheir citizens who need them, particularly those who are unable to afford basic medical care. At the sametime, we reaffirm our commitment to strong and effective intellectual property rights protection as anecessary incentive for research and development of life-saving drugs.

PART II

G8 PLEDGES FOR GLOBAL HEALTH

2002 Kananaskis(Canada)Supporting health research on diseases prevalent in Africa, with a view to narrowing the health research gap,
including by expanding health research networks to focus on African health issues, and by making more
extensive use of researchers based in Africa.
Measures for disadvantaged children should be included in national education plans:
AIDS-affected children: There are now more than 13 million AIDS orphans; this number is projected to reach 35
million by 2010. The unique circumstances of AIDS orphans will require creative-often unique-solutions.
Community groups can play an important role.
We committ to: Helping Africa combat the effects of HIV/AIDS - including by:・ Supporting programmes that help mothers and children infected or affected by HIV/AIDS, includingchildren orphaned by AIDS;・ Supporting the strengthening of training facilities for the recruiting and training of health professionals;
・ Supporting the development, adoption and implementation of gender-sensitive, multi-sectoral HIV/AIDS
programs for prevention, care, and treatment;
・ Supporting high level political engagement to increase awareness and reduce the stigma associated with
HIV/AIDS;・ Supporting initiatives to improve technical capacity, including disease surveillance;・ Supporting efforts to develop strong partnerships with employers in increasing HIV/AIDS awareness andin providing support to victims and their families;
・ Supporting efforts that integrate approaches that address both HIV/AIDS and tuberculosis; and,・ Helping to enhance the capacity of Africa to address the challenges that HIV/AIDS poses to peace andsecurity in Africa.
The impact of HIV/AIDS on the teaching profession and the operations of schools must be acknowledged andaddressed in national educational plans. Technical assistance to help countries address the impacts of
HIV/AIDS on the supply, demand, and quality of education, including the effect on teachers, can make animportant contribution to these strategies.
A country's education system can perform a constructive role in equipping people to address-and ultimately
reverse-the devastating spread of this disease. Teachers can play an important role in reinforcing theimportance of prevention. In these circumstances, the proper training of teachers is essential.
We committ to:
6.2 Supporting African efforts to build sustainable health systems in order to deliver effective disease
interventions - including by:
Pressing ahead with current work with the international pharmaceutical industry, affected African countries andcivil society to promote the availability of an adequate supply of life-saving medicines in an affordable andmedically effective manner;
Supporting African countries in helping to promote more effective, and cost-effective, health interventions to themost vulnerable sectors of society - including reducing maternal and infant mortality and morbidity;
Continuing support for the Global Fund to Fight AIDS, Tuberculosis and Malaria, and working to ensure that theFund continues to increase the effectiveness of its operations and learns from its experience;
Supporting African efforts to increase Africa's access to the Global Fund and helping to enhance Africa's
capacity to participate in and benefit from the Fund;
Providing assistance to strengthen the capacity of the public sector to monitor the quality of health services
offered by both public and private providers; and,Supporting and encouraging the twinning of hospitals and other health organizations between G8 and Africancountries.
z
We committ to:◎ 6.3 Accelerating the elimination and mitigation in Africa of polio, river blindness and other diseases
or health deficiencies - including by:◎◎ Providing, on a fair and equitable basis, sufficient resources to eliminate polio by 2005; and,◎ Supporting relevant public-private partnerships for the immunization of children and the eliminationof micro-nutrient deficiencies in Africa.

910 PART II

2003 Evian(France)

G8 PLEDGES FOR GLOBAL HEALTH・

Global health crises call for close international co-operation on policies and methods. We reaffirm ourcommitment to achieving the development goals set out in the Millennium Summit and at the World
Summit on Sustainable Development. We will work in partnership with developing countries, the private
sector, multilateral organisations and non-governmental organisations (NGOs) to help achieve these
health goals. Multilateral and bilateral Official Development Aid as well as private efforts from companies
and NGOs should match and complement existing efforts to improve health outcomes.

・We welcome the increased bilateral commitments for HIV/AIDS, whilst recognising that significant
additional funds are required. We commit, with recipient countries, to fulfil our shared obligations as
contained in the Declaration of Commitment on HIV/AIDS for the 2001 United Nations General AssemblySpecial Session.

・

We reaffirm our support for the Global Fund to fight AIDS, Tuberculosis, and Malaria.

・We welcome and support the proposal to host, in collaboration with the Global Fund, an international
donors' and supporters' conference bringing together governments, international organisations, NGOs andmembers of the private sector active in this field in Paris this July. The purpose will be to develop
strategies for mobilising resources in order to secure sustainable long term financing for the Fund andother complementary efforts, and to achieve cost effective results-targeted management of the Global
Fund.

・

We call upon those that have not yet done so to consider increasing their support to the Global Fund as
well as to other multilateral and bilateral efforts to combat these infectious diseases.

z

Building on strengthened health systems, in partnership with others, including public-private partnerships,
we will work to develop an integrated approach that will facilitate the availability and take-up of discounted
medicines for the poorest in a manner that is fair, efficient and sustainable. We recognise the complexityof increasing access to medicines in developing countries which, among other factors, depends onaffordable prices. We welcome pharmaceutical companies' voluntary long-term commitments to providing
essential medicines at substantially discounted prices to developing countries and strongly encourage
further efforts, including through supply competition. We will also work with developing countries toencourage greater uptake of such offers of free and discounted drugs, as are now being made. We
support and encourage developing countries to contribute to the goal of affordable medicines by reducing
their tariffs and fees on discounted and donated products.

z

We will take the steps necessary to prevent the diversion of those medicines away from the countries orregions for which they were intended. We call on recipient governments to do the same and we undertaketo provide technical support to assist them to do so. We will not use the preferential prices offered to thedeveloping world as benchmarks for pharmaceutical products on our own markets.

z

To address the practical problems faced by developing countries with no or insufficient manufacturing
capacities, we note that, pending a WTO solution, many of us have instituted moratoria on challenging
any Member of the WTO that, according to the scope and modalities defined in their respective moratoria,
would want to export to a country in need medicines produced under compulsory license for addressing
public health crises, including those relating to HIV/AIDS, tuberculosis and malaria and other epidemics.
We direct our ministers and officials, working urgently with WTO partners, to establish a multilateralsolution in the WTO to address the problems faced by these countries, rebuilding the confidence of allparties, before the Cancun Ministerial.

PART II

G8 PLEDGES FOR GLOBAL HEALTH

2004 Sea Island(US)z

We reaffirm our commitment to combating the global HIV/AIDS pandemic.Both individually andcollectively, we have increased our efforts aimed at HIV treatment, care, and prevention. We
acknowledge the important role of the Global Fund to Fight AIDS, Tuberculosis, and Malaria, UNAIDS,
and WHO in fighting this pandemic. But the human and economic toll of the AIDS pandemic demands
that these activities be complemented by accelerated efforts to develop an HIV vaccine.

z

The best way to meet these challenges is for scientists around the world to work together in acomplementary manner.

z

We believe the time is right for the major scientific and other stakeholders -- both public and private
sector, in developed and developing countries -- to come together in a more organized fashionzz

We endorse this concept and call for the establishment of a Global HIV Vaccine Enterprise.
The Enterprise should establish a strategic plan that would prioritize the scientific challenges to beaddressed, coordinate research and product development efforts, and encourage greater use of
information sharing networks and technologies.

z¾

Encourage the development of a number of coordinated global HIV Vaccine Development
Centers…

z¾

Stimulate the development of increased dedicated HIV vaccine manufacturing capacity…

¾

Establish standardized preclinical and clinical laboratory assessment…

¾

Expand an integrated international clinical trials system…

¾

Optimize interactions among regulatory authorities¾

Encourage greater engagement by scientists from developing countries

We call on all stakeholders in the Global HIV Vaccine Enterprise to complete the development of thisstrategic plan by our next Summit.

z

The United States, in its role as president of the G8, will convene later this year a meeting of all interested
stakeholders in the Enterprise to encourage their collaborative efforts in HIV vaccine development. This
meeting should clarify how the strategic plan is to be implemented. We support this conference becoming
an annual event and we look forward to a report on the follow-up of the Initiative at the next G8 Summit.

zz

We will take all necessary steps to eradicate polio by 2005.
To ensure that polio does not reemerge, we will work to ensure the full integration of necessary measuresin national health strategies and structures in the post-eradication period through 2008.

z

We are pleased that the financing gap for 2004 has now been closed through our efforts and those ofothers. We are determined to close the 2005 financing gap by the 2005 G8 Summit through contributions
from the G8 and other public and private donors.

z

We urge governments that have pledged money for polio eradication to turn their pledges into realcontributions. We will work to ensure that contributions are made in a timely manner so as to enablebudgeting and planning for effective immunization campaigns from now through 2005.

z

We will also remain engaged with the governments of the six polio-endemic countries and the ninecountries in which polio is now spreading to urge them to take stronger steps to contain and destroy thepolio virus. We will also engage other donors and organizations to help support and encourage thesecountries.

z

The G8 welcomes the resolution on polio eradication passed by the Organization of the Islamic
Conference Summit held in Malaysia, from 16-17 October 2003, as another example of partnership in theeffort to eradicate polio.

z

The G8 recognizes the excellent work of the Polio Eradication Initiative and the special contribution madeby Rotary International, through direct financial contributions and the engagement of thousands ofvolunteers throughout the world.。

11

12 PART II

G8 PLEDGES FOR GLOBAL HEALTH（２）The Pledges in Gleneagles G8 Summit, the UKz

HealthGeneralinz

Infectious
Diseaseszzzz

HIV/AIDSz

Malaria

TBzz

Health System
Strengthening
Other
Infectious
Diseaseszz

Financingz

We support our African partners' commitment to ensure that by 2015 all children have access to andcomplete free and compulsory primary education of good quality, and have access to basic health care (freewherever countries choose to provide this) to reduce mortality among those most at risk from dying frompreventable causes, particularly women and children; and so that the spread of HIV, malaria and other killer
diseases is halted and reversed and people have access to safe water and sanitation.
(e) Building on the valuable G8 Global HIV/AIDS vaccine enterprise, increasing direct investment and taking
forward work on market incentives, as a complement to basic research, through such mechanisms as Public
Private Partnerships and Advance Purchase Commitments to encourage the development of vaccines,
microbicides and drugs for AIDS, malaria, tuberculosis and other neglected diseases. We note continuing
work to explore establishing an International Centre for Genetic Engineering & Biotechnology centre in Africa
to help research into vaccines for the diseases that are afflicting the continent.
○We will work to achieve these aims by:(a) Working with African governments, respecting their ownership, to invest more in better education, extra
teachers and new schools. This is made more crucial by the number of teachers dying from AIDS.
○ We will work to achieve these aims by:(d) With the aim of an AIDS-free generation in Africa, significantly reducing HIV infections and working with
WHO, UNAIDS and other international bodies to develop and implement a package for HIV prevention,
treatment and care, with the aim of as close as possible to universal access to treatment for all those whoneed it by 2010. Limited health systems capacity is a major constraint to achieving this and we will work with
our partners in Africa to address this, including supporting the establishment of reliable and accountablesupply chain management and reporting systems. We will also work with them to ensure that all children leftorphaned or vulnerable by AIDS or other pandemics are given proper support. We will work to meet thefinancing needs for HIV/AIDS, including through the replenishment this year of the Global Fund to fight AIDS,TB and Malaria; and actively working with local stakeholders to implement the '3 Ones' principles in all
countries.
Working with African countries to scale up action against malaria to reach 85% of the vulnerable populations
with the key interventions that will save 600,000 children's lives a year by 2015 and reduce the drag on
African economies from this preventable and treatable disease. By contributing to the additional $1.5bn ayear needed annually to help ensure access to anti-malaria insecticide-treated mosquito nets, adequate andsustainable supplies of Combination Therapies including Artemisin, presumptive treatment for pregnant
women and babies, household residual spraying and the capacity in African health services to effectively use
them, we can reduce the burden of malaria as a major killer of children in sub-Saharan Africa.
Helping to meet the needs identified by the Stop TB Partnership. We also support the call for a high-level
conference of Health Ministers for TB in 2006.
Investing in improved health systems in partnership with African governments, by helping Africa train andretain doctors, nurses and community health workers. We will ensure our actions strengthen health systems
at national and local level and across all sectors since this is vital for long-term improvements in overall
health, and we will encourage donors to help build health capacity.
Supporting the Polio Eradication Initiative for the post eradication period in 2006-8 through continuing or
increasing our own contributions toward the $829 million target and mobilising the support of others. We arepleased that the funding gap for 2005 has been met.
The commitments of the G8 and other donors will lead to an increase in official development assistance toAfrica of $25 billion a year by 2010, more than doubling aid to Africa compared to 2004.
On the basis of donor commitments and other relevant factors, the OECD estimates that official development
assistance from the G8 and other donors to all developing countries will now increase by around $50 billion ayear by 2010, compared to 2004.

（３） The Pledges in Sankt Petersburg, RussiazzInfectious
Diseaseszzz

We pledge our continued support to UNAIDS, WHO, GAFTM, WB and other organizations, initiatives andpartnerships actively working to fight these diseases （HIV/AIDS, tuberculosis (TB) and malaria.
We note the possibility of WTO Members to use the flexibilities in the WTO Agreement on Trade-Related
Aspects of Intellectual Property Rights (TRIPS Agreement), as well as the compulsory licensing solution of
30 August, 2003 to enable developing countries without manufacturing capacity in the pharmaceutical sector
to import medicines they need. We note that despite certain achievements, many countries still cannot get
access to safe, effective and affordable medicines for those in need.
We call for a wider use of strategies and tools that promote investment in the research, development andproduction of vaccines, microbicides and drugs for HIV, tuberculosis, malaria and other diseases, and thatassist in scaling up access to these means of prevention and treatment through innovative clinical research
programs, private-public partnerships and other innovative mechanisms. In this regard, we take note of thesteps taken on voluntary innovating financing mechanisms and other funding initiatives, the details of which
are set out in the annex.
we are committed to strengthening cooperation with regulatory authorities in developing countries and to
working with them on identifying appropriate standards and pathways for swift regulatory approval of new
prevention and treatment methods
We call for wider recognition of the rapidly increasing problem of antimicrobial drug resistance. We

PART II

G8 PLEDGES FOR GLOBAL HEALTH
z

z

z

z

HIV/AIDSzz

Malaria

z

TB
z
z
z

Health System
Strengtheningzz

Global Fund

encourage increased mobilization of efforts to address this problem of global dimensions.
We encourage governments around the world to consider eliminating import tariffs and non-tariff barriers on
medicines and medical devices, where appropriate, as a measure to reduce further the cost of healthcare forthe poor, and expand their access to effective treatments.
Combating this disease（HIV/AIDS) will continue to be one of our top priorities. We remain committed tohalting and reversing the spread of HIV/AIDS, as called for in the MDGs, and to the objectives outlined in the
Gleneagles Summit Communiqué, and the call in the UNGASS on HIV/AIDS of June 2006 for scaling up
significantly towards the goal of UA to comprehensive prevention programs, treatment, care and support by2010.
We welcome the focus by the Africa Partnership Forum on HIV/AIDS this year, the first Conference on
HIV/AIDS in Eastern Europe and Central Asia in May 2006 in Moscow and the XVI International AIDS
Conference in Toronto in August 2006, where the world community will address the theme 'Time to Deliver.'In our response to HIV/AIDS, we will adhere to the following principles:◎ （１）further promotion of a comprehensive and well-balanced approach to tackling HIV/AIDS, which
includes prevention, treatment and care;◎ (2) continued involvement of all relevant partners, including CS, the private sector and people living with
HIV/AIDS, in the activities to tackle the HIV/AIDS pandemic and to reduce stigma and discrimination
against people with this disease;◎ (3) scale up support to address the rising rates of HIV infection among young people, particularly young
girls and women;◎ (4) supporting the continued implementation of comprehensive, evidence-based strategies of
prevention, and the development of new and innovative methods of prevention, such as microbicides,
and vaccines against the diseases that increase the risk of HIV transmission;◎ (5) facilitating access to prevention, treatment and care for the most vulnerable segments of the
population;◎ (6)building the capacity of health care systems in poor countries through recruitment, training anddeployment of public and private health workers; and raising public awareness of the existing threat in
all countries affected.
We remain committed to our Sea Island Summit initiative on creation of a Global HIV Vaccine Enterprise, andreaffirm our determination to bring it to fruition. We welcome the Russian proposal to establish a regional
coordination mechanism to promote HIV vaccine development in the countries of Eastern Europe andCentral Asia, and call for this initiative to be carefully coordinated with the Global HIV Vaccine Enterprise. We
also welcome coordination of activities and the cooperation between the Global HIV Vaccine Enterprise andother global initiatives and North/South partnerships active in this field, such as the European andDeveloping countries Clinical Trials Partnership (EDCTP) on clinical trials in Africa.
To address this urgent situation (malaria), we:◎ (1) reaffirm our commitment to work with African countries to scale up malaria control interventions,
reduce the burden of the disease, and eventually defeat malaria on the continent and meet the Abuja
target of halving the burden of malaria by 2010
◎ agree to strengthen malaria control activities and programs in African countries with the objective ofachieving significant public health impact;◎ (2)will collaborate with governments, private sector companies and NGOs in public-private partnerships
to expand malaria interventions and programs;◎ (3) support the development of new, safe, and effective drugs, creation of a vaccine, and promotion of
the widest possible availability of prevention and treatment to people in need;◎ (4)welcome efforts in the framework of the "Roll Back Malaria Partnership" and support activities ofpublic and private entities to save children from the disease◎ (5) we commit ourselves to a regular review of our work in the field of tackling these three pandemics.
We reaffirm the commitment we made at the Genoa Summit in 2001 to halt the spread of this disease (TB).
We will also support the Global Plan to Stop TB, 2006-2015, which aims to cut TB deaths in half by the year
2015 compared to 1990 levels, saving some 14 million lives over ten years, and call upon all donors andstakeholders to contribute to its effective implementation.
We note with concern the rate of HIV/AIDS and tuberculosis co-infection and seek to promote unified
coordination for activities in this regard.
We reaffirm our partnership with African nations and with the AU, and will continue to work with them todeliver on the goals of the NEPAD, to improve health systems overall and to fight infectious diseases.
The limited capacity of health systems is a major barrier to coming as close as possible to universal accessto treatment for those who need it by 2010 and has an impact on other related health outcomes such as
maternal mortality and mother-to-child transmission of HIV/AIDS, hindering comprehensive, effective,
evidence-based prevention, and providing care. In this regard, we agree to continue to support efforts bydeveloping country partners, particularly in Africa, to ensure that initiatives to reduce the burden of disease
are built on sustainable health systems. We will also continue to emphasize the training, deployment andretention of health workers in our health sector assistance programs. In this regard, we take note of thecreation of the Global Health Workforce Alliance, and encourage further work by the WHO and other donororganizations in this area.
We encourage stepped-up discussion at the international level on practical approaches to the expansion of
public, private and community-based health insurance coverage in developing countries.. We invite theOECD and appropriate organizations to work on this issue. We welcome France's offer to host a high levelmeeting on this issue by the end of 2006.
○The Global Fund is an important instrument in the battle against HIV/AIDS. We will work with other donors
and stakeholders in the effort to secure funds needed for the 2006-2007 replenishment period and call upon
all concerned to participate actively in the development of a four-year strategy, aimed at building a solid

1314 PART II

G8 PLEDGES FOR GLOBAL HEALTH
z
z

z

z

Other
Infectious
Diseases

z

z

z

z

Othersfoundation for the activities of the Fund in the years ahead.
The G8 members will work with governments and technical agencies to support the preparation of highquality, timely proposals for Global Fund AIDS, Tuberculosis and Malaria grants.
we support immediate implementation of the provisions of the revised International Health Regulations
considered relevant to the risk posed by avian and pandemic influenza. We will comply with the provisions,
including those related to rapid and transparent notification, and to provision of essential information…
We urgently call for mobilization of financial support and will continue to work collectively and with bilateraland multilateral donors to close the funding gap for 2007-2008, and will continue to work with others towards
securing the resources necessary to finish the program and declare our planet polio-free in the near future.
We will work with other donors and stakeholders to maintain this network（existing polio monitoring network)
after polio has been eradicated, with a view to supporting other public health objectives, in particular thoserelated to disease monitoring.
We will continue our support for the Measles Initiative launched in 2001 and will work towards a steadydecrease in the number of measles-related deaths, progress in halting the spread of measles in regions andcountries, and its eventual elimination.
We will assist the Global Measles Partnership and encourage the WHO to continue to implement its plans on
measles prevention and elimination, as mandated by the World Health Assembly in 2004, and to propose
measures donors and national governments should take to reach and maintain a high level of immunity tomeasles.
We must also increase our efforts in the fight against other preventable diseases, including pneumonia,
diarrhea and neglected diseases such as leishmaniasis, Chagas disease and onchocerciasis, particularly byincreasing the volume and quality of medical research on neglected diseases in developing countries.
We focused on the issue of disaster risk reduction at Gleneagles and outlined the need for a series ofpractical measures, in particular through strengthened early-warning systems, as well as improved
coordination and prompt humanitarian relief efforts….

PART III

HIV/AIDS AND GLOBAL HEALTH: THE G8 GUIDEBOOK 果（４） Pledges in Heiligendamm G8 Summit (Germany)z

HealthGeneralinzz

Infectious
Diseases

z

z
z
z
z

z

HIV/AIDSzz

The G8 countries will scale up their efforts to contributing towards the goal of UA to comprehensive HIV/AIDS
prevention programs, treatment and care and support by 2010 for all, and to developing and strengthening
health systems so that health care, especially primary health care, can be provided on a sustainable andequitable basis...with particular attention paid to the needs of those most vulnerable to infection, including
adolescent girls, women and children.
Recognize that meeting this goal of UA as well as realizing the MDG for fighting HIV/AIDS, malaria andtuberculosis on a sustainable basis and strengthening of health systems will require substantial resources.
We will support responding to those African countries that indicate that they require technical assistance andcapacity building programmes for advancing their access to affordable, safe, effective and high quality
generic and innovative medicines in a manner consistent with the WTO.
The G8 reiterate their support for the work of WHO including its prequalification program and for regulatory
authorities to help assure the safety, efficacy, and quality of pharmaceutical drugs, including those produced
locally, in particular for second-line antiretroviral treatment and for the newly developed more effective
treatment for malaria
The G8 will support the nationwide inclusion of appropriate HIV/AIDS-related information... in school
curricula...as well as prevention information with regard to malaria and other relevant health topics.
The G8 will emphasize the importance of programs to promote and protect human rights of women and girls
as well as the prevention of sexual violence and coercion especially in the context of preventing HIV/AIDS
infections.
The G8 will take concrete steps to work toward improving the link between HIV/AIDS activities and SRH andvoluntary Family Planning programs, to improve access to health care, including PMTCT, and to achieve the
MDG by adopting a multisectoral approach and by fostering community involvement and participation
we will contribute substantially with other donors to work towards the goal of providing universal coverage of
PMTCT programs by 2010. The cost to reach this target, as estimated by UNICEF, is US$ 1,5 billion. The G8
together with other donors will work towards meeting the needed resources for paediatric treatments in thecontext of UA, at a cost of US$ 1,8 billion till 2010, estimated by UNICEF. We will also scale up efforts to
reduce the gaps, in the area of maternal and child health care and voluntary VFP, an estimated US$ 1,5
billion.
The G8 reaffirm their commitment to scaling up towards "UA" to comprehensive HIV prevention, treatment
and care by 2010 and recognise the significant progress made by countries on target setting and planning,notably concerning enhanced availability of affordable antiretroviral treatment. Today one of the core
challenges is for countries in Africa to continue to improve health systems in a comprehensive manner. We
will therefore work with UNAIDS, WHO, WB and the GF to strengthen their efforts and work together with the
African Union and African States, the innovative and generic pharmaceutical industry, private donors, civilsociety and other relevant stakeholders to help deliver next steps towards "universal access". Costed
sustainable and evidence-based national AIDS plans will be key to delivering this goal. In particular we will
work with:◎ African Governmentsto strengthen and finance health systems and make them more efficient with constructive
support of donors and the relevant international organizations such as WHO and World Bank,
to contribute to the provision of affordable and quality medicines by eliminating or substantiallyreducing import tariffs and taxes with the aim to exempt price-reduced or subsidised medicinesfrom these levies as soon as possible and examining logistics and governance issues that mayhinder access,
to strengthen procurement practices, ensuring accountability and transparency and to review thecurrently existing drug and device registration policies with the aim of facilitating timely access tosafe, affordable and effective HIV/AIDS drugs and medical devices,
to develop country-led policies that can ensure effective coordination of donor health programs
and identify technical assistance needs, with the support of the WHO, World Bank, UNAIDS,GFATM and other agencies.
◎ International Organizations and donors
to support country-led efforts to improve coordination between all relevant stakeholders todevelop costed, inclusive, sustainable, credible and evidence-based national AIDS plans which
ensure effective links to health system strengthening,
to intensify their efforts to assist countries in setting up a workable forecasting system forpharmaceutical demand,
to respond constructively to requests by African developing countries without manufacturing
capacities with regard to the use of the flexibilities referenced in the WTO Doha declaration on
TRIPS and Public Health, while respecting WTO obligations,
to continue to support investments in research and development of new medicines, microbicides
and vaccines, including by promoting policies that encourage innovation.
◎ The Pharmaceutical Industry

to continue to explore further initiatives to provide enhanced access to HIV medicines ataffordable prices and to review price policies with regard to second-line antiretroviral drugs.
to consider supporting local production of HIV/AIDS pharmaceuticals by voluntary licences andlaboratory capacities that meet international standards and strengthen regulatory, certificationand training institutes.
to build on their expressed commitment to increase investment in research and development of
new medicines, microbicides and vaccines also by extending public-private partnership.
We welcome the decisions of the UN General Assembly to give UNAIDS the mandate to report and monitor
progress towards the goal of universal access and to assist country-processes by providing a regularassessment of the status of countries' integrated plans and their financing as part of the annual monitoring of
the epidemic. We encourage African parliamentarians and civil societies to promote transparency andaccountability with regard to those steps and support their implementation.
As an important step to scaling up towards the goal of UA to HIV/AIDS prevention, treatment, care andsupport in Africa, G8 members, in support of national HIV/AIDS programs globally, individually andcollectively over the next few years will aim to employ existing and additional programs to support life-saving

15

16 PART II

G8 PLEDGES FOR GLOBAL HEALTH

z

z
z
z

Malaria

z

z

TB
z

Maternal
Newborn andChild HealthReproductive
Healthzz

Health System
Strengthening

z

z

z
z

Global Fund

Other
Infectious
Diseaseszzz

financesanti-retroviral treatment through bilateral and multilateral efforts for approximately five million people, toprevent twenty-four million new infections, and to care for twenty-four million people, including ten million
orphans and vulnerable children.
In view of the G8 countries contributions to achieving the health related international goals we agreed in St.
Petersburg to review the progress in this regard, including our financial commitments, in fighting the threediseases HIV/AIDS, tuberculosis and malaria, regularly. We will undertake this monitoring exercise for the
first time this year under the Presidency's guidance. The report will inform our activities and commitments
and we affirm that we will continue this close monitoring process regularly.
The G8 welcome innovative financing initiatives
we will work with African governments and donors to strengthen the effectiveness of their malaria control
programs in Africa along the three main intervention lines of artemisinin combination therapy, effective casemanagement, effective, tailored vector control strategies and bednets.
We recognize the significant role and contribution of the Global Fund and other bilateral, multilateral andprivate partners of the international community, such as the World Bank Malaria Booster Program and the
U.S. President's Malaria Initiative, which provide substantive funding towards reaching this goal.
G8 members, in support of national malaria control programs, using existing and additional funds, will
individually and collectively over the next few years work to enable the 30 highest malaria prevalencecountries in Africa reach at least 85 percent coverage of the most vulnerable groups with effective prevention
and treatment measures and achieve a 50 percent reduction in malaria related deaths.To accelerate
implementation of the financial commitments we have undertaken at Gleneagles, we will work to reach thisgoal by mobilizing the private sector and its expertise and resources, enhancing public awareness,encouraging public-private partnerships, and urging non-G8 countries to do the same.
We are committed to working toward further integration of efforts against TB and HIV/AIDS and theintegration of DOTS-treatment and other comprehensive approaches necessary to control TB in our
programs and activities in order to alleviate the burden of the co-pandemic○In the overall context of scaling up towards the goal of universal access and strengthening of healthsystems we will contribute substantially with other donors to work towards the goal of providing universal
coverage of PMTCT programs by 2010. The cost to reach this target, as estimated by UNICEF, is US$ 1,5
billion. The G8 together with other donors will work towards meeting the needed resources for paediatrictreatments in the context of universal access, at a cost of US$ 1,8 billion till 2010, estimated by UNICEF. We
will also scale up efforts to reduce the gaps, in the area of maternal and child health care and voluntary familyplanning, an estimated US$ 1,5 billion.
The G8 will take concrete steps to support education programs especially for girls, to promote knowledge
about sexuality and RH and the prevention of STI.
We welcome previous commitments by African countries to increase the share of their budgets devoted tothe health sector and look forward to continued progress in meeting these targets, and appeal to bilateral
donors, to multilateral development banks (World Bank and the African Development Bank), the WHO andthe global initiatives in the health sector to assist and align on country led processes in line with theagreements of the Paris Declaration of March 2005 and to provide targeted support to African health systemdevelopment. In this context, the G8 will enhance coordination of bilateral and multilateral healthpartnerships with national health strategies (Scaling Up for Better Health process) and appeal to the WorldBank and the WHO to support country driven harmonization processes in the health sector in cooperation
with the African Development Bank and the African Union as well as other relevant internationalorganizations.
Based on the St. Petersburg declaration and noting the Paris conference in March 2007, the G8 support theestablishment by African countries of sustainable financing of health systems. Enhancing this process, theG8 welcome the "Providing for Health" initiative as a means to work toward sustainable and equitablefinancing of health systems and improved access to quality health services, through linking national financing
strategies with coordinated international support.
We will work with African states to address the different causes of this lack of human resource capacity within
the health sector, including working conditions and salaries with the aim of recruiting, training and retaining
additional health workers. We will also work with national governments as they endeavor to create anenvironment where its most capable citizens, including medical doctors and other healthcare workers, see along-term future in their own countries. We will work with the Global Health Workforce Alliance, interested
private parties, the OECD and the WHO to build the evidence base on health workforce management andinternational migration.
G8 members pledge to work with other donors to replenish the GFATM and to provide long-term predictable
funding based on ambitious, but realistic demand-driven targets
G8 partners will work with other stakeholders so that GFATM resources continue to be used in alignment withexisting national priorities and processes
G8 in cooperation with partner governments support a gender-sensitive response by the GFATM, with thegoal of ensuring that greater attention and appropriate resources are allocated by the Fund to HIV/AIDS
prevention, treatment, and care that addresses the needs of women and girls.
will make utmost efforts in cooperation with IO and partners to eradicate polio and will also work with others
to close urgent funding shortfalls.
The G8 will continue our efforts towards these goals (UA, MDG for fighting HIV/AIDS, TB and Malaria on asustainable basis and strengthening healht systems) to provide at least a projected US$ 60 billion over the
coming years, and invite other donors to contribute as...

PART III

17

HIV/AIDS AND GLOBAL HEALTH: THE G8 GUIDEBOOK 果PART III:
HIV/AIDS AND GLOBAL HEALTH：THE G8 GUIDEBOOK

the G8 countries and imposed on the rest of the world,
while strengthening and improving positive aspects of
their policies.
tremendous

The cost and

for

civil

societies

workload has been
that

are

seriously

confronting this year-long G8 process. Advocacy towards
the G8 has usually been led by civil society of the G8 host-------------------

country, and cooperate and coordinates with civil society

1. The G8 Processfrom other G8 countries as well developing countries. On
poverty anddevelopmental issues, GCAP (Global

In 1975, the first group of the world's six major

Coalition for Action against Poverty) was responsible forindustrialized countries met in Rambouillet, France. 33

much of the coordination of activities with civil society

years later, the G8 grew from a meeting of majorfrom developing and G8 countries. However, information

developed countries to regulate economic policies, to aon the experiences and activities of civil society working

year long process filled with series of meetings so thaton global health issue for the G8 is yet to be accumulated.

these eight countries that dub themselves a major country
can determine policy directions for global issues that

This guidebook is an accumulation of the experience andaffect the rest of the world.

information on the global health policy making process of
the G8, predominantly using the experiences of the 2008

Civil Society and the G8: Shifting Approaches

G8 Summit in Toya-ko, Japan. The purpose of the guidebook is to leave an institutional memory to be used by

Traditionally, civil society's approach to the G8 has been

future civil society groups of G8 host countries. The

to simply oppose the G8, and if possible to stop the G8

guidebook is divided into the following sections, with eachfrom being held. Although remaining highly critical of thesection including the description of the experiences ofmonopolistic policies determined by an exclusive group ofJapanese civil society and the lessons learned from theireight countries, civil society, beginning with the 2005

experiences:

Gleneagles G8 Summit, changed their approach on theG8. Taking advantage of their economic scale and global(1)

The General Flow of the G8 Process

influence of their policies, civil society took the approach(2)

Creation of Civil Society Networks for the G8

have to address and tackle global issues such as poverty(3)

Global Health as an Agenda Itemand climate change.

(4)

Media and Civil Society(5)

Engagement in the Meetings of the G8 Process(6)

Civil Society and the G8 Summit

Processof calling on them to use this money and influence they

Civil Society of G8 countries carry the responsibility oflessening the harmful effects of bad policies created by

G8 Civil Society Peace Walk, July 5, 2008

18 PART III

HIV/AIDS AND GLOBAL HEALTH: THE G8 GUIDEBOOK果-------------------of leaders of member countries of NEPAD ( New

2. The General Flow of the G8 Process

Partnership for African Development), the chair of theAfrican Union, additional institutions, OECD and the
APRs (Africa Personal Representative). This meeting(1) The G8 Process Setup

is held twice a year: once before and once after the
G8 Summit.

The presidency of the G8 rotates annually among themember countries, with each new term beginning on

・G8 Outreach Sessions: A meeting held twice during

January 1 of the new calendar year and ending on

the actual summit. There are two types of outreach

December 31. The time from January 1 to the actual G8

sessions:

summit is the preparation process, where the country¾

Outreach Session: A meeting which includes

holding the presidency holds a series of meetings. The

theleader

of

the

five

major

emerging

time following the summit is the transition and adjustment

economies (China, India, Brazil, Mexico andperiod with the chair of the next summit. The discussion

South Africa). Sometimes the session includes
other major developing countries.

held during this period will feed into the next G8 summit
process.

¾

Africa Outreach Session: A meeting which
includes the five NEPAD countries (Egypt,
Algeria, Senegal, Nigeria and South Africa) as(2) Meetings in the G8 Process

well as the chair of the African Union.
The meetings that make up the G8 Process can be

Sometimes the session includes a few otherdivided into the following:

major African countries.

i.

Meetings exclusive to government officials of G8ii.

Meetings held with additional countries, institutions

countriesiii) Meetings held with Civil Society

and foundations

・

Civil G8 Dialogue: A dialogue held between G8
Sherpas and civil society members representing

iii. Meetings held with civil society

different issues and different parts of the world. Thisi) Meetings exclusive to government officials of G8

meeting first began during the 2006 G8 Summit

Countries:

process in St. Petersburg and continued in theGermany and Japan's G8 Summit processes.

・

Meetings of the Sherpas: Meetings held by the G8

・

・

・

Session between International NGO's and the Chairof the G8: The chair of the G8 host country met with

Sherpas in preparation for the summit.
fora few number of International NGOs working in global

various sectors, held a meeting in preparation for theissues such as poverty and climate change to havesummit. The ministerial meetings that were held arepolicy dialouge. First held in the 2006 St. Petersburg

as follows: Foreign Minister, Science and Technology,

G8 process by Russian President Vladimir Putin in

Finance,which he had a discussion with numerous civil society

Ministerial

Meetings:

Justice

Ministers

and

Home

responsible

Affairs,

Energy,Environment, Labor and Development.

organizations for over three hours. This type of

G8 Summit: Besides the Outreach Sessions withmeeting continued in Germany and Japan, althoughnon-G8 countries (Africa and emerging countries),

the chair of the G8 met with a much smaller number

the G8 Summit is exclusive to the leaders of G8

of NGOs and held in a more discrete manner.

countries.
These meetings, which are a part of the G8 process, areii)

Meetings

held

with

additionalcountries,

institutions and foundations:

held continuously from January to the actual summit. An
aggregate of all the schedules of the meetings held inJapan is attached to this guidebook. Civil Society・World Economic Forum (Davos Conference): Top

strategically approached each of the meetings as part ofbusiness and national political leaders of the world

their strategy for the G8 process at large.

gather annually to have dialogue on major global
issues. The chair of the G8 host Country traditionallyparticipates and makes a speech.
・Africa partnership Forum: An initiative launched in
2002 Kananaskis G8 Summit, is a meeting consistingPART III

19

HIV/AIDS AND GLOBAL HEALTH: THE G8 GUIDEBOOK

A list of the G8 Process Events: 2008 G8 Summit in Japan

G8 Hokkaido-Toyako Summit 2008: Key Events
IssuesCalendar

G8 Process

October

2007
November

DecemberJanuary

The end of month/
1st/ Japan's G8
Africa Partnership
Unofficial G8
Presidency start
Forum in Algeria
Sherpa meeting

February

March

G7 Finance
Ministers mtg

2008
April
May
5th-6th: G8
G8 Sherpa mtg,
Development
11th-13th: G8
Ministers Meeting Labour Minister
meeting (Niigata)(Tokyo)June

23-25th: G8
Sherpa Meeting
23th-27th: World
Economic Forum,
Japan will
announce G8Agenda (Davos)

14th-16th: G20
mtg no Climate
Change andSustainable
Development

G8 Civil Society
Process

TICAD Process
Poverty, Development

Official Processes
and Events

14-15th; 1st G8
26th: PM Fukuda's Health Experts
Speech on Global Meeting (Tokyo,
G8, H8, Norway
Issues in Davosand AU)
16th, Global
Health Summit,Japan
UNAIDS figures
17th: Global
announced, 20thHealth Experts
21st G8 civil
Workshop withsociety meeting in
Civil Society
Global Health
Komura will
Japan announces
Summit, Japanannounce Global
budget for FY2008
health Issue(16th)In Japan

Otherdevelopmentrelated

ASEAN+3, 21th:
East Asia Summit(Singapore),
UNDP Human
Development
Report

AU-EU Summit
AU General(Lisbon), EFA
High Level Group Assembly
Meeting (Senegal)

25th-27th: G8
26th-27th: G8
Environment
Foreign Ministers
Ministers Meeting
Meeting (Kyoto)(Kobe)

7th: Civil Society
Session, Africa
PartnershipForum

mid-June: Civil
Society Meetingwith Japanese
Sherpa23-24th: Civil G8
Dialoguemid-June: Int'l
NGO Meeting withJapanese PM(Chair of G8)

20-21st: TICAD
Preparatory
Ministerial
Meeting in
Libreville, Gabon

30th-31th: TICAD 21-22th, TICAD
Regional Meeting Regional Meetingin Tunisia
in Zambia

28th-30th: TICAD
Ⅳ(Yokohama)

9-10th: 2nd G8
Health Experts
Meeting (G8+some H8 Orgs)

25th: FM
Koumura's
Speech on Health
Process on Global
Health7-8th: Africa
Partnership
Forum (Tokyo)

World Health
Assembly(Geneva)

10-11th: UNGASSHLM on HIV/AIDS

23-24th: Friendsof the GF
Symposium (PM11-12th: 3rd G8
Health Experts
Meeting

Japanese Dietapproves budget
FY200814th-16th: G20
mtg no Climate
Change andSustainable
Development

22-23rd: FTI
Meeting in Japan

4th: OECD DAC
Aid figuresannounced

July

13th-14th: G7
7th-9th: G8
Finance Ministers Hokkaido-Toyako
Meeting (Osaka) Summit

Late-June: AU
Summit20 PART III

HIV/AIDS AND GLOBAL HEALTH: THE G8 GUIDEBOOK果

the Rules of Operation clearly stated the Forum's
rejection to any activities that will be violent or
unlawful. This ensured that the activities of theorganizations within the Forum will abide to the law
and will not use violent and unlawful tactics.

-------------------

3. CREATION OF CIVIL SOCIETY NETWORKSIN HOST G8 COUNTRY FOR THE G8PROCESS(1) Overview
Carrying out effective advocacy and mass mobilization
campaigns for the G8 process requires civil society toembody a common framework and create awell-coordinated coalition. Furthermore, the coalition mustsuit the history, culture and have an understanding of theconditions of the host county's civil society, and haveenough flexibility to adjust to changes.
Traditionally, within a country, there are civil society
networks on the basis of common issue (environment,
MDGs, national issues), region (proximity to capital,
region), type (advocacy, project), policies, ideologies etc.
It is desirable when several of these networks cometogether and create a framework that will allow them towork as one. If it is difficult for the networks to cometogether to form one common framework, it is desirable
for the different networks to create a mechanism forcoordination.

b) On Cooperation and coordination with othernetworks・・Besides the Forum, the G8 Action Network was set
up, consisting of NGOs or social movement
organizations that questioned the existence of the G8
and/or opposed the G8. Although the Forum did nothave any official relations with this network, on
activities such as the peace walk that took place
before the G8 Summit, they coordinated with eachother and concieved a joint civil society statement in
the case of a clamp down from security and police
forces.
In Hokkaido, which was the venue of the 2008 G8
Summit, the G8 Summit Hokkaido Civil Society
Forum was launched. The 2008 G8 Summit NGO
Forum worked in cooperation with the Hokkaido
Forum, and co-hosted the People's Summit 2008 in
Hokkaido during the G8 Summit(2) Experience from the 2008 G8 Processc) On the organizational structure of the Foruma) On the Making of the 2008 G8 Summit NGO Forum・

Towards the end of 2006, under the call of JANIC(Japan NGO Center for International Cooperation), aJapanese networking NGO working on development
and international cooperation, several preparatory
meetings were held to create the foundations for thisforum. On January 2007, the 2008 G8 Summit NGO
Forum was officially launched with the involvement ofmany NGOs. From the early stages, the Forum had aframework that not only included NGOs involved indevelopment and poverty in developing countries, but
those involved in climate change and otherenvironmental issues and peace and human rights.
・ The primary task of the Forum was to produce policy
recommendations, irrelevant of if one is for or against
the existence of the G8.
・ The Forum produced a 2008 G8 Summit NGO Forum
Prospects(See
http://www.g8ngoforum.org/forum/wp-content/upload
s/2007/09/ngo_forum_prospectus.pdf ) and Rules ofOperation(See
http://www.g8ngoforum.org/forum/uploads/ngo-forum-rules-of-operation.pdf ), and NGOs in agreementwith these two documents became part of the Forum.
The Prospects emphasized adherence to the law and・・

The Forum was divided into three issue-based units("Environment", "Poverty and Development" and"Peace and Human Rights") that worked together
while simultaneously working on advocacy and therelease of statements within each unit. Furthermore,decisions on issues that encompassed all units were
led by the Board of Trustees which consisited of theleader and sub-leader of each unit, the chair, the vicechairs and the campaign leader.
The Poverty and Development Unit consisted of fiveissue-based working groups and a unit policy teamcalled the Poverty and Development Policy
Committee. The working groups that dealt with global
health issues was called the Global HealthCommittee.

(3) Evaluation
・・

The Forum, which was conceived well over half ayear before the 2008 G8 Summit hosted in Japan,
has created the foundations for civil society
engagement in the shaping of policies, and thesmooth succession into advocacy that followed, left apositive impact of civil society.
Furthermore, we should take into account that NGOs
working in poverty and development issues andPART III

HIV/AIDS AND GLOBAL HEALTH: THE G8 GUIDEBOOKNGOs working on environmental issues worked
under a common framework of the 2008 G8 Summit
Forum. Together, they created a structure in which
they could hold both formal and non-formal
discussions. NGOs working in poverty anddevelopment have taken part in building thefoundations, and on an equivalent base, coordinatedin the summit processes. Such examples incudes the
Civil G8 Dialogues, a process which was originally
led by NGOs working on environmental issues.

4. GLOBAL HEALTH AS AN AGENDA ITEM
(1) Overview
Since the Kyushu-Okinawa G8 Summit in 2000, infectious
diseases had become one of the major agenda items
within global issues of the G8. Every year, some kind of
discussion on this topic takes place, followed by a newcommitment.
On HIV/AIDS, at the 2005 Gleneagles G8 Summit and the2006 St. Petersburg G8 Summit, the G8 countries
committed to the attainment of Universal Access to
HIV/AIDS treatment, care and prevention by 2010.
Not until the 2007 Heiligendamm G8 Summit, had Health
System Strengthening become a major topic within the
global health agenda of the G8. Meanwhile, adequate andnecessary focus and commitment on the improvement ofmaternal health was lacking due to the particular positionof the U.S. Republican Administration. The same could besaid with the lack of discussion and commitments on the
reduction of child mortality rate.
NGOs working on global health issues needs to work toensure that Millennium Development Goals that are off
track of being met, will become a major topic within the
global health agenda every year of the G8. This requires
more then NGOs calling upon the government for theattainment of the goals, but to work with various formal
and informal sectors that can cooperate with NGOs sothat the decision of the Governements to make global
health as an major agenda item will become a reality.
As NGOs working on HIV/AIDS and other infectious
diseases, it is necessary to urge the G8 governments to
not only work on the policy-making process for maternal,
newborn and child health (MNCH) and health systemstrengthening (HSS), but also work to ensure theimplementation of the pledges and programs of infectious
diseases and HIV/AIDS, which already has a policy andframework.
(2) Experience from the 2008 G8 Processi.

The Global Health Committee of the 2008 G8 Summit
Forum called on the Ministry of Foreign Affairs toensure that global health is one of the main agenda
items of the G8.

ii.

A year before Japan took its turn as the G8 chair, civilsociety of the G8 country had began some contact
with private foundations and bilateral aid agencies
interested in bringing focus to global health issues.
The Global Health Committee took advantage ofthese contact opportunities to create a network, sothat these various sectors could work as one to push
the Japanese Government to place global health as
one of the major agenda items of the G8.

iii. Outside the Forum, a large movement that took place
to ensure global health as one of the major agenda
items was the “Challenges in Global Health andJapan's Contributions: Research and Dialogue
Project” and its working group (also known as the
Takemi
Working
Group:
see
http://www.jcie.or.jp/thinknet/takemi_project/index.ht
ml ) led by Keizo Takemi, former Senior Vice Ministerof Health, Labour and Welfare and former, as well as
Senior Vice Minister of Foreign Affairs. Funding wasprovided by the Gates Foundation and Japan Center
for International Exchange served as the secretariat.
They helped create an opportunity for advocacy to
top-level officials, such as the Prime Minister and the
Cabinet. The participation of NGO members in thisworking group was a breakthough because it has
made it possible for advocacy to the top level officials
to include the assertions of NGOs.
iv. Such movements paved the way to Foreign Minister
Masahiko Koumura to state on November 2007, in apolicy speech on global health, "to develop a set ofcommon framework for action [on global health]shared by the international community".This speech
set global health as one of targets for the Toya-ko
Summit.
(See:
www.mofa.go.jp/policy/health_c/address0711.html)(3) Evaluation
The above processes helped push global health into
becoming one of the central issues within the broader
development agenda. For NGOs working on global health,this has created a tremendous opportunity.
However, many issues exist within the global health, suchas maternal and child health, Health System
Strengthening and infectious diseases. Throughout
2007-2008, there were much heated debates on which ofthese issues to emphasize within the area of global healthpolicies.

21

22 PART III

HIV/AIDS AND GLOBAL HEALTH: THE G8 GUIDEBOOK

Furthermore, Japan has traditionally favored a horizontal
approach or an overall approach such as those centeredaround Health System Strengthening, than a vertical or astraightforward approach, which focused specifically on
certain diseases. Japan has arrived at their global healthpolicy by emphasizing on this overall approach.

果

The media of the G8 contries holds a large influence on
the policy direction of the G8 countries, thus it is importantfor civil society of G8 countries, to strengthen theircooperation with the media.
(2) Experience from the 2008 G8 Summit Process

At this stage, there had been disappearing momentum on
tackling HIV/AIDS and other infectious diseases within thecontext of policy discussions for the G8. Although policy
frameworks and commitments were already in place for
infectious diseases, there were questions to whether theywould keep those commitments. The Global HealthCommittee worked to balance the NGOs focusing on
certain issues as Health System Strengthening, maternaland child health, and infectious diseases and called for ascale up in the global health sector as a whole.
Furthermore, the Takemi Working Group also took asimilar position as NGO’s. Thus, infectious diseases
including HIV/AIDS were ranked high on the agenda of
the G8.

5. MEDIA AND CIVIL SOCIETY(1) Overview
Within the strategy for G8 advocacy, cooperation with themedia should be taken as one of the priority activities. The
government, bureaucrats and members of the Diet are
directly linked to policy decisions. In contrast, the media is
not directly linked to the policy decisions, however, themedia is the only institution that can function at a macrolevel to connect the policy making sector with othersectors though information disbursement. Especially intopics pertaining to the G8 Summit, it is not an
exaggeration to say that the media can regulate the trend
or the focus on a certain issues, in a way that can swaythe trend or focus of the policy-making sector.
Since 2000, the international media have been taken up
global issues as one of central issues of the G8. Large
numbers of U.S. and European media have been covering
issues of poverty and development in developing
countries such as global health issues as the major
agenda item of the G8 Summit (although less thanenvironmental issues such as climate change). The
activities of Civil Society and the media have shaped the
public opinion of G8 countries, and in turn, these public
opinions have had a strong influence on the policy
decisions or indecisions of the G8 country governments.

・The overall direction

Japanese media has traditionally taken a liking to theclimate change issues, whereas poverty and development
issues such as the Millennium Development Goals, andfurthermore, global issues such as global health havetaken the backseat in coverage. Furthermore, thecoverage of international events had been low in theirpriority; especially regions such as Africa were amongst
the lowest in priority for regions of coverage. Albeit, there
are a number of dedicated journalists working to coverissues such as health and Africa, however, their hard work
has not been sufficiently reflected within the bureaucracyof the dominant media companies.
However, media coverage on Africa and poverty anddevelopment issues has slightly increased since 2007,
due to the fact that the 2008 Tokyo International
Conference on African Development (TICAD IV) took
place in the same year that the G8 Summit was hosted by
Japan. Furthermore, media interest in the activities ofNGO has begun to increase as well. This has been
especially true of the increasing attention given to the G8
NGO Forum, which was made up of over 100 NGOs
working of issues ranging from development, environmentand Human Rights. Beginning with the latter half of 2007,
the G8 NGO Forum has held press conferences withmajor Japanese print media companies such as Asahi,
Mainichi, Yomiuri and Sanakei to increase awareness andeducate them on global issues such as poverty anddevelopment and issues related to Africa.
The press conferences not only strengthened Civil
Society cooperation with interested journalists, but
created some influence on high-level people withdecisions making power over editiorial policies and article
selection.
Lastly, throughout the Summit, media showed interest in
the activities of NGOs at the International Media Center,leading to the coverage of statements and messages ofNGOs in newspapers and television shows.

PART III

HIV/AIDS AND GLOBAL HEALTH: THE G8 GUIDEBOOK-------------------

January. There has been a tradition that the chair of the

6. TOWARDS THE G8 SUMMIT: INITIAL PHASE(JANUARY ~ FEBRUARY 2008)

G8 attends the World Economic Forum, held in the latter
half of January every year, to announce the major agenda
items of the G8. In 2008, Prime Minister Fukuda attended
the World Economic Forum, and in a special session(1) Overview

chaired by Tony Blair, the former Primer Minister of the
The official transfer of the summit chair occurs on January

United Kingdom, made a speech in which he announced

1 of the new calendar year, but consideration for major

the major agenda items of the G8 to include global health.

agenda items or the policy positions they will take has
already began as the actual summit of the previous year

Now that the decision and the announcement have beencame to an end. The major agenda items of the G8

made, the chosen issues would now be part of the G8

includes issues that that were well-prepared beforehand

process and the policy making process on the issues will

and urgent issues that have occurred recently and must

be in full force. In the experience of the 2008 G8 Summit

be addressed in a global scale. In the context of theprocess, from February 13 to 14, the first G8 H8 Health2008 G8 Summit process, global health was an issue

Experts Meeting was held. Furthermore, on February 16,that has been well-prepared for beforehand and the

Health Policy Institute Japan (HPIJ), a think tank on

recent sharp rise in food and fuel costs are recent issues

Japanese health policy, with the cooperation of the World

that must be addressed.

Bank, hosted the Global Health Summit, aimed mainly atnational policy makers in Japan. If global health becomes

From January to February of the new year, the issues that

one of the main agenda items of the G8, there may be ahave been prepared for are narrowed down, decided upon

possibility that private sector driven health policy forums

and then presented to the public. Typically, decisions on

and the summit process to be intertwined.

the agenda items are made at the Sherpa Meeting in(2) Sherpa Meeting
Brief Overview
・The Sherpa meetings, as the name suggests, are meetings held by the Sherpas of the G8. The Sherpa meetings,
held approximately once a month, functions as a steering committee on the substance of the G8 Summit. The dates
and the places of the meetings are kept private for security reasons.

・ The Sherpas are the backbone of the G8 policies. At the meetings, the Sherpas plays an important role ofconsolidating the trends or policies of each G8 country on the major agenda items, and then find the direction theywould take on those agenda items. To ensure civil society can hold an effective advocacy, civil societies of each G8
country must create a relationship of mutual trust with their respective Sherpas and/or relevant official, proactively
hold meetings or discussions, synthesize the information they have gathered, analyze the policy direction of eachcountry, and using the analysis, hold a coordinated advocacy.
Experience from the 2008 G8 Process: The first Sherpa meeting・The first Sherpa meeting for the 2008 G8 Summit was held towards the early part of January 2008 in Japan. The G8
NGO Forum did not carry out any out of the ordinary advocacy towards this first Sherpa meeting.

・

Generally, in Japan, the Deputy Minister for Foreign Affairs (Economic) serves as the G8 Sherpa, thus making Mr.
Masaharu Kohno, the G8 Sherpa for the 2008 G8 Summit. In addition, Mr. Yoichi Otabe, the Director-General of
Economic Affairs Bureau of the Foreign Ministry, and Mr. Rintaro Tamaki (later Mr. Takehiko Nakao), Senior Deputy
Director-General of the International Bureau of the Ministry of Finance served as the sous-sherpas (also known as
sub-sherpas). As G8 NGO Forum, there were limited opportunities to meet directly with Sherpa Kohno, such as the
NGO and Government Dialogue Meeting on G8 Summit, held in February. However, civil society was able to holdmore frequent meetings with Otabe Sous-Sherpa and Koro Bessho, director general of international Cooperation
Bureau of the Foreign Ministry, who was in charge of issues related to poverty, development and MDGs.

23

24 PART III

HIV/AIDS AND GLOBAL HEALTH: THE G8 GUIDEBOOK果(3) The World Economic Forum (Davos)
Brief Overview
The World Economic Forum (Davos Conference) is an annual gathering in Davos, Switzerland, of top leaders in business,finance, national politics and intellects of the world, taking place in the latter half of January. Dubbed as the World's Rich
Man's Club, civil societies of the world in opposition, created the World Social Forum, first launching in 2001 at Porto
Alegre, Brazil. But with growing acknowledgement of the important role of civil society in the policy decisions of global
issues, the hosts of the World Economic Forum began to invite the participation of dominant international NGOs. For
example, in issues related to poverty and global health, Oxfam International participated in the Forum. Furthermore, Bono
(Data/One serves as the policy team to Bono), vocalist of U2 actively engaged himself at the World Economic Forum andcarried out meetings with heads of states and members of the media.
The World Economic Forum and the G8 Summit: The role of Civil Society¾

The G8 Summit is one of the areas of interest at the World Economic Forum with a tradition that the chair of the G8
Summit attends the Forum and participates in a session in which he/she will announce the major agenda items of theG8 Summit. Although, by the time of the Forum, the major agenda items of the G8 are virtually decided unofficially,
civil society can still work to influence the speech of the chair of the G8. Usually, the speech by the head of state isbroadcasted on the web and the footage is made public on television.
(See: www.mofa.go.jp/policy/economy/wef/2008/address-s.html)¾

Civil Society can take the following actions:・Work in cooperation with think tanks and institutions/organizations of the G8 host country associated with theWorld Economic Forum to make recommendations on the speeches of the G8 Summit Chair.

・To work in cooperation with notable figures working on global health issues participating in the World Economic
Forum (such as Bono and Jeffrey Sachs) to advocate to the G8 Summit chair.

・To have international NGOs (such as Oxfam International and Data/One) to monitor the statements and remarksof the G8 chair and find possible advocacy routes.

Experience from the 2008 G8 Process
・

The G8 NGO Forum made the World Economic Forum a point of focus, and released a four page statement as a
response to the speech Prime Minister Fukuda made at the special session. This statement was disbursed tomembers of the media. (See Reference 1 : page 39)

・

The G8 NGO Forum coordinated with a Japanese think tank on health and medical policies, the Health Policy
Institute of Japan (HPIJ), which is also involved in the organization of the World Economic Forum. Coordination withHPIJ began to form during the February Global Health Summit, which was also hosted by this think tank.

・ There was information sharing from the two international NGOs that participated in the World Economic Forum,
Oxfam International and World Vision International.

Global Health Civil Society Symposium (February 6, 2008)

PART III

HIV/AIDS AND GLOBAL HEALTH: THE G8 GUIDEBOOK(4) G8 Health Experts Meeting
Brief Overview
・ Within the G8 process, several Ministerial meetings according to various topics takes place. A G8 Health Ministerial
meeting does not exist, thus, within the G8 process, there is a lack of ministerial level meetings on the issue of health.
・ Although not a complete substitute to the Ministerial Meeting, the G8 Health Experts meeting was set up by aninitiative of the Japanese Government for the 2008 G8 Summit in order create a draft for global health policy. The
creation of the G8 Health Experts meeting is a response to the speech made by the Minister of Foreign Affairs,
Masahiko Koumura in November 2007 to develop a set of common framework for action shared by the international
community. Each G8 government chose a health expert to draft the Common Framework for Action, and thegathering of these health experts became what is now known as the G8 Health Experts meeting.
・ The G8 Health Experts Meetings were held three times (February, April and June) throughout the G8 Process. In
addition, the health experts met several times among themselves at an adjustment meeting up till moments before
the actual summit.
・ Whether the G8 Health Experts Meeting will be held for future summits is yet to be determined. However, it is safe toassure that Global Health will be on the agenda until 2010 since the outcome of the 2008 Summit, the Common
Framework for Action, created a follow up mechanism. Thus, there is a high possibility that a meeting similar to the
G8 Health Experts Meeting will be held for the next Summit.
Experience from the 2008 G8 Process
・ The office in charge of G8 global health policies of the Japanese Government and the Foreign Ministry are the Global
Issues Cooperation Division of the Office of Director General for Global Issues. Mr. Jun Yamazaki, in addition toserving as the chair of the Health Experts meeting, also served as the head of the Japanese delegation to the Boardof the Global Fund to Fight AIDS, Tuberculosis and Malaria.
・ Even before the G8 Health Experts Meeting took place, there were already some informal dialogue among the Global
Issues Cooperation Division of the Ministry of Foreign Affairs and various sectors including civil society. As for civilsociety, the Global Health Committee of the G8 NGO Forum held "Study Sessions", four times throughout December
to February 2007. These study session provided an opportunity for the government officials to take in the expertiseon global health issues of civil society, while gathering objective information on the global health policies of G8
Countries.
・ The themes of the Study Sessions are as follows:¾ HIV/AIDS and Infectious Diseases¾ Maternal and Child Health¾ Health System Strengthening¾ Dialogue with International NGOs
・ In these sessions, there were opportunities to have dialogue with international NGOs. On, February 6, notable NGO
leaders working on various global health issues (see guest below), were invited by the Global Health Committee tohold a dialogue with the Ministry of Foreign Affairs. (See Reference 2, Page 43)
Valerie DeFillipo（International Planned Parenthood Federation）＝Maternal and Child HealthLucy Chesire（Kenya AIDS NGO's Consortium）＝infectious diseases（Tuberculosis & HIV/AIDS）
Mogha Kamal-Yanni（Oxfam, Great Britain）＝Health System Strengthening & HIV/AIDS
Rotimi Sankore (Africa Public Health Rights Alliance）＝Health System Strengthening & HIV/AIDS・ From the Ministry of Foreign Affairs, several staff members involved in global health issues in the Global Issues
Cooperation Division participated in the session, and actively exchanged ideas and information.
・ On February 7, the Global Health Committee held a symposium on Global health titled Civil Society Symposium on
Global Health: What world's civil societies expect from Japan toward TICAD IV and G8 Summit. The fourinternational guests participated in the panel to speak about global health policies and the G8. There were over 200
audience members, as well as coverage from leading media stations, including NHK (Japan Broadcasting
Corporation).
・ This process allowed the Ministry of Foreign Affairs to have a concentrated discussion on global health policies withleaders of national and international civil societies before the G8 Health Experts meetings takes place. Furthermore,
we believe that this was a valuable opportunity for them to gain comprehension on the current direction of global
health policies. For Japanese civil society, this was a significant step in building a relationship of mutual
understanding with those in charge of policy at the Ministry of Foreign Affairs.

25

26 PART III

HIV/AIDS AND GLOBAL HEALTH: THE G8 GUIDEBOOK果Breakdown of the Health Experts Meeting
・ The first Health Experts Meeting was held from February 13-14. Participants, in addition to the G8 Health Experts,
were international institutions working on global health issues including the WHO, UNAIDS, UNFPA, the World Bank,International Planned Parenthood Federation (IPPF), Private Foundations such as the Gates Foundations andexperts from the AU. The purpose of the meeting was to create a draft of the Common Framework for Action, and theparticipants primarily listened to the statements of experts from each country and institutions and organizations.
NGOs were not officially invited to the Health Experts Meeting and were only allowed participation in the receptionthat followed. Proposals made by the Health Experts on global health issues that are accompanied by the issue offinancial contribution, are made under the condition that it received consensus from the meetings of the Sherpas.
・ The Second Health Experts Meeting was held from April 9-10. Participants, in addition to the G8 Health Experts
include international institutions and other associated institutions, organizations and foundations. At this meeting, thefirst draft of the Common Framework for Action was put on the table, and consisted of discussions around this draft.
Civil society submitted a demand paper in lieu of the Second Health Experts Meeting.
・ The Third Health Experts Meeting was held from June 11-12. At this meeting, the final draft of the Common
Framework for Action was drafted. Each G8 country expressed their different opinions in the "struggle" for the
position and content of the Common Framework for Action. There was a tug-of-war on each issue, which continued
through the June 23-25 Sherpa Meeting and even until the day of the actual Summit. Even after the meetings had
ended, various unofficial processes took place among the health experts to settle issues on this document.

(5) Global Health Summit
Brief Overview
・ Several events titled Global Health Summit has been held, but the organizers and the content of the summit are
extremely diverse. For example, the 2005 Global Health Summit was hosted by TIME Magazine with the promotion of
the Gates Foundation. With private foundations and think tanks as the core discussants and with the addition ofmembers of NGOs and international organizations, discussed issues in global health. Furthermore, in 2007, theAmerican Public Health Association held Global Health Summit II.
・ The Global Health Summit (See: http://www.global-health-summit.org/) held in Tokyo in February of 2008 wassignificantly different to the previous Global Health Summits. This Global Health Summit was hosted by the Health
Policy Institute Japan (HPIJ), a think tank on Japanese health policy, with the cooperation of the World Bank. The
Summit was aimed at high-level people in the Japanese Government and Economy and holds a significant role in thepolicy making process for TICAD and G8, with the purpose of conveying them the importance of global health.
Invitations to the Summit were given to 100 key persons and included speeches from Junichiro Koizumi, former
Japanese Prime Minister, Sadako Ogata, President of JICA and Joy Phumaphi, Vice President for Human
Development at the World Bank. Such events with the aim to educate high-level people in Japan are significant in acountry where understanding of the importance of global health in the global agenda is lacking.
・ There is a possibility that a Global Health Summit may take place in future G8 host countries for the purpose of
putting focus on the issues of Global Health for the G8. The hosts of the 2008 Global Health Summit in Japan (HPIJ
and the World Bank) is looking into that idea.
Experience from the 2008 G8 Process
・ The Global Health Committee of the G8 NGO Forum made contact with HPIJ as soon as they had information on the
Global Health Summit in Tokyo. The Forum had learned from the host (HPIJ) that this summit will be different fromthe 2005 Summit hosted by TIME Magazine, and that the purpose will be to create awareness of global health issues
among policy-makers in Japan. Several invited NGO members attended the Summit.
・ On the day after the Summit (February 16), to aid in the effort of HPIJ and the World Bank, the G8 NGO Forum
Global Health Committee held a Global Health Experts Session. Guest speakers included Joy Phumaphi, Vice
President for Human Development at the World Bank and Kiyoshi Kurokawa, Chairman of the Health Policy Institutein Japan. From the side of the NGO, Masaki Inaba of the Global Health Committee made a speech (the content of the
speech is attached: Reference 3, Page 47). There was participation from noted international institutions andorganizations and representatives of the government that has participated in the G8 Health Experts Meeting and the
Global Health Summit. This has helped ferment their confidence in the policy-making abilities of Japanese NGOs.

PART III27

HIV/AIDS AND GLOBAL HEALTH: THE G8 GUIDEBOOK-----------------------------Development Assistance Committee (DAC) of OECD

7. TOWARDS THE G8 SUMMIT: MID-PHASE(MARCH – APRIL 2008)(Organizationfor

Economic

Co-operation

andDevelopment) published their annual ODA data. This
release of the ODA data is an important opportunity for
advocacy. Furthermore, the Africa Partnership Forum took

(1) Overview

place at this time and provided and opportunity for the G8
At this phase, the directions the G8 leaders/G8 Countries

and Africa to hold a dialogue. But most importantly, thewould take on the major agenda items decided at the

Civil G8 Dialogue takes place. This is a process that firstinitial phase becomes definite. Furthermore, urgent issues

took place at the 2006 St. Petersburg Summit in whichthat must be discussed at the G8 Summit are inInternational Civil Society and the G8 Sherpas have adetermination. The direction of the Summit is almost

dialogue on various issues.

settled at this phase. Moreover, civil society is now on
track on the direction they will take in their advocacy andAt the 2008 G8 Summit, adding to the complexity of theactivities as the - minimum level of concession the G8

work of Civil Society, the Fourth Tokyo International

Countries will provide- becomes more evident.

Conference on African Development took place. In Marchof 2008, the Ministerial Meeting for TICAD IV took place in

In relation to poverty and development, at this phase, theGabon, and towards the latter half of May, TICAD IV took

Development Ministers Meeting takes place and theplace in Yokohama, Japan.

(2) TICAD Ministerial Meeting
TICAD IV and the G8 Process
・ The Tokyo International Conference on African Development (TICAD) is an initiative led by Japan to promote highlevel policy dialogue amongst African leaders and their development partners for the development of Africa. TICAD
was co-hosted in addition to the Japanese Government, by the United Nations Office of Special Advisor on Africa(UN-OSAA), the United Nations Development Programme and the World Bank. Since the first TICAD was held in
1993, the conference has continued on every five years in Japan. TICAD stands as a core conference in the
diplomatic exchanges between Japan and Africa.
・ For the reason that TICAD is not an official process of the G8, it will not be discussed in full detail in this book.
However, 2008 became a special year for Japan because they would host both the G8 and TICAD, leading to theJapanese Government to put African Development as one of the main agenda items of the G8, and in attempt toincrease the international significance and standing of TICAD, inevitably placed TICAD as part of the G8 process. In
such incidence of when a diplomatic initiative of one G8 country becomes connected to the entire G8 process, civilsociety response must be taken case by case.
Experience of the 2008 G8 Process
・ The past three TICADs were held in the fall (September or October). However, in 2008, when the G8 and TICAD
would take place in the same year, and in order to make TICAD an integrated process of the G8, TICAD was moved
to take place before the G8.
・ Heavily influenced by the advocacy from the African Diplomatic Corps, Japan, whose competence have been
growing in the lead up to the G8, and irritated by the ever aggressive Chinese interest in Africa, Japan chose to takeon economic growth and increasing private sector investments as their priority policies for TICAD IV. This decision
made by the Japanese Government contrasted significantly with civil society who had been emphasizing on theMillennium Development Goals and the elimination of poverty.
・ Towards the end of March, at the Ministerial meetings for TICAD in Libreville, Gabon, the Yokohama Declaration (See
http://www.ticad.net/ticadiv/yokohamadeclaration.shtml) was adopted and the related document, the Yokohama
Action Plan (See: http://www.ticad.net/ticadiv/actionplan.shtml) was distributed. However, the contents of these
documents, even on the major agenda items such as economic growth and private sector investment, not to mention
the attainment of the MDGs and social development issues were extremely weak. Despite the victory of the African
Diplomatic Corps, Japan which demanded a mechanism to ensure accountability on the TICAD Process, led to thedrafting of the Declaration and the Framework for Action, the documents are meaningless when the content isextremely lacking and weak.
・ For the Ministerial meeting for TICAD, civil Society in Japan and Africa worked in solidarity to present a joint civilsociety statement, which calls on the attainment to Universal Access to prevention, treatment and care by 2010(SeeReference 5, page 54). Furthermore, the G8 NGO Forum worked in cooperation with the TICAD IV NGO Network, a
Network of NGOs working for TICAD. Together, they came out with a more comprehensive civil society statement,
Voices (http://www.ticad-csf.net/TNnet/download/Voices_Final(e).pdf ). 10 Civil Society members from Japan and28 PART III

HIV/AIDS AND GLOBAL HEALTH: THE G8 GUIDEBOOK

果

about an equal number of Civil Society members within Africa representing various issues participated in the
Ministerial Meeting in Gabon. After the Ministerial Meeting in Gabon and the weakness of the content of the
Declaration and the Action Plan was revealed, Civil society worked actively with politicians and the media to advocate
to the Ministry of Foreign Affairs and those in charge of TICAD to call for the attainment of the MDGs and theelimination of poverty as the priority issue.
・ As part of the advocacy, civil society created and submitted a comprehensive alternative document of how MDG
related issues could be included in the Action Plan. The Ministry of Foreign Affairs and co-organizers of TICAD had
taken into account some of the items on the alternative document.
・ The Action Plan that came out at the official TICAD IV in May, showed some success of the advocacy as some of thecontents for MDG related issues improved. Specifically on health, such areas as Health System Strengthening andreproductive health came with a commitment to a comprehensive action plan. Furthermore, on the issue ofaccountability, although far from sophistication, there were attached matrices with specification on actions they willtake as part of the TICAD process. However, on HIV/AIDS, there were no concrete goals; moreover there was no
mention of Universal Access. Civil Society reacted by issuing a protest statement Ref. 6, Page 57).

(3) G8 Ministerial Meetings
Brief Overview
・ In relation to poverty and development issues, one of the most important ministerial meetings that take place in the
G8 process is the Development Ministerial Meeting. In the context of Africa and Development, they will makecomprehensive decisions on issues such as quantity and quality of ODA, aid harmonization, responses to emerging
donor countries and actions for the attainment of MDGs.
・ As civil society, we must ensure that the decisions made at the Development Ministerial Meetings place emphasis on
the attainment of past G8 commitments on poverty, development and MDGs and a comprehensive and concrete
action plan for its attainment. We cannot allow this Ministerial Meeting become an abstract meeting or a "Saloon
where they review developmental issues".
Experience of the 2008 G8 Process
・ The Development Ministerial Meeting for the 2008 G8 Summit took place from April 5-6. From the viewpoint of theJapanese Government that this meeting would be a comprehensive discussion on development, rather then for theattainment of existing G8 commitments, the following issues became the center of their discussion:¾

Climate change and development¾

Emerging donors, partnership with private foundation and organizations¾

Human Security (includes MDGs)

・ In lieu of the Development Ministerial Meeting, the Poverty and Development Unit of the G8 NGO Forum submitted ademand paper centered on the policy demands on issues related to the MDGs, to Mr. Itsunori Onodera, the Japanese
Senior Vice Minister for Foreign Affairs.
・ The OECD DAC annual data on ODA was released coincident to the Ministerial meeting on April 4, in which theresults show that in 2007, the ODA of OECD countries as a whole has slightly increased, but the ODA of the G8
countries as a whole had decreased. The fact that the ODA of Japan, the host of this year's G8 Summit, hasdecreased 30% from the previous year and their ranking in the world (in term of amount, rather then percent of GDP)fell to number five in the world was revealed. In reaction, the G8 NGO Forum, emphasizing the results of this data,
released a civil society statement titled Where has the 'the country that keeps its promise - Japan' gone?, criticizing
the decrease of Japan's ODA.

Civil Society Meeting toprepare for G8 advocacy

PART III

HIV/AIDS AND GLOBAL HEALTH: THE G8 GUIDEBOOK(4) Africa Partnership Forum
Brief Overview
・The Africa Partnership Forum (APF), first established in the wake of 2003 Evian Summit, is a process in which Africa
and the G8 have dialogue on African Development. Participants includes the Africa Personal Representative of each
G8 country, representatives of the 5 NEPAD (New Partnership for Africa's Development) countries (Egypt, Algeria,
Senegal, and Nigeria and South Africa), representatives from the African Union, as well as representatives fromseveral other African countries. Coordinated by the OECD, the Africa Partnership Forum takes place twice a yearwith one taking place in the G8 host country in the spring and another in a country in Africa.

・ Although the Africa Partnership Forum process is part of the G8 process, it is not well acknowledged. However, there
are many civil society groups in Africa, actively expanding their advocacy to include NEPAD and the African Union,
has been actively releasing policy statements on the Africa Partnership Forum. It is important that in advocacy, we
work in cooperation with these civil society groups in Africa.
Experience of 2008 G8 Process
・NGOs in Japan, including the G8 NGO Forum did not have much insight on the APF.

・This year, in lieu of the APF, NEPAD discussed with the Japanese Government and the OECD to hold a grand scale
civil society session. As a result, although the "grand scale" did not come into reality, APF allotted one session as acivil society session. This included the participation of four representatives of different civil society groups who had
submitted policy proposals to NEPAD and the AU. The participants are as follows:

Ibidapo Oyewole＝Center for African Policy and Peace Strategy (Nigeria)

N'deye Bineta Diop
＝Femme Afrique Solidarite (Senegal)

Fall Khady Mbengue＝Association des Femmes de l' Afrique de l' Ouest (Senegal)Elizabeth Akinyi Nzioki＝Center for Land Economy and Women's Rights (Kenya)

・

The G8 NGO Forum and TICAD IV NGO Network worked in cooperation to create a task team and hosted the above
civil society representatives from Africa arriving in Japan. On April 4, civil society from Japan and Africa held an APF
preparatory meeting at the Ministry of Foreign Affairs, and from April 5-6, held a workshop to draft a presentation for
the APF civil society session. The guests from Africa were highly qualified and intelligent, and we could say that thecivil society session ended successfully.

・

The APF as an entirety is held with the Japanese Government and several African governments who has their own
intention/agenda for this meeting. Thus, issues such as economic development and the promotion of private sector
investment, rather then the MDGs became the main agenda items of APF (Civil Society Statement for APF: See Ref.
4, Page 52).

・ Although the Africa Partnership Forum process is part of the G8 process, it is not a well-known process. However, it is
an important opportunity to strengthen cooperation with civil society in Africa and work together to advocate to thevarious governments. The civil society of G8 host country and civil society in Africa that has been working toward the
APF should continue to work in cooperation in order to actively carry out advocacy.

29

30 PART III

HIV/AIDS AND GLOBAL HEALTH: THE G8 GUIDEBOOK果------------------8. 2008 G8 SUMMIT PROCESS: CIVIL G8
DIALOGUE

Since the tradition began at the 2006 Summit in Russia,
the Japanese government supposed that a Civil G8
Dialogue will take place in Japan as well. On the financial(1) Broad Overview:

aspect, the Japanese government covered the cost of theroundtrip tickets and accommodation of the invited

Civil G8 Dialogue is a process that was first launched inoverseas guests. The Japanese government did not

the 2006 G8 Summit in St. Petersburg, Russia.

directly issue the monies to the G8 NGO Forum, but

In Russia, the Civil G8 Dialogue took place two weeks

through travel company contractors. Other financial costs

before the actual G8 Summit from July 3-4 and included

were covered by a grant the G8 NGO Forum submitted tothe participation of civil society of each G8 country. Thesethe Open Society Institute.

invitation-only participants had a discussion with President
Putin for well over three hours. The Civil G8 Dialogue for

The Civil G8 Dialogue, in addition to the the approxamitely

the 2007 G8 Summit in Germany took place two months

150 from Japanese civil society, included the participation

before the actual G8 Summit from April 25 - 26.

of 52 civil society members from overseas (including theRepresentatives from Germany and International Civil

27 invited guests), bringing the total

Society and G8 Sherpas discussed issues such as

participation to 200. On the selection of overseas guests,

environment, poverty and development. The Civil G8

each of the three units from the G8 NGO Forum (poverty

Dialogue is the only meeting of the G8 process that allows

and development, environment and human rights andcivil society to have a discussion on an equal basis withpeace) compiled a list of possible candidates. From there,

the organizers and those responsible for G8 policies ofthey chose the 10 that would be given invitations.

each country. Japan also chose to have a Civil G8

Overseas guests that have covered for their own costs

Dialogue. It is necessary that the Civil G8 Dialogue

were informed about the Civil G8 Dialouge through their

becomes a permanent part of the G8 process.

Unit's respective mailing lists, and from there, applied tonumber ofattend the Dialogue through affiliated NGOs.
・

Russia Civil G8 information

All those

who applied were accepted.

http://en.civilg8.ru/1195.php
・Germany Civil G8 information

Listed below are the names of individuals from NGOs

http://www.forum-ue.de/137.0.html?&L=1

involved in global health issues that has participated in the
Civil G8 Dialogue:(2) Experience of the 2008 G8 Process
Elizabeth Anne Peterson (World Vision International)
The Civil G8 Dialogue in Japan, organized by the G8-United States, MDG4 (Child Health)

NGO Forum, took place April 23-24 for two days in Kyoto.

Dorothy Shaw (FIGO)

The dates were chosen to coincide with the G8 Sherpa-United States, MDG5 (Reproductive Health)meeting that would also take place in Kyoto. At the

Rachel Wilson (Path)meeting held on the 24th between G8 Sherpas (8 Sherpas-United States, MDG5 (Reproductive Health)excluding the Sherpa from France) and civil society,

Jill Shefield (Family Care International)

particpants exchanged dialogue for approximatly two-United States, MDG5 (Reproductive Health)hours.

Paola Giuliani (Action Aid Italia)-Italy, MDG6 (HIV/AIDS)

Civil Society from Japan understood that the Civil G8

Olayide Akanni (African Civil Society Coalition on AIDS)

Dialogue is essential to their advocacy. The G8 NGO-Nigeria, MDG6 (HIV/AIDS)

forum quickly launched a Civil G8 Working Group, andWinstone Zulu (Kala Counseling)with the facilitation of the environmental unit (which had-Zambia, MDG6 (HIV/TB)

the experience of actively participating in past Civil G8Louis da Gama (Global Health Advocates)

Dialogues), the poverty and development and the Human-United Kingdom, MDG6 (Malaria)

Rights and Peace Unit participated on an equal footing to

Irungu Houghton (OXFAM GB)

actively work towards the organization and the execution-Kenya, Health Systemsof the Civil G8.

PART III

31

HIV/AIDS AND GLOBAL HEALTH: THE G8 GUIDEBOOK
to balance issues, gender, region, etc.

In choosing the representative for HIV/AIDS related
issues, a selection committee was formed. The committee
consisted of the following people: Masaki Inaba (Japan,

On content: at the morning session of the second day of

G8 NGO Forum), Marcel van Soest (World AIDS

the G8, the Poverty and Development unit held threeCampaign), Felicita Hikuam (South Africa, World AIDS

different workshops: (1) Global Health (2) Development

Campaign) and Steven Cockburn (UK, Stop AIDS

and ODA (3) Governance and Anti-corruption. Within eachCampaign). Together, the committee sent out request forworkshop, the participants raised issues and questions

participation to their respective mailing lists, and chose 1that must be emphasized. At the first part of the afternoon

member from a developed county and 1 member from asession, the participants of the thee workshops camedeveloping country to participate in the Civil G8 Dialouge.

together and came to a consensus on which issue andquestions will be raised for the actual dialogue between
civil society and the Sherpas. In addition, participants of(3) Civil G8 Dialogue in Reality

global health issues came together to create a civil society
The Civil G8 Dialogue has been constructed as two day

statement to present to the Sherpas (See Ref. 7, Page

long process, however, the actual dialogue between civil

58).

society and the Sherpa took place in the last two hours of
the second day. At the 2008 Civil G8, the first day

For the processes on the selection of the speakers for theconsisted of plenary sessions of the three main agenda

meeting

items of poverty and development, environment, anddevelopment unit, actively invited the participations of all

Human Rights and Peace. The morning and part of theand emphasized that the discussion be as democratic as

afternoon were allotted to meetings on the three main

possible. As a result, there was a high praise from theagenda items.

participants on the transparency and democracy of the

with

the

Sherpasforthepovertyandprocess.
The most important aspect of the Civil G8 Dialogue was
who will speak and what will be spoken at the actualWithin the two-hour time limit of the dialogue between civil

two-hour discussion between the Sherpa and Civil

society and the Sherpas, the first 10 minutes wereSociety.

allocated to the Sherpas, the next 40 minutes to Climatechange, another 40 minutes to poverty and development

Although the framework of the meeting with the Sherpa at

and the last 30 minutes to human rights and other issues.

the Civil G8 allows the participation of all, the speakers

The dialogue ended with the Sherpas responding with

were limited to 18 people. Thus civil society decided onbroad answers without any substance to the questions

dividing the speakers as the following: 9 for Poverty andand opinions raised by the Civil Society. However, theDevelopment, 8 for Environment and 1 for Human Rights.

management and the operation of the Civil G8 Dialogue

A strategy meeting was held on the 21st (before theran efficiently and smoothly, and the substance of theofficial Civil G8 that began on the 22nd) with Japaneseissues raised during the dialogue with the Sherpas was of

and International participants involved in poverty andhigh quality. Thus, the Sherpas left the meeting holding adevelopment issues choosing the 9 speakers for Poverty

high impression of the policy making and management

and Development. The speakers were carefully selectedabilities of the civil society.

☆

☆

☆

-----------------------------

become clear. Each country will use some kind of political

9. TOWARDS THE G8 SUMMIT: TICAD AND
FINAL PHASE (MAY - JUNE 2008)

maneuvering and negotiations to ensure that their own
position is pushed through. Furthermore, situations willarise when a government of a country will have a policy(1) Broad Overview:which is their endeavor or a vision on an issue in which
they would like to be renowned for. In order to push thisWe are reaching for final stretch of G8 Summit process,policy forward, they will use various tactics to persuadeand by now the G8 has boiled down the position andthe other G8 countries.

direction they will take on the major agenda items. Aroundthis time, a draft of the G8 Communique and related

We cannot say that civil society is extraneous to these

documents should be ready on the table. At the same time,

tactics. Such tactics includes finding a backing from civil

the policy position/direction of each G8 country shouldsociety on this policy, and using their communication and32 PART III

HIV/AIDS AND GLOBAL HEALTH: THE G8 GUIDEBOOK

果

advocacy abilities to put pressure on the governments ofAt the last Sherpa meeting before the actual G8 Summit,

other countries. There are also instances when a country

final adjustments are made to the draft G8 outcome

will leak the position or policy of another country to the

documents and to the financial commitments. However

civil society, so that civil society can rally against or

much of the adjustment will be left without final

criticize the position or the policy of that other country.

agreements, leaving the final decisions in the hands of the

Civil Society must lend their ears to these calls by

G8 leaders.

governments

andquicklygather

these

kinds

of

information, but at the same time, it is necessary for civil

Around this time, civil society members that havesociety to advocate from their independent standing or

continuously been working towards the G8 begin to feelposition of the issue.

the accumulation of their fatigue. But don't give up now,the summit is right around the corner.。

(2) Meeting between the chair of the G8 and International NGOs
The meeting between the chair of the G8 and International NGOs
・ Within the past several years, arenas in which Civil Society and officials of the G8 can hold a discussion have opened
up. One such instance is the Civil G8 Dialogue and another is a meeting among international NGOs and the chair of
the G8 Summit. The aim of this meeting is for the chair of the G8 to have a thorough communication with renowned
International NGOs working on global issues such as MDGs and climate change. This meeting first occurred during
the 2006 St. Petersburg G8 Summit process and formalized after a refined version of the meeting was held during the2007 G8 Summit process.
Experience of the 2008 G8 Process
・ On June 18th, a meeting between Prime Minister Fukuda and 10 international NGOs was held. The environmental
unit of the G8 NGO Forum took the lead in initiating this meeting. The invitees mainly included representatives fromlarge European and US NGOs that has participated in the meeting held with the Chancellor in the 2007 G8 Summit.
But from a perspective that NGOs from developing countries in African and Asia must be included, Arjun Karki fromLDC Watch, based in Nepal, was invited to participate in the meeting. There was no participation from the civil society
members working on global health issues.
・ A meeting between the chair of the G8 and international NGOs working across national borders is considered very
important and highly desired by civil society for it to continue in future G8 Summit processes.
(3) The Final Stretchcommon strategy and position among civil society, andcalled for civil society to meet with the Health Experts andAs the final phase of the G8 Summit process approaches,

Sherpas of each country.

in the battle for the contents of the Toya-ko Framework for
Action, the agendas and thoughts of each G8 countries

Furthermore, at this meeting, the final civil society

becomes increasingly more visible. The Global Healthstatement to the G8 by the Global Health Committee, “WeCommittee of the G8 NGO Forum, in cooperation withWill No Longer Wait” was finalized (See Ref. 10, Page 68).

international civil society, worked to improve the contentsThisof the Toya-ko Framework for Action on Global Health.

organizations from 34 countries, was sent to the heads ofstatement,

signed

on

by

110

civil

society

the G8 countries.
The battle among the G8 countries for the content of the
Toya-ko Framework for Action on Global Health is one

In addition, International NGOs such as Oxfam and World

that is complex and tangled as stated on Part 1 Section 3

Vision, both members of the Global Health Committee,(3). The action and activities of the Global Healthused their organizational networks to advocate to theCommittee, together with Africa Japan Forum and Japan

governments of each G8 country.

AIDS and Society Association are the following:
On June 29, an UK newspaper, The Financial Times
The day after the 2008 United Nations High-Level Meetingleakedon HIV/AIDS held in New York from June 10 to 11, Japan

http://www.medicalnewstoday.com/articles/113644.php) to(See

AIDS and Society Association, Africa Japan Forum andthe public that the most recent draft of the Communiquethe Open Society Institute co-hosted a Strategy Meeting

did not include the Gleneagles G8 Summit Commitment ofon Advocacy for Global Health in the G8 Process. At theincreasing aid to Africa by USD 25 Billion every year until

meetings, civil society member of each G8 country shared2010 nor did it include the expiration date of 2010 on theinformation on their Governments' position towards the

Universal Access goal. In protests, NGOs working on

Toya-ko Framework for Action on Global Health, formed a

global health issues and HIV/AIDS, as well as civil society

PART III

33

HIV/AIDS AND GLOBAL HEALTH: THE G8 GUIDEBOOK

working on developmental issues released a civil society
statement. Furthermore, civil society groups in each G8This is just another example of the differences andcountry advocated and campaigned to their respective

conflicts held by the G8 countries on policies related togovernments. Specifically, the G8 NGO Forum called on

global health. Some problems were solved before thethe Ministry of Foreign Affairs for the inclusion of specificSummit and other issues were brought to the actual

amounts and timelines for the commitments. As a result,

Summit table (for example, the time limit for the

dollar amounts and expiration dates were written into the

Heiligendamm 60 billion commitment).

final G8 communique.

☆

☆

☆

-----------------------------

Foreign Affairs (MoFA) using as a base, a list that has

10 G8 SUMMIT:
CENTER

been created by the G8 NGO Forum.

INTERNATIONAL

MEDIA(2) Preparation(1) Broad Overview
The greatest task in the preparation for the IMC has been
After the 1999 World Trade Organization Ministerial

the creation of the list of nominees of NGO members from

Conference in Seattle, Washington ended in a failure withoverseas (which has been limited to 100 people). The G8

massive demonstrations and the 2001 Genoa Summit

NGO Forum wanted to create the list of the 100 possible

where large demonstrations and an massive crackdown

nominees through a transparent, democratic and fairby police ended in the death of one, recent G8 Summits

process.

has been planned far from city centers in remote resortareas at the insistance of the security officers. The 2008

MoFA held the final authority to select the NGO

G8 Summit that took place in Toya-ko is located 1000 Km

participants for the IMC. Civil Society finally decided tofrom Tokyo and 100 Km from Sapporo, the major city inmake a list of recommended participants for MoFA.

Hokkaido Prefecture, is another exemplary case of theFirst, each Unit (Poverty and Development, Environment,

remoteness of the G8 Summit locations.

Peace and Human Rights) of G8 NGO Forum called for
The International Media Center is located approximately

applications for participation at the IMC using various

20km northeast from Toya-ko, in Rusutsu Resort in thee-forums from 19th to 23rd of May, and then made a list ofvillage of Rusutsu. Much of the media and NGOs working

all the applicants. During the calls for application, theat the IMC stayed in hotels in Kutchan Town and Niseko

Units set criterias for NGO participants to the IMC. The

Town, located more than 20km north over the Volcano

total numbers of applicants were more than 130.

Shiribeshi. Shuttle buses connected the hotels and
The representatives of the Units reviewed the lists, cut the

Rusutsu IMC.

names of the applicants whose application forms were
The G8 NGO Forum has been working long before the G8

invalid or those who could not afford to come to Japan

Summit,thewithout financial support, and created the final list of 100

participation and activities of NGOs at the International

nominees, and submitted the list to MoFA. MoFA used theMedia Center. As a result, the government set up in a set

list to select the IMC participants.

with

the

Japanese

Government

onspace for NGOs at the IMC, where NGOs can launch
information and statements and hold small meetings.

(3) The International Media Center

Furthermore, a space to hold press conference for NGOs
was also set up, allowing NGOs a place to hold press

The International Media Center was a home to many

conferences with the media. This is the first time in theJapanese and international media. It is important to note

history of the G8 Summit that such a corner for NGOs washere that members of the media actively engaged andestablished.

heldinterviews

with

NGOs.

Both

regionalandinternational papers, as well as TV stations, actively
However, the number of NGO members that were allowed

covered the advocacy activities of NGOs to the G8,

entry into the IMC was limited to 100 NGO members fromresulting in several TV appearances and newspaper

overseas and 20-30 members of the G8 NGO Forum. The

columns. One such reason for the large amount of

selection of those admitted were chosen by the Ministry ofcoverage is that the only live interviews the media could34 PART III

HIV/AIDS AND GLOBAL HEALTH: THE G8 GUIDEBOOK

果

have was with NGOs working at the IMC.
Asia Russell （Health GAP, US)
Using the advantage of the large amount of media

Paola Giuliani (Italian Network against HIV/AIDS, Italy）

members gathered in the IMC, the NGOs held many

Emmanuel Trenado (AIDES, France)press conferences on various issues. On issues related to
global health, on July 7, the first day of the Summit, NGOs

These activists worked in cooperation with Japanese civil

gave a briefing on central issues within global health. On

society working on issues of HIV/AIDS and global healthJuly 9, another press conference was held on NGO

to analyze the documents that came out of the G8 Summit

evaluation of the Toya-ko Framework for Action.

and

in

the

creation

of

civil

societystatements.

Furthermore, these activists has furthered their interaction
At the press conference, the NGOs used a "report card" towith other activists working on global health issues, as

evaluate the results of the outcome documents of the G8.

well as activists from Global Call to Action Against (GCAP),

NGOs working on global health issues chose 10 major

which is an world wide alliance campaigning in the fightagenda items within global health, and on each issue,

against poverty. Thus, IMC has also provided thegave a grade of A, B,C, D and F. The media had highly

opportunity to bring together and create connections

praised the creation of this report card, resulting in 10

among activists working on various issues from all overminute news coverage on Japan TV and NHK (see Ref.

the world. Final Statement of civil society working on

12, Page 76).

global health (See Ref. 13, Page 77)

In relation to HIV/AIDS, the following are the names of

The results of the G8 Toya-ko Summit are attached in Part

overseas civil society activists that have participated in the

I.

International Media Center:

☆

☆

☆

------------------------------

with other events including Indigenous People’s Summit,

11. Alternative Summit

World Religious Leaders Summit, G8 Women’s Rights
Forum, Peace Walk and much more.

The alternative summit has its roots in the 2005 G8
society

The People`s Summit was organized by GCAP Japan,

organizations. Since then, alternative summits have

who also served as the secretariat since the early stages

become more organized and increased its impact.

of the G8 process.In the case of Japan, there was several

Alternative summits are held coinciding to the dates of the

motivation behind holding a summit. Many guests, both

G8 summit in a location close by. This includes

national and international will gather in Japan, and as the

symposiums, round table discussions, and break out

civil society of the host country, there was a need for all

sessions such as skill building workshops. Participants

these guests to gather and speak, debate and campaign

largely include members of civil society with a sparseon issues or speak out against having the G8 summit. It

number of interested local citizens, government officials

provided a peaceful arena in which guests and civil

and members of the media.

society organization can make a forward moving politicalsummitin

Gleneagles,organized

by

civil

statement alongside other civil society members.

The

If the alternative summit will take place and how it isalternative summit in Japan was also held under the sortorganized is up to the members of civil society. Thusof obligation or duty to hold the summit as a place fordepends on the will and capability of the civil society

members of civil society can gather.

organizations and groups of the host country to decide themagnitude of the alternative summit. Organizing groups

As to the goal of this summit, was to create a place where

include those that are interested in a certain issue or

civil society with different perspectives from overseas andthose who call for the end of the G8.

national civil society members can have a place to meetand provide a creative and independent input of the G8.

The People’s Summit took place from July 6-July 8,

The alternative summit is a place where they can discuss

mainly at the Sapporo Convention Center in Sapporo,“alternative” ideas or go against even holding the G8. It

Hokkaido, 60 miles away from where the G8 leaders were

has also created a place where they can create the voice

meeting. The People’s Summit is part of the Sapporoof the Civil society and provide clear and innovative

People’s week on G8, taking place from July 1- July 10,

policies in the backdrop of the actual G8 leaders failure toPART III35

HIV/AIDS AND GLOBAL HEALTH: THE G8 GUIDEBOOK

have forward moving policies and speak about real

Declaration. The media was also able to pick up on thesolutions to the current problems faced by the rest of theintelligence and the organization of civil society, and civil

world. This was well picked up by the media, which havesociety was able to receive a good coverage and goodthemselves notice the lack of initiatives coming out of theimpression by the media.

actual G8 – and paid attention to the civil society which
was able to come up with ideas and policies that are real

In specifity of the HIV/AIDS and other global health issues,

solutions or settlements to the current issues such as theNoireene Kaleeba, board member of Action AID and thefood crisis, global health, and problems associated withfounder of TASO (The AIDS Support Organization) based

financial speculationin Uganda. We used our extensive network, held several
symposiums including Tackling HIV/AIDS issues: From

As to the outcome of this meeting, the Sapporo

Africa to the G8 Summit, which also included civil society

Declaration,(Seegroups based in Hokkaido. As well in a related event

http://www.g8ngoforum.org/english/2008/07/sapporo-decl

called the G8 Women Rights Forum Part 2: Women in thearation-global-voi.html ) which was a declaration that

World Speak Out, Noireene spoke that without thecompiled the issues and policies that the G8 must commit

protection of women and girls rights, Universal Access

to, written and endorse by the participants of the G8

andsummit. The alternative summit was able to come out with

unattainable.

theMillennium

Development

concrete and realistic outputs such as this Sapporo

Civil Society Symposium on HIV/AIDS at the People’s Summit 2008:
Ms. Noeline Kaleeba and Ms. Sara Paterlini

Goals

will

be

36 PART III

HIV/AIDS AND GLOBAL HEALTH: THE G8 GUIDEBOOK

Epilogue:果

apparent that the G8 countries on their own cannot

Civil Society and the G8 Process: The
Creation of an Institutional Memory

govern the global economy and politics. Sooner or later, it

The G8 Process is a year long policy-making andWe, the civil society should prepare for the expansion ofdecision-making process. To influence this process, civilsociety has to strategically work with appropriate
diciplines, as well as focusing on mid and long-term goals.
Unfortunately, the history of civil society advocacy in the
G8 process has been short and sometimes lacking the
preparation necesary to approach the G8 with deep
consideration of its importance and complexity. As a result,
Civil Society’s approach to the G8 was filled with many
"trials and errors".

is almost with certainty that we can say that the G8 will be
expanded to become the G13.

the G8. Civil societies of G8 countries should strengthen
its relationship with civil societies of the G5 countries.
Furthermore, it is necessary to reform the current
structure of civil society, which has been dominantly leadby civil society of western countries.
Japan is currently the only member of the G8 that is not
located in Europe or North America. The Toya-ko Summit
held in Japan was an important "test-case" for theThis "Guidebook" was made as a starting point in thecreation of an "institutional memory" of civil society
advocacy in the G8 process for it to be used for further
advocacy work towards the G8. We hope that this bookwould be an important resource for civil societies working
to futher the global health agenda in the G8 throughadvocacy.

expansion of the G8, considering that the G5 countries
are dominantly non-European and non-North American.
The same can be said about Japanese civil society, whichfunctions much more differently then civil society of otherG8 countries. Japanese civil society made a large effort totake the responsibility in leading the G8 and global civilsociety throughout the G8 process. The G8 and global
civil society recognized and supported the initiatives taken

We must recognize that the G8 is a process involving
drastic changes. For example, some G8 countries,
including continental European countries and the UK,
have been proposing to invite the G5 governments (Brazil,
China, India, Mexico and South Africa) to the existing G8process. Japan has strongly resisted there inclusion, but
the current economic and political situation makes it

by Japanese civil society.
We truly hope that civil society can use our experiences todevelop a greater global civil society movement to tackle
global issues. The movement must be transparent,
democratic and open to all civil socities working to createa more democratic, sustainable and people-centeredworld.

G8 Follow-up Workshop on July 10, 2008

Reference Page 37＜Ref.1＞ Civil Society Statement on PM Fukuda’s Speech in Davos （January 26, 2008）38＜Ref.2＞ A Civil Society Proposal for the Toya-ko Common Framework （February 4, 2008）

42＜Ref.3＞ NGO Presentation in the Global Health Experts Session （February 18, 2008）

48＜Ref.4＞ Civil Sociey Statement for Africa Partnership Forum（April 7, 2008）

51＜Ref.5＞ Japanese and African Civil Society Joint Statement on Global Health and TICAD (March 1, 2008)

53＜Ref.6＞ TICAD Fails to Address HIV/AIDS in Africa （May 29, 2008）

56＜Ref.7＞ Global Health Priorities for the Civil G8 Dialogue （April 24, 2008）

57＜Ref.8＞ Recommendations for the Hokkaido Toya-ko G8 Summit Communique（June 14, 2008）

59

rd＜Ref.9＞ Action Alert for the 3 Health Experts Meeting（June 8, 2008）

62＜Ref.10＞ We can no longer wait: Joint Statement on Global Health （June 23, 2008）

67＜Ref.11＞ Take the Leadership in Listing all Travel Restrictions for PLWHA （July 1, 2008）73＜Ref.12＞ Score Card on Global Health, Hokkaido Toya-ko Summit （July 9, 2008）74＜Ref.13＞ Final Press Release from Civil Society

75（July 9, 2008）

Reference Page 38＜Ref.1＞ Civil Society Statement on PM Fukuda’s Speech in Davos （January 26, 2008）<Alert>Prime Minister Fukuda Declares a “Participatory Approach” ー including
Civil Society and NGOs ― in Preparation for the Toya-ko Summit〜 Calling for Concrete Policies and Action for Global Issues〜
2008 G8 NGO Forum: Poverty and Development Unit
For any questions or comments, please contact:
Poverty and Development Lobby Team Leader: Masaki Inaba
Africa Japan Forum2nd floor, 1-20-6 Higashi Ueno Taito-Ku, Tokyo 110-0015 Japan

1.
2.

■OVERVIEW■
We welcome the declaration by Prime Minister Fukuda at the World Economic Forum to actively work to tackle such global
issues as climate change, African development, and to ending global poverty ahead of the Toya-ko Summit.
We praise the call by the Prime Minister for a "participatory approach", which includes members of civil society and NGOs.
With this acknowledgement, civil society calls for the need for a more concrete policy, and notes the following points (bytopic):A) Gender and Women: Concerning the absence of a follow-up to women and gender issues highlighted at the 2007 G8
summit in Heilgendamm. We call upon the Prime Minister to take the leadership on this issue.
B) Global Health: Although we welcome the Prime Minister for taking leadership on health system strengthening, it isessential to continue and develop the fight against infectious diseases such as AIDS, Tuberculosis and Malaria. In order
to attain results, we need to increase financial contribution, starting with concrete financial commitment to the Global
Fund.
C) Education: We welcome the Prime Minister for bringing forth basic education as one of the agenda items. Yet, it is vitalto understand basic education as a human right, and Japan must have a comprehensive measure to achieve education
for all.
D) Africa: Imbalanced trade and economic policies is hindering Africa from true economic independence, thus Japan
should take the leadership, as the president of this year's G8 summit, to part ways with such policies and to create
measures to tie microeconomic aid to macroeconomic success.
E) Climate Change: Call for the introduction of a midterm target on CO2 emissions at an early stage. Furthermore, we callon concrete financial aid through multilateral frameworks to developing countries that will most likely be the greatest
victims of the climate change. ODA will not be the source for this fund, but from an alternative source.
F) Global Economy: Speculation money has shaken the global finances, causing a sudden rise in such commodities as oiland threatening the cost of living. Thus, we call for higher restrictions of speculative money.

On the occasion of the Annual Meeting of the World Economic Forum, a special address was made by Prime Minister Yasuo Fukuda,
expressing the Japanese position for the G8 Hokkaido Toya-ko summit.
Prime Minister Fukuda brought forth current global issues such as climate change, health, education, water, and Africa.
Furthermore, unlike previous governments, he has called on a “participatory approach”; this will include participation from different sectors ofsociety including NGO’s. We, the 2008 G8 NGO Forum Poverty and Development Unit welcomes and highly praise these points.
However, not only does the Prime Minister’s statement lack concreteness, but also lacks clarity in how Japan can work in cooperation orprovide additional support to current multilateral agreements and initiatives by developed countries. It is essential for Japan to contribute toReference Page 39
strengthen current global actions. With less then half a year left until the G8 Summit, the ability of the political strength and the ability tocreate policies will be tested.
Furthermore, the Prime Minister made no reference to gender and women, an issue that was highlighted at the 2007 Heillengendum summit
by an initiative from Chancellor Merkel. We cannot talk about climate change, global health and African Development, without the regard togender. Prime Minister Fukuda has shown his deep understanding and developed strategies in population; thus, we look forward to him
taking on the leadership.
We, the G8 NGO forum, will answer the call from the Prime Minister for the “participatory approach”, and within the limited remaining time, tohelp create policies and strategies for the global issues. An evaluation by Japanese civil society is highlighted below, according to the topic
issue.

■Global Health: From Plan to Action - Scaling Up is Vital■
Prime Minister Fukuda brought forth current vital issues concerning global health, emphasizing on the high maternal and childmortality rate and the shortage of healthcare professionals in developing countries, and promised to construct an action plan to
improve the entire health system. Furthermore, it called on the participation of all stakeholders, including NGO's and civil society. We
not only welcome the Prime Minister for raising these current global health issues, but we would also like to answer the call by thePrime Minister by actively participating on the decision making and execution of a global action plan.
Despite Prime Minister Fukuda praising the progress on the fight against infectious diseases since the Okinawa summit, we are still inthe midst in the fight against infectious diseases such as malaria, Tuberculosis and HIV/AIDS. Currently, there are still six million
people dying of these three major infectious diseases every year. Maternal and child health, health system strengthening andinfectious diseases are all interrelated issues. We ask to integrate these various aspects of health and call for an overall increase infunding for global health.
Prime Minister Fukuda promised an action plan, but the ability to carry out this action plan depends significantly on sufficient funding.
Japan has embodied the idea of “human security” and has the technology and experience to improve maternal and child health and tofight Tuberculosis. But even then, it will be impossible for Japan to create results in health without increasing qualitative andquantitative investments into health. We strongly urge the Prime Minister to take the leadership in the strengthening the overall ODA
budget, including dramatically increasing the Japanese contributions the Global Fund and to make a clear commitment to global
health ahead of the Toya-ko Summit.
■Education: Creating a comprehensive action plan for "Education for All"■
We welcome the declaration by Prime Minister Fukuda to make education as another key issue in the Toya-ko G8 summit. However,as civil society, there are three points to which we raise our concerns:
The Prime Minister proclaimed, "For all people and all nations, education is the basis for engendering self-reliance and development".
Albeit, before we can speak of education as a basis for development, there is a need to strongly emphasize education as a basic andfundamental human right. The current statistic of 72 million children unable to attend school and 800 million adults unable to read andwrite is an issue in it of itself. Vocational training and higher education cannot be attained without basic education attained throughprimary education and adult literacy.
Secondly, Prime Minister Fukuda declared, "In order to achieve the Dakar Education For All goals, which aim at the expansion ofhigh-quality basic education, it will be necessary to strengthen international collaboration", however it is imperative to create concretemeasures and strategies in which to achieve this goal. According to the 2007 Heiligendamm Summit communiqué, all G8 countries
agreed to fill in the 500 million dollar deficit in order to achieve the EFA fast track initiative, the mechanism used to achieve the Dakar
Education for All goals. The Japanese government needs to be concrete on how far they are willing to commit for the achievement ofReference Page 40
this goal.
Finally, there is a similar situation in education as Prime Minister Fukuda described of the severity of human resource shortage in thehealth sector. UNESCO warned that there is a shortage of 18 million teachers if we are to achieve the Dakar targets. Ahead of thesummit, the Japanese government must declare an increase in their financial commitment to education such as the salary of teachers
and textbook fees.
■Africa: For leadership in creation of a system towards a truly independent Africa■
We welcome the principle of Prime Minister Fukuda's declaration that Japan will play a leading and essential role in the developmentof Africa in the 4th Tokyo International Conference on African Development (TICAD) and the Toya-ko G8 summit.
On the development of Africa, Prime Minister Fukuda emphasized on the principle of "self-help, and on the importance of international
cooperation to support the economic growth and private investment in Africa. However, in reality, Africa's true economic
independence has been hindered and prevented by excessive economic liberalization and unfair trade that are advantageous fordeveloped countries, all which are forced upon by policies of the international community, led by G8 countries. Japan must take theleadership for the international community to part ways which such tendencies; and to aid in the construction of a system that will leadto a truly independent Africa.
African nations are moving towards true independence through their own initiatives, such as the formation of the African Union andthe strengthening of inter-regional mechanisms. Furthermore, an extremely active civil society exists in Africa. Japan should promote
the participatory approach, including the civil society, on the matter of development of Africa.
As examples of the Japanese contribution of African development through “One Village, One Product Movement”, Prime Minister
Fukuda brought forth the local manufacturing in Tanzania of long term insecticide treated mosquito nets Oriset, which plays an
extremely important role in the fight against Malaria, and the production of Shia butter in Ghana. These are truly important
contributions of Japan. However, integrated strategies to scaling up these micro level aids are essential to the economic and social
growth in Africa. Furthermore, it is important to create environment in which people in Africa can live a full and prosperous life throughending poverty and hunger, and securing access to health and education. Japan needs to take the lead and show its concretecommitment to the achievement of the Millennium Development Goals in Africa for the TICAD and the Toya-ko G8 summit.
■Climate Change and Poverty: CO2 emissions reduction and supporting developing countries - early and concrete support■
1. CO2 emissions reduction
We welcome the intention of the Prime Minister Fukuda in his declaration to achieving emissions reduction targets. However,declarations such as "The target could be set based on a bottom-up approach by compiling on sectorial basis energy efficiency as ascientific and transparent measurement and tallying up the reduction volume that would be achieved based on the technology to be inuse in subsequent years" and "base year should also be reviewed " raises our concern because it hinders setting early goals. In orderto achieve the long term goal of "halving the green house gas emissions by 2050" which was declared at the Heiligendamm Summit,
mid-target goals such as a target reduction of 30% by 2020 is essential at the earliest time.
2. Aid to developing countries
In recent years, developed countries are showing intentions of supporting climate change measures in developing countries. We
welcome the Japanese government on having this intention as well. But Japan has yet to shed light on the details of this funding
mechanism thus we have outlined what is necessary for Japan to fully show their leadership.
A)

Neither the current ODA budget nor the increase in the ODA budget to reach the 0.7% of GNI target should be thesource for this fund, and instead secure an additional source for funding. Any additional increase in the ODA budgetReference Page 41

B)

C)

D)

is essential for the attainment of the Millennium Development Goals, and should not be used for the climate change
measures created by developed countries.
Requires security that international aid will be distributed on the basis of need, used efficiently and effectively, andmaintain transparency and accountability. This will require a funding flow through multinational frameworks such as
the Least Developed Countries Fund and the Adaptation Fund managed under the United Nations Framework
Convention on Climate Change.
On measures to combat climate change, policies of developing country governments must reflect and draw thevoices of local communities, for they best know their needs and strategies. Conditionalities that will hinder theprocess of carrying out these policies will not be placed.
To hold a consultation which will be all inclusive (including civil society organizations and representatives from poor
communities which are most affected by the climate change), and adequate time must spent on this consultation.

■World economy: Responsibility of starting restriction of speculation money■In the backdrop of the sub-prime mortgage loan problem and with the shake in the financial market, the "risk of the global economy
taking a downward turn is increasing." As a result of this speculation money, there is a sudden increase in the price of commodities
worldwide, including rapidly rising price of food and energy. Those already living in poverty in developing countries are sinking deeper
a lower level of poverty. Before we "engage in discussions on the state of the global economy and financial markets", we must takethe responsibility as one of the developed countries to restrict the trade of speculation money, which has caused this world economic
destabilization.

END

Reference Page 42＜Ref.2＞ A civil society proposal for the Toya-ko Common Framework （February 4, 2008）
February 4, 2008
Global Health Committee, 2008 G8 Summit NGO ForumThe Common Framework for Action in Global Health:
Input from the Global Health Committee

Contents
1. On the Goal-Specific Approach
1) MDG 4 and 5, Maternal, Newborn and Child Health (MNCH) and Reproductive Health2) MDG 6, HIV/AIDS, Tuberculosis and Malaria
A. HIV/AIDS
B. Tuberculosis
C. Malaria
2. On the Comprehensive Approach, including Health System Strengthening (HSS)
3. Strengthening Research and Development (R&D) in Global HealthAppendix: Conceptual Map: Health System, MNCH and Infectious Diseases
The recommendation was written by World Vision Japan and JOICFP (1), Research Institute of Tuberculosis/Japan
Anti-Tuberculosis Association/Results Japan (2A), Africa Japan Forum (2B, C), OXFAM Japan (3), IAVI (4A, B, C).

1. On the Goal-specific Approach
1) MDG 4 and 5: Maternal, Newborn and Child Health (MNCH) and Reproductive Health
The G8 and other donor countries should:
A. Provide focused support to strengthen the capacity of health services in rural areas by increasing thenumber of community health workers, midwives and other health personnel and strengthening healthinfrastructure.
B. Support the concept of “continuum of care” proposed by Partnership of MNCH.
C. Integrate and scale up effectively MNCH and RH with interventions for infectious disease, such as
HIV/AIDS, Malaria and TB:
・ reaffirm the 2007 G8 commitment on prevention of mother-to-child transmission (pMTCT), pediatrictreatment, and orphans and vulnerable children (OVCs)
・ Training of midwives with skills on pMTCT・ Utilize the exiting delivery channel of the HIV/AIDS program in community & reinforce home basedcare to provide essential health services.
D. Give more attention and support the midwife-centered approach in order achieve strengthen MNCH
package programs. The advantages of midwife-approach include:・ Midwives function as a “hinge” of bottom-up approach and top-to-down approach・ Less costly than training medical doctors
・ More likely to stay at their community than nurses (role and function of midwife are limited)
・ By placing midwife (usually women) in the community, women in the community have easier and better
access to MNCH serviceReference Page 43

The Government of Japan is encouraged to:・ Review 60 years of experience to promote MCH/FP in Japan and make full use of lessons learnt to
HSS (e.g. prioritization of programme and community health workers and village volunteers)
・ Consider the high prevalence of HIV/AIDS in Africa, in applying Japanese experience. Make special
attention to OVCs, children who has no mother2) MDG 6: HIV/AIDS, Tuberculosis and Malaria
A. Tuberculosis
International collaboration efforts are key to success of the TB control within the integrated public healthstrategies. It is important to be reminded that Health System Strengthening and community empowerment
within normative community DOTS approaches are reckoned as priority objectives under the STOP TB
partnership at global level.
i) G8 and other donor countries prospective contribution for TB control
・ Commit to the target of halving TB prevalence and mortality as well as TB/HIV co-infection and drug
resistant TB in line with the ‘Stop TB Partnership Global Plan to Stop TB’ and ‘Global MDR-TB and
XDR-TB Response Plan 2007-2008’.
・ Sustain strong commitment to reduce TB and HIV burden in Asia and African countries through TB andHIV control programs.
・ Strengthen health system through improving TB and HIV/AIDS control programs, integrated into
primary health care services.
・ Empower patients and the communities to fight against TB, HIV and other infectious diseases.

ii) Japan’s prospective contribution for TB control
By drawing upon the outstanding outcomes of TB control programmes that proved drastic reduction of TB
burden in Japan, it would be recommended that the government of Japan to express its willingness to achievea clear objective within global TB control efforts with launch of “STOP TB Japan Initiative” which aims to save
10% global TB deaths (160,000 lives a year) as well as benefiting world's TB patients (9 million per year).
The areas of activities may be expanded as follows:・ International TB and HIV/AIDS symposium to call on high level political dialogue and review the
progress towards the goal and share future strategies to reduce these high mortality-diseases.
・ TB control projects with an integrated approach incorporating HIV/AIDS programme, community
participation and capacity building, IGA, MCH (PMTCT), food and nutrition.
・ Capacity building of community health workers and voluntary care givers and sustained active
participation of people to the while project cycle.
・ Operational research to identify problems and solutions and to promote human resources
development.
・ Strengthened laboratory facilities and training of staff to diagnose TB/HIV and MDR/XDR-TB
effectively.
・ TB prevalence surveys to measure burden of disease and accurately monitor its trend.
・ Development of new drugs for effective diagnosis and treatment of TB including MDR/XDR-TB andsafe treatment for PLWHA receiving HAART.
・ Bilateral assistance under the current schemes e.g. JICA grant projects or technical assistance by TB
trained experts.
B. HIV/AIDS

Reference Page 44
1) The G8 and other donor countries should reaffirm the G8 commitment at the Saint-Petersburg Summit in2006 to achieve universal access to HIV/AIDS treatment, prevention, care and support by 2010, andimmediately create a plan to achieve the 60 billion USD pledge made at the Heiligendamm Summit in
2007.
2) The G8 and other donor countries should recognize the importance of Integrated approach and・ Develop and scale up integrated programs of HIV/AIDS and income generating activities,
micro-finance and farming to improve quality of life of PLWHA
・ Develop and scale up integrated programs of management of TB/HIV co-infection, including
strengthening linkage of VCT and TB detection
・ Develop and scale up integrated programs of maternal care, VCT, care of OVC, recognizing thatmaternal care services are also the entry point of prevention, care and treatment of HIV/AIDS, TB and
Malaria for women and children
・ Develop integrated programs of HIV/AIDS and gender, in recognition that gender equity andabolishment of harmful customs for women's health and property rights are essential for HIV/AIDS
prevention, access to care and treatment
3) On care, support and treatment, the G8 and other donor countries should:
・ Ensure predictable funding and capacity development of community health workers andcommunity-based organizations, and strengthen the capacity of local health authorities to manage
care/ support work on HIV/AIDS・ Integrate care and support for HIV/AIDS with care for other chronic diseases in the home-based careat the grass-roots level
・ Strengthen capacity and supply of community level health facilities, and referral systems
・ Expand access to treatment at the health centers at the grass-root level in the countries of generalized
epidemic, by supporting the capacity building of local health workers
・ Expand access to second-line ARV and make every effort to reduce its price to affordable andaccessible level in low-income countries
・ support the capacity development of community organizations working with and for PLWHA to improveadherence to treatment and strengthen the efforts of improve treatment literacy4) On prevention, the G8 and other donor countries should・ Support expansion of existing prevention programs such as condom education and procurement,
Information, Education and Communication (IEC) and Behavior Change Communication (BCC)
programs
・ Support those programs that promote gender equity and teach negotiation skills.
・ Pay special attentions to prevention in the communities of vulnerable groups in the countries ofconcentrated epidemic, including harm reduction programs.
・ Pay special attentions to mobility and HIV/AIDS with respect of human rights of migrants, especially
their rights of travel and residency
・ Further invest in development of new preventive technologies, such as vaccines and microbicides.
5) The Government of Japan is encouraged to:・ Reaffirm its commitment to HIV/AIDS treatment, and expand its programs to include support for
improving treatment literacy in community-based groups, technical assistance to monitor drug
resistance level, and provide necessary infrastructure and supplies for treatment.
・ Increase support for JOCVs for AIDS with more strategic and integrated plans to linkage community
work on HIV/AIDS, income generating activities and rural development.

Reference Page 45
C. Malaria
1) On prevention, the G8 and donor governments should:
・ Expand support to provide long-lasting insecticide treated nets (LLITN) and other preventive tools
・ Integrate malaria prevention as one of the components of climate change adaptation program, inrecognition of the threat of malaria in humanitarian situation caused by natural disasters such as floodand drought2) On treatment, the G8 and donor governments should:
・ Expand access to Artemisinin combination therapy (ACT) by improving procurement and supply of
ACT・ Expand access to rapid test kits for malaria detection in order to provide appropriate and effective
malaria treatment
・ Develop infrastructures for transportation and better communication, such as mobile phone network inrural areas to ensure urgent treatment of malaria in rural setting.
2. On the Comprehensive Approach, including Health System Strengthening (HSS)
1) The overarching principles:・ Global health is a critical issue on the global development agenda.
・ Strengthening of public health system is at the heart of equitable achievement of health-related MDGs.
・ Vertical, disease-specific measures and horizontal, cross-cutting measures should be effectively
integrated.
・ No new or separate health administration or organization is to be created to implement verticalprogrammes.
・ The G8 governments should increase the overall international funding available, rather than simply
reallocating the already committed resources, by fulfilling the Gleneagles commitments on aid and debt,
and announcing a timetable towards achieving the UN target of 0.7% GNI.
・ The G8 governments will further harmonise and coordinate aid among donors and overcome theburdens on developing country governments associated with reporting obligations and procedures, inways that respect the spirits of the Paris Declaration on Aid Effectiveness.
・ The G8 is committed to supporting, in a coordinated, long-term and predictable manner, one national
health sector plan, formulated, prioritised and budgeted by the national government itself in effective
consultation with relevant civil society organisations and community representatives.
・ In order that the national plan is truly owned nationally and not driven by donors, and that it isdelivered as planned, the G8 shall also support the policy advocacy work of competent civilsociety organizations so that they can effectively engage with the formulation andimplementation of the policies at the community, municipal as well as the national levels.
2) Some specific measures to establish and strengthen a comprehensive health system in developing
countries include:A) Expanding the scale and improving the quality of public health system
・ The training, recruitment and retention of the 4.25 million missing health workers (doctors, nurses,
midwives, medicals, and community heath workers) which needs to be invested in through long-termand predictable budgetary support as well as increased mobilisation of domestic resources. This
includes:Creating a favourable environment for women providers to stay and work in rural areas.
・ Appropriately integrating in this human resource strategy the workers/providers being trained andsecured through disease-specific measures such as DOTS for Tuberculosis and home-based care
workers for HIV/AIDS.
・ Mitigating some of the international “pull” factors of brain-drain by regulating the domestic health sector

Reference Page 46
recruitment practices in the G8 countries.
B) Ensuring universal access for the poor, particularly women, by making it affordable (which means making it
free of charge at the point of use in low-income countries)C) The need to strengthen and expand the relevant supplies and logistics (e.g., drug procurement for
HIV/AIDS and malaria treatment), some of which should continue to be supported by disease-specificinitiatives/funds, such as the Global Fund.
D) In order to ensure sufficient and timely flow of essential medicines, developing country governments need to
be guaranteed the right to use the flexibilities contained in the WTO’s TRIPs agreement and the G8 muststop the pursuit of stricter control on intellectual property rights in their bilateral and regional trade
agreements with developing countries.
E) Addressing the specific needs of different geographic settings (urban and rural) and different demographic
groups.
F) Putting appropriate infrastructure and referral systems in place.
G) Placing due emphasis on education and prevention.
H) The degree to which national plans target women whose conditions as users and providers must be
improved.
I) Management experts (planning, implementation, monitoring/evaluation, coordination, etc) are to be involvedfor HSS.
J) Effective HSS has to be done hand in hand with technological innovation. (Introduction of IT into healthadministration including surveillance, information dissemination and prevention of outbreak of newly
infectious diseases).
K) The G8 shall advise international financial institutions not to impose policy conditionalities that continue tohinder developing countries’ efforts to achieve MDGs.
L) The G8 governments should fully support WHO’s “Treat, Train, Retain” to strengthen national healthsystems.
3) The Japanese government is encouraged to:・ Introduce sector-based aid budgeting so that Japan’s contribution to health system strengthening
becomes clear, and the downsides of single-year budgeting of aid are eliminated.
・ Start and expand support for the recruitment of local health workers, in addition to training existing
personnel.
・ Assess the impact on the countries’ health sector budget by the repayment of past yen-loans, andcancel or reduce the debts that undermine the efforts to achieve the MDGs.
・ Exercise its influence on the policies of international financial institutions against imposition of policy
conditionalities such as the privatisation of the health sector.
3.

On Strengthening Research and Development (R&D) in Global Health

The overarching principles:・ Investment in R&D for better tools to fight diseases of poverty, such as vaccines, new drugs anddiagnostics, are critical in reaching the health-related MDGs
G8 and other donor countries should:
・ Help to build R&D capacity in developing countries by investing in training and health infrastructure;
・ Provide more incentives for domestic researchers and industry to foster innovation for better tools tofight diseases of poverty;
・ Promote productive research partnerships among G8 countries as well as with developing countries;
・ Fully participate in existing mechanisms such as Advance Market Commtiments (AMCs) and others,
which are designed to promote R&D for global health;・ Increase its support product development public-private partnerships (PDPs) working in the areas ofdrugs, vaccines, diagnostics and other tools to fight the diseases of poverty.

Reference Page 47

The Government of Japan is encouraged to:・ Create a mechanism/vehicle to bridge Japanese innovation and R&D and global R&D efforts in global
health: such inter-ministerial mechanism would provide more funding for basic and applied R&D for
diseases of poverty; create a more enabling policy environment for R&D (de-regulation withoutcompromising safety); and foster global partnerships with developing countries and otherindustrialized countries;
・ Specific examples of Japanese support can include on-going R&D efforts in TB and HIV/AIDS, towhich Japanese scientists are already making contribution: Anti-TB Drugs, New Diagnostics Drugs,
and HIV/AIDS vaccine.
・ Participate in future AMC or other innovative funding mechanisms to foster R&D for global health.

Reference Page 48
Appendix: Conceptual Map: Health System, MNCH and Infectious Diseases

MNCH

and

Goals, Targets One technically sound national plan for HSS madeby national ownership with participatory manner,and Plans
including civil society and donors

DiseaseSpecific

Human
Resources

Doctors, Nurses, other medicals and community
health workers
Training, Recruitment and Retention

ApproachcanClear policy to stop brain-drain

Favorable
Environment

Security for medical staffs and community workers,
especially for female medical service providers inrural and urban poverty areas

strengthen

Respect from Communities
Appropriate salaries

HealthSupplies

Procurement of drugs and commodities
Global Mechanism of supply in affordable andSystems

accessible prices

Infrastructure Community level health centers with appropriate
andreferral trained staffs and supplies, integrated with
community health activities
systemeffective referral hospitals in local, provincial andnational level
Strong TB management system (DOTS)

Integration
with
Community
HealthActivities

Involvement of community health activities, such ashome based care of PLWHA
Integration

withpromotingprevention

sanitation etc.

communityofmobilization

infectiousfordiseases,Reference Page 49＜Ref.3＞ NGO Presentation in the Global Health Experts Session （February 18, 2008）

Global Health Advocacy
from Japanese Civil
Society

Japan 2008 G8 Summit NGO Forum:
The Uniqueness and Structure•••

Established: January 2007 (1 year and 2 months old)
Members: 112 NGOs working on global issues
Coordination Mechanism for broad, effective and integrated advocacy
from civil society to the G8 Summit; the first NGO coalition with wide
scale to deliver policy recommendation from civil society to G8

112 NGOs

Delivering Policy Recommendations
as One Voice for TICAD IV and G8

Poverty andDevelopment Unit

Masaki Inaba
Chair, Global Health Committee
Japan 2008 G8 NGO Forum

Peace andHuman Rights Unit

Global HealthCommittee (14 NGOs)

１

２

Global Health Committee: Delivering
Comprehensive Global Health Policy
Recommendations*14 NGOs working on various issues on global health*Civil Society has worked to put forward a comprehensive set ofrecommendations for global health: “Overall Scale Up of
Investment for Health”*Advocacy in open and constructive manner

Civil Society Position Paper on Health (September 2007)

Achieve allallthetheexisting
existing pledges,
pledges, goals
goals andandtargets!
targets!
Achieve
ReduceChild
ChildMortality
Mortality(MDG4)(MDG4)
ReduceImproveMaternal
MaternalHealth
Health(MDG5)(MDG5)
Improve*ToG8:G8:*To*ToG8:
G8:*To-significant integrated approach-significant integrated approach
withMaternal
Maternalhealthhealthimprovement
improvementwith- Achieve the ICPD Programme of- Achieve the ICPD Programme of
Action(Universal(UniversalAccess
Accesstoto
Actionreproductivehealthhealthservices)
services)
reproductive-scale up the fight against-scale up the fight against
infectiousdiseases
diseasesamong
among
infectious
childrenchildrenrealizegender
genderequity,
equity,eliminate
eliminate- -realize
gender-based violence, response togender-based violence, response to
the feminization of HIV/AIDS
the feminization of HIV/AIDS*ToGoJ
GoJ*To*ToGoJ
GoJ*To-Cooperation with Developing-Cooperation with Developing
Countries to make sustainable
Countries to make sustainable
immunizationprograms
programs
immunization-Japanese leadership with past
-Japanese leadership with pastexperiences
experiences

Principles
Keep the Promises
Overall Scale up of healthinvestment

MNCH (MDG4 and 5)
Infectious Diseases(MDG6: HIV, TB and
Malaria)
Health System
Strengthening

Comprehensive
PolicyRecommendations
Package

Universal Access of Basic
Health Services

Policy Consultation
Proposing appropriate
policy recommendation for
specific issues on health- To increase funding for UNFPA and- To increase funding for UNFPA and
IPPFtotothe
thelevellevelofofthetheyearyear2000
2000
IPPF- More involvement of NGOs for aid- More involvement of NGOs for aid
relatedMDG5,
MDG5,based
basedon
onJapaneseJapanese
relatedexperiences on MNCH
experiences on MNCH

Barriers

Discriminationand Stigma
Lack of
Political will

Vulnerable
Populations*ToGoJ
GoJ*To- Sustainable and predictable funding for- Sustainable and predictable funding forthe fight against HIV/AIDS, TB and Malaria
the fight against HIV/AIDS, TB and Malaria- deliver the services to the most needy- deliver the services to the most needy
population
population

HealthSystem:
System:foundation
foundationto
toovercome
overcomeglobal
globalhealthhealthchallenges
challenges
HealthLack of Political Will
and Commitment tofight HIV/AIDS, TB,
Malaria etc.

Strengthening
Health Systems
THE MOST IMPORTANT:OVERALL SCALE UP OF
HEALTH INVESTMENT

Disease/Issue
Targeted
Funding inHarmonized
Manner

Disease/Issue
Targeted Approach as
Driving Force for
Scale Up

PULL

Health System
Dysfunctional
procurement
systems
Lack of facilities
And infrastructures

Shortage of
Health Workers

Barriers- Fund the necessary financial resources- Fund the necessary financial resources
based on fair-share manner (the Global
based on fair-share manner (the Global
Fund, GDF, etc.)
Fund, GDF, etc.)- Achieve the Universal Access to HIV- Achieve the Universal Access to HIV
prevention, treatment and care by 2010,
prevention, treatment and care by 2010,
targets of the Plans of TB and Malaria.
targets of the Plans of TB and Malaria.

4

UNHARMONIZEDMASHROOMING INITIATIVES

Patients

*ToG8
G8
*To

GlobalHealth
Healthto
tobe
beplacedplacedhighhighononthe
theG8
G8Agenda
Agenda（Achieved）（Achieved）
GlobalWhat are the Bottlenecks?
Views from Civil Society
Lack oftransportation

CombatHIV/AIDS,
HIV/AIDS,TB,
TB,Malaria
Malariaand
andCombatotherdiseases
diseases(MDG6)(MDG6)other

ToG8
G8Countries:
Countries:Stop
Stopbrain
braindrain
drainand
andretain
retainhealthhealthworkers.
workers.Abolish
AbolishUser
UserFees
Feestotoensure
ensureuniversal
universal
To
accesstotoessential
essentialhealthhealthservices,
services,sector-wide
sector-widebudgetarybudgetarysupport
supporttotosustain
sustainpublic
publichealthhealthsystems
systems
accessTo
GoJ:
financialandtechnical
support
not
only
for
trainingbut
also
retainingandcreateenvironment
To GoJ: financial and technical support not only for training but also retaining and create environment toto
work.Make
MakeJapaneseJapaneseaid
aidpredictablepredictableandandvisible
visible
work.

３

USER
FEES

Environment Unit

Lack of Community Mobilizationsand Grass-Roots Health Activities

Common root causes: poverty, gender inequality, gender based violence, rights violation,
marginalization of vulnerable population, stigma and discrimination

5

PUSH
Budgetary
Conditionalities toprevent national
budget to healthHigh Prices ofEssential Drugs
and Commodities

Human
Resources
Information
Systems
Funding inHarmonized
MannerPUSHStrengthening
Community
Responses(DOTS, HBC, Maternal
Care..)

Infrastructure
Drugs andCommodities

ONE NATIONAL PLAN

6

Full
Involvement ofCivil Society

Reference Page 50

Promoting Integration between
Different Target Approaches:
improving Effectiveness
Infectious
Diseases Control
Community Systems
Strengthening: DOTS andHome Based Care

HIV/AIDS
Access toTreatment

Strengthened
Health Systems
and Community
Response for
Health are theKey

Tuberculosis
Approach theHigh risk of TB
after delivery

VCT and
TB TestManagement of
TB in Children

Child
Survival

pMTCT

IPT

Malaria

Provision of LLITNs
for Maternal Women

Integrated management

Maternal Care

Maternal, Newborn
and Child HealthRemove Barriers to ensure people’s
access for basic health services• Strengthening Public Health Systems• Free/Affordable Access to Essential HealthServices (including Abolishing User Fees)• Remove Barriers of Transportation and Accessto ICT• Free/Affordable Access to Essential Medicines(Utilize Flexibility of TRIPs Agreement and Doha
Declaration)

7

8

Keep the Promises: Achieve the
Existing Goals and Targets
Millenium Development Goals (MDGs)
MDG4: (1990-2015)Reduce by 2/3, Under-5 Mortality Rate
MDG5A: (1990-2015) Reduce by 3/4, the maternal mortality Ratio
MDG5B: (1990-2015) Achieve Universal Access to Reproductive Health
MDG6A:Have halted by 2015 and begun to reverse the spread of HIV/AIDS
MDG6B: Achieve by 2010 universal access to treatment for HIV/AIDS for all who need it
MDG6C: Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases

MDG5-Related Plans/targets
ICPD Plan of Action
Maputo Plan of Action

G8 Political/Financial
Commitments:

MDG6-Related Plans/targets•Global Plan to Stop TB 2006-2015•Global Strategic Plan, Roll Back Malaria
2005-2015•UNGASS Political Declaration on HIV/AIDS•Universal Access to HIV Prevention, Treatment
and Care¾2005 Gleneagles Commitment¾2007 Heiligendamm Commitment(60 Billion to ATM+HSS)

International Commitments:¾Monterey Agreement¾Paris Declaration (Aid Effectiveness)and more…

9

Thank You!!
• Global Health Committee, 2008 G8
Summit NGO Forum– Contact: Masaki Inaba (Africa Japan Forum)– Masaki.inaba@gmail.com, info@ajf.gr.jp– Phone: 03-3834-6902– Fax: 03-3834-6903

11

Delivering One Voice from Civil
Society: towards TICAD and G8
•
•
•
•
•
•
•

March 20-21: TICAD Ministerial Conference in Gabon
April 5-6: Development Ministers Meeting
April 7-8: Africa Partnership Forum
April or May: Civil G8
May 28-30: TICAD
June 10-11: UNGASS on HIV/AIDS
July 7-9: G8 Summit in Toya-Ko

Mobilizing Popular Call for G8
action on Global Health :• Popular Campaign "me too: give everyone a chance tolive": to be launched in March

10

Reference Page 51＜Ref.4＞ Civil Sociey Statement for Africa Partnership Forum（April 7, 2008）

PRESS RELEASE
From the APF Venue
Japan, 7 April 2008
17:24

African and Japanese Civil Society speak to the Africa Partnership Forum in One Voice
Civil society participants from Africa and Japan attending the 10th Meeting of the African Partnership Forum (APF) in
Tokyo have committed themselves to organise and monitor the African development process with a view to holding
international development partners and African governments to account in order to create a peaceful, progressive,
democratic and prosperous continent
The civil society participants urged the APF members attending the meeting which was the themed “Making a Vibrant
Africa a Reality through TICAD IV and G8 Hokkaido Toyako Summit” to take the African continent in the away from thepains and challenges that characterised the continent’s past. They urged the APF not to lose focus in achieving the
MDGs in Africa and Africans international partners use the opportunity to “listen more, to understand more and to learn
how best to support African people as they take ownership of their own development process”.
The civil society participants recognised all the positive developments in Africa such as economic growth andincreasing democracy. They expressed hope that the APF, the forthcoming TICAD IV and G8 Summit can be platforms
for greater partnership and more effective action in addressing Africa’s challenges. They, however, stated that greatercommitment from governments both in Africa and other developed countries would be needed for this to happen. They
recommended the following:a. More urgent attention to be paid to issues of good governance, ensuring that the electoral processes are lessvolatile, free and fair.
b. The international community and development partners to ensure that African constitutions are safeguarded
from modification, especially regarding the elongation of the terms of incumbent governments.
c. Refocus attention on establishing the MDGS as the focal point for poverty reduction and human developmentin Africa.
d.
e.
f.
g.
h.
i.
j.
k.
l.

Mainstream pro-poor growth in all development processes.
Ensure that adequate and predictable funds are provided for activities that will boost economic development e.g. investing in
SME, providing micro and macro finance etc.
Pay more attention to the informal economy as well as agriculture as these represent the bulk of Africa’s ‘real’ economy
Remove the trade barriers and subsidies that continue to stifle and strangle the profits of African agricultural producers.
Invest more in infrastructure and Information Communication Technology to increase the quality of life and economic
activities of the rural people, especially women.
Provide finance for supporting adaptation separate from and in addition to the already-existing commitments for ODA. Funds
should be responsive to the diverse needs at the grass roots level – accessible to civil society partners.
Ensure that development partners in the richer nations keep the promises they made at the Gleneagles G8 summit to scale
up aid.
At all levels, civil society participation, especially grassroots community based organisations should be ensured if the voices
and concerns of the people are to be reflected in efforts to tackle poverty and promote pro-poor economic growth.
Strengthen collaboration and partnership between African and Japanese civil society.

Apart from all the above, the civil society would also like to stress the importance of addressing the plight of African
women as they remain the key to ensuring economic growth, reducing poverty, peace and security and good
governance. The group would like to see a greater participation of women in the political, economic and socialReference Page 52

spheres in a manner that removes the burden that they carry and empowers them to unlock their potential for political,
economic and social leadership. Bineta Diop, who chaired the African Civil Society APF Technical Committee, said
“we will now work to ensure that the issue of gender stays on the agenda”.
Lastly, the civil society called upon the leaders to recognise that structured civil society participation should become
an integral part of the G8 and APF processes. The group asked the leaders to acknowledge that the civil society
comes to the table with technical, contextual and practical knowledge that can help to achieve the goals of the APF.
‘Dapo Oyewole, the Focal Point for African civil society input at the APF said “we will continue to engage APF
members to ensure that the voices and concerns of civil society are heard as our leaders make decisions about our
future”. The African civil society participants said they were willing to work with the leaders to achieve the goals of the
APF but reiterated that they would maintain their independence in the APF process.
- END –For further information contact:’Dapo Oyewole, Focal Point for African civil society
Masaki Inaba, Focal Point for Japanese civil society (2008 G8 Summit NGO Forum)
Toko Tomita, Focal Point for Japanese civil society (TICAD IV-NGO Network)

Reference Page 53＜Ref.5＞ Japanese and African Civil Society Joint Statement on Global Health and TICAD (March 1, 2008)
Joint Statement of African and Japanese Peoples to Urge TICAD Co-organizers to Scale Up
Overall Investment to Fight HIV/AIDS, TB, Malaria, Maternal and Child Mortality, and Strengthen Health
Systems
1st March, 2008
“There will be no stability and prosperity in the world in the 21st century unless the problems of Africa are resolved”-Yoshiro Mori, Former Prime Minister of Japan“Our work as health practitioners needs a leadership that cares for the health and well-being of the people, a leadership thatis always in the front-line of the war against disease, poverty, ignorance and hunger -- the greatest evils affecting our people
and delaying our development.”-Late Olikoye Ransome-Kuti, Former Minister of Health, Federal Republic of Nigeria

We, representatives of African and Japanese civil societies advocating for health, speak with a common voice to theGovernment of Japan and the co-organizers of TICAD IV.
Our voice speaks for representatives of African people living with and/or affected by HIV/AIDS, tuberculosis, Malaria
and other related diseases, and burdened by weak and inadequate health systems. We speak for representatives of peopleof Japan, who are working in solidarity with African civil society, and are concerned with the recent trend of declining
international assistance of the Government of Japan.
We call upon the Government of Japan and the TICAD Co-organizers to:Reaffirm Japan’s political will to achieve Universal Access to HIV/AIDS treatment, prevention and care by
2010, as once pledged by all G8 countries in St. Petersburg in 2006;
Redouble efforts towards achieving the Millennium Development Goals and associated global and African
targets and initiatives on health, which includes but not limited to the Global Plan to Stop TB (2006-2015),
2010 Roll Back Malaria Goals and the Global Malaria Business Plan, the Declaration of Commitment on
HIV/AIDS in 2001 , the Political Declaration in 2006 for the three diseases and also the African Union
initiatives incorporating and complementing global efforts especially the Africa Health Strategy, Maputo Planof Action for Reproductive and Sexual Health and Implementation Plan on HIV/AIDS, TB and Malaria.
Create a clear and strategic implementation plan for health system strengthening, as well as
support country driven initiatives including Community System Strengthening aimed atattaining Universal Access to essential health services, and take the lead in providing thenecessary resources to achieve these targets and goals to realize sustainable essential healthservice delivery globally.
Africa continues to disproportionately carry the heavy burden of health problems due to; but not limited to weak healthsystems and shortage of health workers. Trapped by the political and economic policies of the Cold War era that did nottake account of Africa’s long term development, African countries were unable to develop strong and sound healthsystems to protect the most basic of human rights. The AIDS pandemic which hit Sub-Saharan Africa in the 1990’s, wasalso largely ignored for a significant period, due to “aid-fatigue”, as shown in the declining trend of international aid.
We recognize that TICAD played an essential role during the "lost decade" of the 1990's to facilitate dialogue for
Africa’s development, as well as increasing Japanese aid for Africa, making Japan the top donor of many Africancountries at that time. Furthermore, TICAD created the principle of respecting African ownership. We especially takenote of the Action Plan adopted in TICAD II in 1998, which provided the basis for the Millennium Development Goals.
These are but few evidence of why we, African and Japanese civil society, hold high expectations that the TICAD
process will lead to an improved development process that will truly benefit the people of Africa.

Reference Page 54
The breakthrough of the G8 Okinawa Summit in 2000 has led to a rapid increase in overall investment for infectious
diseases. But it is far from enough, and now in 2008, we still face many challenges. Despite the current myth in global
health experts’ debates that "AIDS is overfunded", only half of the resource required to achieving Universal Access by2010 is available. TB/HIV co-infection is one of the biggest health issues in Southern Africa, where people face the real
threat of an MDR/XDR-TB outbreak that can undermine what has already been achieved. We are now aware that
African health systems have been systematically weakened in the recent two decades.
Despite such conditions, the people of Africa continued to fight the health challenges by strengthening community
responses, giving rise to critical targets such as Brazzaville Commitment on Universal Access to treatment, prevention
and care by 2010 set in March, 2006, in the Republic of Congo. Now it is time for donor communities to do their part byinvesting financial resources to achieve these goals.
In order to achieve sustainable progress on health, there must be an end to the exploitation of health workers from Africa.
Greater efforts and resources are needed to train and retain health workers to ensure the sustainability of African healthsystems to deliver essential health services to the African people.
On their own part, African governments must keep their pledge to allocate 15% of their national budgets to health as
outlined in the 2001Abuja Declaration of the African Heads of States. Overall scale up to the health investment is crucial
to achieving the existing goals and targets, and to create a “vibrant and healthy Africa”.
We, representatives of African and Japanese civil societies believe there are already enough pledges, plans and strategies
and ask for funding and implementation of existing ones. We ask for responsibility and accountability. We thank thegovernment of Japan and co-organizers of TICAD IV for their tremendous efforts and urge them to take theresponsibility to facilitate multilateral dialogues for African development to achieve health-related MDGs which would
ultimately translate to a better world where all the people can have access to essential health services. We can only
achieve this when developed nations like Japan commit to and demonstrate the will to fight HIV/AIDS, TB, Malaria,
Maternal and Child Mortality as well as make a commitment for overall scale up of health investment.
The slogan for TICAD IV is “Vibrant Africa: a Continent of Hope and Opportunity”, but a vibrant and healthy Africa
can only be achieved through responding to the people’s hope and providing real opportunity through increased funding
and implementing commitments to health development.
Signatures
Africa Japan Forum (AJF)
African Council of AIDS Service Organizations (AfriCASO)
African Civil Society Coalition on HIV/AIDS
Africa Public Health Rights Alliance / 15% Now! Campaign
Project RING, Japan AIDS and Society Association (JASA)
Réseau Africain de Personnes Vivant Avec le VIH d’Afrique Centrale (RAP+AC)
CONTACT
Africa Japan Forum (AJF)
Masaki Inaba, Program Director for Global Health
Address: 2nd Fl, Maruko Bldg, 1-20-6 Higashi-Ueno, Taito-Ku, Tokyo 110-0015 JAPANReference Page 55
NGO Signatories
African NGOs
Stop AIDS In Liberia (SAIL), Liberia
World AIDS Campaign, South Africa/Global
MIFRO - Missa~o sem Fronteiras, Angola
Ambassadors of CHANGE, Kenya
ACTWID KONGADZEM, Cameroon
Plate-Forme Associative de Lutte contre le SIDA du Centre, Cameroon
Association BOMOI, Republic of Congo
Malawi Network of People Living with HIV/AIDS (MANET+), Malawi
Reseau National Femme et developpenent, Comoros Islands
Treatment Action Campaign, South Africa
Réseau Afrique 2000, West Africa and Burundi¾ Association Nationale de Soutien aux Seropositifs (ANSS), Burundi¾ AMEPOUH, Cote d’Ivoire¾ Association de Femmes Guinéennes pour la lutte contre les Maladies Sexuellement transmissibles et le Sida –ASFEGMASSI, Republic of Guinea¾ Responsabilite Espoir Vie Solidarite (REVS+), Burkina Faso
¾ Ruban Rouge, Cote d’Ivoire¾ Association African Solidarite (AAS), Burkina faso
¾ Kenedougou Solidarite, Mali
¾ Renaissance Sante Bouake (RSB), Cote d’Ivoire¾ Association de Recherche Communication et Accompagnement a Domicile des Persones Vivant avec le VIH(ARCAD/SIDA), Mali
¾ Espoir vie Togo (EVT), Togo
¾ Mieux Vivre avec le SIDA (MVS), Niger¾ Lumiere Action, Cote d’Ivoire¾ Association Laafi la Viim (ALAVI), Burkina Faso
¾ Alternatives Cameroun, Cameroun¾ Colibri, Cameroun¾ Association des Femmes Actives et SOlidaires (AFASO), Cameroun¾ Association de Soutien et d'Entraide des Personnes Vivant avec VIH (ASEPVV), Tchad¾ Association des Jeunes Positifs du Congo (AJPC), Congo Brazzaville¾ Congrès National des Jeunes Femmes Vivant avec le VIH (CNJFV+), Centralafrican Republic¾ AFASAMAS, Mali
¾ Yeewu-Yeete, Senegal

Japanese NGOs
Space Allies, Japan
Japan AIDS and Society Association, Japan

NGOs Supporting the Statement
International Women's Health Coalition, USA
World AIDS Campaign, the Netherland/Global
Willing Ways Project of Sadaqat Clinic, Pakistan
Global Union AIDS Programme, France/Global
World AIDS Campaign, Global
Positive Malaysian Treatment Access & Advocacy Group (MTAAG+), Malaysia
Caribbean Vulnerable Communities Coalition, Jamaica/Caribbean RegionReference Page 56＜Ref.6＞ TICAD Fails to Address HIV/AIDS in Africa （May 29, 2008）

Press Release May 29, 2008

TICAD Fails to Address HIV/AIDS in Africa
Civil Society: Universal Access by 2010 is key to Human Security
Tokyo International Conference on African Development, brought together over 45 heads of states from Africa
to “provide a road map for support of African growth and development under the TICAD process”, with apriority in ensuring human security. Yet, the Yokohama Action Plan fails to recommit and take action, let alonestate, a key commitment to ensuring human security: the attainment of Universal Access to prevention, careand treatment for HIV/AIDS by 2010.
As the G8 conference is connected to the TICAD process and its outcomes, we call on the Japanese
Government to reevaluate the Yokohama Action Plan, and to take leadership at the G8 Summit:
1. To recommit and provide the necessary support, including finance and technical support to achieve
Universal Access by 2010.
2. To contribute the Japanese fair share to the Global Fund to Fight AIDS, Malaria and Tuberculosis.
3. To ensure that the fight against HIV/AIDS is not limited to strengthening research and prevention, but
to treatment, care and support as well. .
Financial and Technical support necessary to achieve Universal Access by 2010
With 80% of the global AIDS burden concentrated in Africa, G8 countries acknowledged the need to scale up
in the fight against AIDS by committing to Universal Access by 2010 at the St. Petersburg G8 Summit. Yet, theYokohama Action Plan fails to address and to fully support, through financial and technical means, theattainment of Universal Access by 2010. Without addressing HIV/AIDS and the key document that provides
targets and timelines for the fight HIV/AIDS, Africa will never attain the economic, social and political goals.

Funding the FundThe Global Fund to fight AIDS, Tuberculosis and Malaria in the efforts to scale up efforts to fight AIDS as
recognized in the Yokohama Action Plan. Leading to the Japanese Government committing US 560 Million forthe coming few years. Although, we applaud the Japanese contribution for the Global Fund, it still falls far shortof what Japan should be committing as the world’s second largest economy, and based on increasing requests
from countries Global Fund funding.

Access to prevention, treatment and care
Although prevention is key to decreasing the prevalence rate of HIV/AIDS, in areas of generalized epidemics,
such as Sub-Sahara Africa, prevention, treatment and care must all be strengthened. Unless Japan is able toprovide an added value to the aspect of prevention, and cooperate and coordinate with national andinternational partners that work on treatment and care, Japan must go beyond strengthening prevention.
TICAD should have been the first step in showing that Japan will take leadership in securing human security.
Yet the failure to address the need to scale up on the fight against HIV/AIDS, and the failure to ensure thesupport necessary to achieve Universal Access by 2010 has already revealed that Japan has already missed
that first step. But Japan can have this opportunity to show its willingness and responsibility to commit tohuman security though the attainment of Universal Access by 2010 at the G8 Toya-ko Summit.

Reference Page 57＜Ref.7＞ Global Health Priorities for the Civil G8 Dialogue （April 24, 2008）
23rd April, 2008

Global Health Priorities for the Civil G8 Dialogue, 2008 in Kyoto, Japan
Global health issues are one of the biggest challenges in development. G8 countries have a critical role to play insupporting the achievement of the health MDGs. This is why we think health issues should be a constant, permanent
agenda item for future G8 summits. In addition, the G8 should create a clear mechanism to monitor progress on pastand future commitments and annually report on them.

FIRST WE WANT TO BEGIN WITH PAST COMMITMENTS
The fight against HIV/AIDS, TB, and Malaria is making progress but we have only just begun. We are very worried that
G8 may abandon its effective focus on these diseases and will not fulfill its commitments.
Therefore we demand the full $60 billion in new, additional funding promised at the 2007 G8 summit and an action planof how much will be paid by which country on what timeline and a plan for predictable and sustainable future funding.
This $60 billion figure should be time-specific over the next 2 to 3 years and must be a part of achieving thecommitments already agreed to by G8 countries:
・・・・

The Global Plan to Stop TB,
Universal Access on HIV/AIDS by 2010,
Scaling up for impact for malaria interventions,
A fully funded Global Fund at a $6-8 billion annual level

ON NEW COMMITMENTS
We welcome the fact that new and critical items are being brought to the agenda this year.
First, we want to address MDGs 4 and 5.We can save more than 6 million lives of mothers, newborns, and children.
We can ensure universal coverage of the basic services needed for achieving MDGS on maternal and child mortality by
2015 for a cost of $10.2 billion annually.
We welcome the G8 agenda item on water and sanitation as it is critical to achieving the other MDGs and is extremely
cost-effective intervention--$1 gets a $9 return. The G8 should commit to establishing a global plan of action based on
facilitating and coordinating national plans. This should include establishing a high-level task force, reporting annually,
and a commitment that no credible national plan should fail for lack of finance.

HEALTH SYSTEMS
Strong health systems are key to reach all of these targets. This is why they need additional funding commitments—andmoney committed for other targets should not replace that.
We call on the G8 to reassert their commitment at the Gleneagles summit to promote free access to primary healthcare
and mention specifically their will to support the removal of user fees in particular for the most vulnerable people suchas pregnant women and children.
We also demand that training, deployment and retention of qualified health workers is prioritized and funded. Vague
conversations about health systems that do not have any targets or funding levels are insufficient. Urgently, we urge G8
to take their responsibility to increase at least 4.25 million additional health workers globally, including 1 million for
Africa.

Reference Page 58

FUNDAMENTAL QUESTIONS・ On the $60 billion commitment made last y ear on HIV?AIDS, TB and Malaria and strengthening health systems
which countries will be putting up money and on what timeline? Will you announce this at the G8 meeting?
・ Will the G8 make a firm commitment to ensure that $ 10.2 billion is available each year for maternal and child healthand that there is a plan to achieve water and sanitation MDGs?
This Statement was adopted by;
The Participants of the Break-Out Session for Global Health, Kyoto, the 23rd April 2008
Global Health Committee, Japan 2008 G8 Summit NGO Forum
Dorothy Shaw-Millman, the International Federation of Gynecology and Obstetrics, Canada
Elizabeth Anne Peterson, World Vision International, the US
Jill Sheffield, Family Care International, the US
Irungu Houghton, OXFAM GB, Kenya
Olayide Akanni, Journalists against AIDS (JAAIDS) Nigeria, Nigeria
Louis da Gama, Global Health Advocates, the UK
Matthew Kavanagh, Results Educational Fund, the US
Paola Giuliani, Action Aid Italia, Italia
Rachel Wilson, Path, the US
Steven Cockburn, End Water Poverty, the UK
Winstone Zulu, Stop TB Partnership, Zambia

Reference Page 59＜Ref.8＞ Recommendations for the Hokkaido Toya-ko G8 Summit Communique（June 14, 2008）
June 14, 2008
Poverty and Development Unit, 2008 Japan G8 Summit NGO Forum

Recommendations for the Hokkaido Toya-ko G8 Summit Communiqué
1. First Priority on Poverty and Development Issues for G8 Communiqué andOutcome Documents
ODA

The G8 must acknowledge that they are off track to meet their own key
commitments on aid quantity and quality, and act to get back on track.
Food
1. In recognition of the magnitude of the current food crisis and its prolonged
negative impact on social development and the achievement of MDGs, the G8
must commit to meeting the financial needs in responding to food insecurity
and nutrient needs of the people affected by the current food crisis. Food aid
must be delivered faster and more effectively, and as "cash" allowing the local
governments, relevant agencies, and NGOs to purchase products locally or
within their region. Such food aid must focus especially on protecting children
and pregnant/lactating mothers against long-lasting impact of malnutrition andhunger.
2. In recognition of the magnitude of the current food crisis and its prolonged
negative impact on social development and the achievement of MDGs, the G8
must commit to meeting the financial needs in responding to food insecurity
and nutrient needs of the people affected by the current food crisis. Food aid
must be delivered faster and more effectively, and as "cash" allowing the local
governments, relevant agencies, and NGOs to purchase products locally or
within their region. Such food aid must focus especially on protecting children
and pregnant/lactating mothers against long-lasting impact of malnutrition andchronicle hunger.
Climate Change 1. The G8 must deliver adequate adaptation finance, delivered through the UN,
and Poverty
and should not count this money towards aid budgets.
2. The G8 must agree to limit global warming to below 2 degrees.
3. The G8 should commit to reducing G8 countries’ domestic carbon emissions by
25-40% by 2020.
Education
The G8 communiqué must reaffirm the pledge that 'no country seriously committed
to the achievement of Education For All should be thwarted in this ambition for lackof resources' and should interpret this commitment as applying to conflict-affected
and fragile states as well as strong performers.
HealthNoting the importance of tackling global health issues, G8 countries must ensure
global health be a permanent agenda item of the G8. Adding to that, G8 must
construct within the G8, a system that will annually monitor and evaluate theprogress towards the attainment of global health commitments, which will be theresponsibility of the G8 host country. Furthermore, to ensure that countries are held
accountable, to hold a peer monitoring of progress towards fulfilling theircommitments and to construct a mechanism that will advise countries not fulfilling
their financial commitments.

Reference Page 60

2. Second Priority on Poverty and Development Issues for G8 Communiqué andOutcome Documents(1) ODAODA

1. Aid quantity
Japan must lead the G8 to deliver a detailed emergency plan with annual budget increases to meet
Gleneagles G8 promises and go further to reach 0.7% of GNI.

2. Aid quality
The G8 must act rapidly to increase aid quality, implementing and exceeding agreed targets contained in
the Paris Declaration on Aid Effectiveness, especially increasing multi-annual predictable commitments
and the amount of aid channelled through governments, use of country systems and mutual
accountability.

3. Accountability
The G8 should agree to an independent monitoring mechanism of the G8 commitments on aid quantityand quality.

4. Debt
The G8 should agree on debt cancellation for all the countries that need it to reach the MDGs.

(2) Education
Education 1. The G8 must commit a minimum of $15-16 billion per annum in aid to ensure the achievement ofsix goals of Education for All, a sum that includes provision for adult literacy, early childhood careand education, targeting the hardest-to-reach children and expansion of lower secondary education.
2. The G8 should commit to this aid being given predictably and to finance recurrent costs, in orderthat 18 million teachers can be trained, hired and paid between now and 2015.
3. The 2007 commitment to fill the FTI financing gap must be met: the G8 must report back onprogress since last year, and should reaffirm the pledge that it will pay its fair share of the annual
external financing requirement to enable FTI plans to be realised.
4. The G8 should support the creation of an annual replenishment cycle for the Catalytic Fund of the
FTI, and encourage the endorsement of a further 16 countries' plans in 2008 and 2009.

Reference Page 61(3) Health
Health1. (Addressing Health Workers Shortage) G8 should support all developing countries in achieving the
WHO goal on minimum health worker density of at least 4.1 health workers per 1,000 population,
including at least 2.3 doctors, nurses and midwives per 1,000 to face the problem of health worker
shortage. To achieve, by 2015, an additional 1.5 million health workers in Africa, or 4.6 million healthworkers globally. To include in the summit progress report, the creation of a midterm target, as well as theG8 countries to hold themselves responsible for recruiting, educating, training and retaining healthworkers. Furthermore, to include the creation of a comprehensive and time bound action and financial
plan, with each country spelling out how much it will contribute over what timeframe.
2. (Heiligendamm Pledge) G8 should create firm plans and timetables to show ‘who will pay how muchwhen’ for the US 60 Billion Dollar pledge made at the 2007 G8 Summit in Heiligendamm to fight thethree infectious diseases(HIV/AIDS,TB, Malaria) and to Health System Strengthening. If the USD
60 Billion pledge is to be of any significance, the full amount must be paid by 2010 and must be
made additional to contributions given to other existing commitments.
3. (Measures for Infectious Diseases) G8 should recommit to the attainment of Universal Access to
HIV/AIDS treatment, prevention and care by 2010 as once promised by all G8 countries at the 2006
St. Petersburg G8 Summit. To the creation of a comprehensive action plan which each country
spelling out how much it will contribute, financially and technically over what time frame to attainthis goal. Also, in emergence of HIV/TB co-infection, Multi-drug resistant (MDR) and extensively
drug-resistant (XDR) TB, G8 countries should address these issues and support Global Plan to Stop
TB which aims to halve TB prevalence and deaths by 2015 compared with 1990 levels.
4. (MNCH) Measure to attain MDG 4 (reduction of the child mortality rate), MDG 5 (improvement ofmaternal health) and related child, maternal and reproductive health issues has been slow and has
lacked a progressive internationally agreed upon plan. The G8 countries must create a concrete
action plan to address these issues, as well as a concrete and time bound financial commitment of anadditional 10.2 Billion US Dollars a year, as calculated by the World Health Organization (WHO)and the United Nations Fund for Population Fund (UNFPA), to achieve these goals.

(4) Food
Food

1. The G8 must introduce regulations on the flow of speculative money and to make futures trading onfood more transparent. As one of the effective methods of such regulation, G8 must advance thediscussion on establishing a commodity futures transaction tax whose revenue can then be madeavailable for filling the financial gap for development aid.
2. The G8 must increase its aid in agriculture development focused on small-scale and sustainableagricultural and livestock production, and must especially support the African governments inmeeting the 2003 target to allocate at least a tenth of their spending to agriculture.

Reference Page 62＜Ref.9＞ Action Alert for the 3rd Health Experts Meeting（June 8, 2008）

ACTION ALERTDeliver Your Voices to “Health Experts” and Sherpas of Your Governments
Contact: Global Health Committee, 2008 Japan G8 Summit NGO Forum
Takumo Yamada
Masaki Inaba

Dear international colleagues
We are writing to share with you the latest intelligence gathered from various sources by the Global
Health Committee of the Japanese NGO Forum on the G8 Summit 2008, and to call for a concerted civilsociety lobby action across the G8 countries and the EU.
This note contains the following information.

1.
2.
3.
4.

Call for Action
What to push (at the proposed lobby meetings)
Latest overall intelligence and political analysis (to back up your lobby work)
Detailed Intelligence

1. Call for Action
The Japanese NGOs working on global health towards the G8 Summit in Hokkaido would like to urge
those of you who can to lobby your respective governments, preferably the officials attending the experts’meeting, or, if not then the sherpas or the sous-sherpas. This lobby work should ideally happen before therespective governments dispatch their health experts to the G8 health experts’ meeting (11-12th June),and if this is not possible, then please lobby your sherpas before the Sherpa meeting (23-25th of June).
The attached is a civil society statement we are preparing in Japan, which we think might be useful for
you to use when lobbying your governments, because it builds on the joint statement prepared by thoseinternational civil society actors who attended the Civil G8 Dialogue with the G8 and EU sherpas in late
April, and incorporates the latest development that we are aware of.

2. What to really push
The attached statement outlines both the demands concerning the policy substance on MDGs 4, 5 and 6
and Health System Strengthening, and those for an accountability/follow-up process to be in place.
Of these, we can reasonably hope for1.
2.

an outcome document separate from the overall G8 Communiquéa permanent accountability/follow-up mechanism on existing and future G8 commitments on healthto be put in place

So, while we would encourage you to push the respective health experts on all the points contained in thestatement, we would particularly urge you to make sure that they hear our voices on the accountability
aspects.

Reference Page 63

3. The latest overall intelligence and political analysis(to supplement the call to action above)

1. Top line intelligence
Japan seems to be pushing hard for producing a G8 outcome document separate from the overall
communiqué, outlining a comprehensive diagnosis of the related issues, with clear references to relevant
existing G8 commitments. This document is supposed to reflect the discussions by the G8 health experts1.
We also believe that this document is intended to include a concrete follow up mechanism on existing G8commitments.
These are some concrete gains we can reasonably hope to win out of the Toya-ko summit. On the other
hand, we think at this stage it is not very likely that all the right things contained in the document will bebacked up by new money. On this, we need to be critical.
But important to note is that even the possible wins on the accountability mechanism is not guaranteed
unless all the G8 governments are pushed by civil society across the G8 countries and the EU in aconcerted manner, even this wins may be weakened.
See the detailed intelligence for more backgrounder.

2. Political Analysis and Proposal for a Civil Society Strategy
This is clearly Japan’s own initiative, but it is also apparent that the US government is strongly backing
Japan. This shows in the following aspects of the Japanese proposal.
z All of the four main policy recommendations by Prof. Takemi (former Senior Vice Minister of Healthof Japan who has been behind the scene in the process) are included in the documents (as can be seenin the detailed outline of the contents of the health document)2.
z On the other hand, the proposal is weak on aid coordination and harmonization, for which normallythe EU countries are stronger advocates.
As the chair of this G8 Summit, Japan will likely hold onto this health proposal, as they have nothingmajor to sell on the other major issues on the agenda: food or climate change. The fact that the US is
behind Japan on this makes it all the more likely.
We heard that EU countries are showing reluctance to the follow-up mechanism. Despite their statedreason being General Budget Support (see the detailed intelligence below), there may be political reason,
which is the discomfort at the Japan-led and US-backed initiative, because objectively speaking, the EU
countries have much to sell vis-à-vis Japan on their financial support to the health sector, e.g. theircontribution to the Global Fund, and budget support alone seems like a weak argument against thisfollow-up idea.

Some countries are not very keen for this G8 to produce such a document (especially Italy and Canada), questioning
whether that was ever the mandate of the health experts meetings.
2 The four recommendations are:z
Concrete national health plan, and establishment of a peer review mechanism to make name and shame possible
among developing countries.
z
Clear commitment to long-term financial commitment by donor countries for 20 yearszCommit to developing a common indicators and methodologies that they will accept for monitoring and evaluating
their both bilateral and multilateral supports (linked to the strengthening of the WHO)z
Pilot projects to address health worker crisis within the human security framework1Reference Page 64
Given above, it seems our common strategy towards Toya-ko should be to:z Secure the accountability mechanism, by getting the Europeans on board
z Do so by encouraging a language that the Europeans should propose to the Japanese on themechanism (we will have to rely on our European colleagues for this)z Make sure that this mechanism will also lead to mobilization of additional resourcesz Make sure that aid coordination and harmonization become a central feature of this mechanism

4. Detailed intelligence
1. Japan, post-TICAD
z

z
z
z

Commitment to double Japanese aid to Africa in 5 years (bilateral grants and TA only, excluding debt
relief), announced at TICAD, was a best compromise possible within the government at the time
(MOFA wants to see increase of overall aid budget, MOF against). Further political leadership on
overall aid unlikely before Toya-ko.
TICAD Action Plan contains higher-than-before ambition on the part of Japan on health. Wants tobuild the G8 agreement on this.
Sense in the Japanese media that “Africa/Development” have now been dealt with and climate andfood are the issues to work on towards Toya-ko
Climate and food overshadowing other development issues globally

2. The contents of the proposed G8 outcome document on health
Leaders' communiqué will contain bite-size messages on health (written mainly by sous-sherpas.
Development section would probably be around 10 pages, and health will be part of these 10 pages). The
separate document on health (written by health experts, to be endorsed by the leaders), will be about 10
pages long, and reflect on the discussions at the G8 Health Experts meetings.
A second draft of the 2) has already been circulated among the G8 and EU health experts.
The substance of this second draft seems to contain the following sections:A. Current context (since Okinawa, progress made, the new challenges, etc etc. Not too much volume
on this section as people know already)B. Guiding Principles
C. Health System Strengthening
D. Maternal, Newborn and Child HealthE. Infectious Diseases
F. Multi-sectoral cooperation
G. International cooperation
H. Appendices on follow-up on existing (and new) commitments

More in detail on each of the sections.
1. Current context: since Okinawa, progress made, the new challenges, etc etc. Not too much volume on
this section as people know already.
2. Guiding Principles
z Human security framework (empowerment of the individual and community)z Interconnectedness of MDGs 4-6
z the need to look towards post 2015 and to exceed the MDGsz the importance of R&D
z Paris Declaration (ownership and coordination of various initiatives)

Reference Page 65z

G8 as an appropriate platform to ensure such coherence

3. Health System Strengtheningz Emphasis on health workers crisis
z Japan keen to support training, monitoring and evaluation. It has committed at TICAD to train
100,000 workers in Africa in 5 years.
z The 2.3/1,000 and 4.1/1,000 by 2015 targets to be mentioned as “aspirational targets” (i.e. notcommitments) but some oppose to this idea.
z On monitoring and evaluation, will stress the importance of reliable info, which is also stressed by
the WHO, Gates, Health-related NGOs. G8 generally agree on this, but will differ on details.
z Other components of HSS such as procurement of drugs, governance, will be mentioned but not to thesame extent. Will be open to suggestions from other G8 governments.
z Will also touch upon the need for effective health measures in disasters.
4. MNCHz PM Fukuda and his spouse particularly interested in this area.
z Japan pushing for universal access to reproductive health services, increased birth attendance byskilled birth attendants in Africa to 75% in five years, nutrition and continuum of care, incorporating
the TICAD outcomes.
z US may resist this, especially on the language of “reproductive health”, depending on the politicalmood in the outgoing administration.
5. Infectious diseases
z Will acknowledge progress but also stress the need for continued support
z HIV/AIDS¾ Universal access to be clearly mentioned as commitment¾ issues such as restriction on travel to be mentioned as issues to be tackled.
z Tuberculosis¾ Global Stop TB Plan to be endorsed and supported.
¾ Multidrug-resistant (MDR) and extensively drug-resistant (XDR) TB and TB/HIV co-infection to
be mentioned as issues to be tackled.
z Malaria¾ Will not go back on past commitments¾ Hightened political interests in the recent months might mean G8 governments might bringsome new pledge. Japan unlikely to block this.
z Polio¾ Needs a “final push” to eradicate it – caution against reduced efforts¾ Aware that some countries were named and shamed at WHA on this.
z Neglected Tropical Diseases¾ US high interests, but Japan prefers a wider scope.
z measles
6. Multi-sectoral cooperationz Stress the importance of collaboration with work on MDGs 1, 2, 3 and 7.
z Water and Sanitation¾ 20% of Japan’s aid to Africa is WATSAN-related. Intended to improve access for 6.5 million
people. Japan likely to call on other G8 countries to scale up their watsan aid.
z Education¾ basic education: health education, nutrition, etc.
¾ secondary and advanced education: crucial in increasing health personnelz basic infrastructure¾ local roads, electricity, etc. related to healthz climate changeReference Page 66¾

WHO is currently interested

7. International cooperationz stress the timing as mid-point to 2015, and towards 2010 Universal Access goals to nurture “a senseof urgency”
z call for some mechanism to better deliver aid, which would include H8, academics and NGOs in theprocess.
8. Appendices on follow-up on existing (and new) commitmentsz a speed-up/follow-up mechanism to deliver existing commitmentsz will attach a matrix to be publicised, to ensure accountability
z This matrix will show which G8 countries have committed how much/what by when, and the progress.
May include new commitments, based on the “sense of urgency”.
z Largely two parts: existing G8 commitments on 1) health in general, 2) infectious diseases (incl.
polio)z Japan and the US keenly supportive of this.
z Europeans are reluctant, saying General Budget Support is hard to break down and trace into
particular sectors (i.e., saying such a matrix would not do justice to their actual contribution)z Japan trying to convince the Europeans, saying that this is going to be an annual report and theformat can be improved in time to represent the reality better.
z The G8 is supposed to have agreed on a similar process at St Petersburg as a result of push by theGermans, but the Germans did not have enough time to get it in place for Heiligendamm. Japan
calling “for this initiative to be rescued”.
ENDSReference Page 67＜Ref.10＞ We can no longer wait: Joint Statement on Global Health （June 23, 2008）

We Can No Longer Wait
Joint Statement by the Global Civil Society Concerning Global Health
Now is the accepted time, not tomorrow, not some more convenient season. It is today that our best work can be done and not somefuture day or future year. It is today that we fit ourselves for the greater usefulness of tomorrow. Today is the seed time, now are thehours of work, and tomorrow comes the harvest and the playtime.
W.E.B. Du BoisAt the dawn of the 21st Century, we have given birth to the Millennium Development Goals (MDGs). With this, we havebid farewell to the 20th century filled with war and deprivation, and ushered in a new world order of peace andsustainability based on the foundation of human security. That same year, heads of state of G8 countries declared that a
massive scale up was in need to fight the three infectious diseases. Within these few years, numbers of commitments,
policies, promises, initiatives and organizations were piled up one on top of another. One such significant commitment,
first made at the G8 Gleneagles summit in 2005, is the goal to achieve Universal Access to HIV prevention, treatment
and care by 2010.
Much progress was achieved in the past eight years. Several million people have received access to life saving
Antiretroviral drugs. Tens of millions received voluntary counseling and testing. Tens of millions obtained mosquito nets
to help fight the spread of Malaria. Tens of millions obtained access to TB treatment through DOTS.
However in the same eight years, far too many, children and pregnant and nursing mothers have lost their lives toinfectious diseases, respiratory problems, diarrhea and complication in pregnancy and birth, all of which could have
easily been prevented and treated. Furthermore, there are still many more people in need of access to prevention andtreatment against the three infectious diseases, especially in the poorest of regions.
We can no longer wait. The world can no longer wait. The G8 countries, who call themselves responsible for leading theworld, have chosen to walk the longer road to ensuring human security for all. We can no longer wait, as millions of
lives are lost as the financial commitments slowly trickle in, at a speed that will make the attainment of all health goals
impossible. We can no longer wait, as promises made by the G8 leaders themselves are broken.
The 2008 G8 Summit will take place in Toya-ko, Hokkaido. “Toya”, in the language of the indigenous people of
Hokkaido, the Ainu, means shore. At this shore, we will wait for the promises to be fulfilled. This is the last chance for
the G8 leaders to fulfill the mountains of promises and commitments they have made to the world. They know whatneeds to be done; they know that promises and commitments are nothing without action; they know that all that is left to
do is to take action now.
We, the members of the Global Civil Society concerning Global Health, ask the G8 governments to take the following
actions:
1. On the G8 Summit Official Documents:
The G8 governments should:(a) Include in the Communiqué of the G8 Hokkaido Toya-ko Summit, a component that addresses the current issues in
global health and a separate comprehensive common framework for action to achieve health related MDGs andrelated health goals.
(b) In addition to the common framework for action, issue a report on current progress towards the achievement ofhealth related MDGs and related health goals, and a report on the reality of the financial contribution of the G8
countries toward the attainment of these goals. This report must include all points included in A Review of theWork of the G8 in the Field of Tackling the Three Pandemics HIV/AIDS, Tuberculosis and Malaria, which wasReference Page 68
issued by the German Government.
(c) In all of the above, reflect the reality that women and girls are especially affected by initiatives to improveglobal health and that a commitment to gender equality is integral to success
2. On global health as a permanent agenda of the G8 and the establishment of a firm process to track,
monitor and evaluate the delivery of health related commitments:
The G8 governments should:(a) Noting the importance of tackling global health issues, ensure that global health is a permanent agenda item of
the G8.
(b) Construct within the G8, a mechanism that will annually monitor and evaluate the progress towards theattainment of global health commitments such as the MDGs and the goal of Universal Access by 2010.
Furthermore, the G8 governments should ensure that countries are held accountable, hold a peer monitoring of
progress towards fulfilling their commitments and construct a mechanism that will advise countries not
fulfilling their financial commitments.
(c) Furthermore, the monitoring and evaluation mechanism must include the participation and input of relevant
UN agencies, international institutions, and civil society.
3. On increasing the number of health workers and health system strengthening:(a) We reject vague promises to strengthen health systems that are not backed up by firm targets and adequate andsustained funding.
The G8 governments should:(b) support developing countries in achieving the WHO goal on minimum health worker density of at least 4.1 healthworkers per 1,000 population, including at least 2.3 doctors, nurses and midwives per 1,000 to tackle the problem of
health worker shortage and develop and implement comprehensive, costed, health workforce plans. Furthermore,
include the creation of a comprehensive and time bound action and financial plan, with each G8 country spellingout how much it will contribute over what timeframe(c) support the recruitment, training and retaining of additional 1.5 million health workers in Africa, or 4.3 million
health workers globally by 2015 and include in the summit progress report, the creation of a midterm target, e.g.,
600,000 new health workers in Africa by 2012.
(d) Furthermore, agree and implement a code of practice on health worker migration to tackle the ‘brain drain’.
4. On fulfilling existing commitments:
The G8 governments should:(a) agree and announce a comprehensive funding and action plan for their contribution to meeting the Universal Accessgoal. Meeting the goal requires a quadrupling of the current resources available to reach over $40 billion in 2010(b) recommit to the attainment of Universal Access to HIV prevention, treatment, and care by 2010 as first promised atthe 2005 G8 Summit in Gleneagles and reaffirmed at the 2007 Heiligendamm Summit with particular attention to
the need of most vulnerable to infection, including girls, women and children.
(c) create firm plans and timetables to show ‘who will pay how much when’ for the $60 billion pledge made at the 2007
G8 Summit in Heiligendamm for the three infectious diseases and health system strengthening. It must be notedthat the $60 billion is nowhere near enough to stop the 6 million needless deaths from AIDS, TB and Malaria
every year. In 2009 alone the world need $40 billion to fight AIDS, TB and Malaria in addition to the funds
required for health systems and health workers.
(d) commit to fully fund the Global Fund to fight AIDS, TB and Malaria so that it grows to size of at least $6-8

Reference Page 69
billion by 2010 and leverages emerging opportunities such as the additional funding round in 2008.
(e) address the urgency of the emerging HIV/TB co-infection, multi-drug resistant (MDR) and extensively
drug-resistant (XDR) TB, and need to commit and support Global Plan to Stop TB which aims to halve TB
prevalence and deaths by 2015 compared with 1990 levels.
5. On new commitments:(a) Measures to attain MDG 4 (reduction of the child mortality rate), MDG 5 (improvement of maternal health)and related child, maternal and reproductive health goals (including the target of universal access to sexualand reproductive health) have been slow and have lacked a progressive, internationally agreed upon plan. The
G8 countries must create a concrete action plan to address these issues, as well as a concrete and time boundfinancial commitment of an additional $10.2 billion a year, as calculated by the World Health Organization(WHO) and the United Nations Population Fund (UNFPA), to achieve these goals.
(b) On the development of a concrete contribution plan on water and sanitation:
Every day 5,000 children lose their lives due to the lack of access to clean drinking water. According to theUnited Nations Development Programme, USD 10 Billion a year will be needed to meet the MDG goal onwater and sanitation. The G8 countries must commit the necessary funding to meet this objective with atime bound, specific and concrete contribution plan.
(c) On the problem of nutrition and food security and the rapid rise in food prices:
The G8 countries must take immediate and necessary short term and long term measures to ensure adequate
nutrition and improved food security for people living with and affected by HIV/AIDS. The G8 must notprescribe the same economic policies and institutions that have contributed to the food crisis as a solution.
6. On strengthening aid coordination for the attainment of health-related MDGs:(a) G8 countries should strengthen aid coordination on health to attain health-related MDGs to overcome current
ineffectiveness caused by the lack of coordination among various health institutions, policies and initiatives.
This should result in additional funding and should not be an excuse to pit disease specific interventions against
equally critical health systems strengthening.
(b) The structure of aid coordination should be simple and transparent, and ensure the full participation and inputof all stakeholders including civil society at all stages.
(c) G8 countries should promote to ensure maximizing accessibility, affordability and availability of primary
health care services, including the removal of user fees, in particular to reach the most vulnerable population.
We do not need meetings without contents, promises without actions, institutions without all the voices of those
who are affected. We need responsibility and accountability. Most importantly, we demand a world in which no
human beings lose their lives to treatable and preventable causes.

CONTACT:
Masaki Inaba (director), Aki Ogawa (International Coordinator)
Project RING, Japan AIDS and Society Association (Project to Reinforce Innovative Commitments of Japanese NGOs to the Global Fund)
A Project of Japan AIDS and Society Association
Address: c/o Africa Japan Forum, 1-20-6 Higashi-Ueno Taito-Ku Tokyo JapanReference Page 70

Signatures (as of June 20, 2008)

Japan
Global Health Committee, 2008 Japan G8 Summit NGO Forum and its 15 NGOs
Africa Japan Forum
Japan AIDS and Society Association
Japan Foundation for AIDS Prevention
OXFAM Japan
Research Institute of Tuberculosis/Japan Anti-Tuberculosis Association
International AIDS Vaccine Initiative
Services for Health in Asia and African Regions (SHARE)Japanese Organization for International Cooperation in Family Planning
Women and Health Network
Space Allies
Medecins du Monde Japon
Plan Japan
Results Japan
Health and Development Services (HANDS)World Vision Japan

International
Argentina
Cameroon

CanadaComoro/France
China
Democratic Republic of Congo
FranceGermany
Ghana
India

Italy
Liberia
Kenya

Mulabi- Espacio Latinoamericano de Sexualidades y Derechos
Foundation for Studies and Research on Women (FEIM)
Cameroon Coalition Against Malaria
African Action on AIDS (AAA)
Positive-Generation
Reach Out
Fogué Foguito Positive-Generation
Action Canada for Population and Development (ACPD)The Canadian HIV/AIDS Legal Network
Interagency Coalition of AIDS and Development (ICAD)
Results Canada
Students Against Global AIDS
Canadian Grandmothers for Africa
Fédération des Associations Comoriennes de France
Beijing Aizhixing InstituteHong Guang Alliance
Conseil Mondial de Soins
AIDS Coalition to Unleash Power Paris (ACTUP Paris)
AIDES
Equilibres &Populations
French Family Planning Movement
Médecins du Monde France
PLUS, Coalition Internationale Sida
SIDACTION
Bread for the World
German Foundation for World Population (DSW)
African Media and Malaria Research Network (AMMREN)
Ghana Voices for Malaria-free Future Project
Delhi Network of Positive People (DNP+)EMPOWER India
JEEWAK WELFARE SOCIETY NAGPUR
MAMTA -Health Institute for Mother and ChildWorld Care Council, India
Associazione italiana donne per lo sviluppo
Ossevatorio Italiano sull'Azione Globale contro l'AIDS
Millennium Campaign-Liberia
Ambassadors of Change
Youth Intercommunity Network
WEM Integrated Health ServiceReference Page 71
KosovoMalawiMalaysia
MexicoMyanmar
Nepal
Netherlands
New ZealandNigeria

Norway(NSRR)
Philippines
Republic of South Africa
Spain
Somalia
Sri Lanka
Tanzania
Trinidad and Tobago
UgandaUnited Kingdom

United States

Venezuela
Zimbabwe
AfricaEast Africa(EANNASO)
Asia & Pacific

EuropeLatin America/Carribbean
International

Little People of Kosova
Youth Net & Counselling (YONECO)
Positive Malaysian Treatment Access & Advocacy Group (MTAAG+)El Closet de Sor Juana
NGO Gender Group
Nyaya Health
Safe Motherhood Network Federation
International Civil Society Support
New Zealand Family Planning International
Association Of Civil Society Organisations in Malaria Immunization and
Nutrition
Communication for Development Centre
Journalists against AIDS (JAAIDS) Nigeria
Treatment Action Movement
the Norwegian heart and Lung patient Organization
Norwegian Association for Sexual and Reproductive Health and Rights
Positive Action Foundation of the Philippines Inc (PAFPI)The Development Action for Women Network (DAWN)
Treatment Action Campaign (TAC)
Oxfam GB Southern Africa-Regional Management Centre
Instituto de Cooperacio'n Social
Somali socio cultural organization (SOSCO)
Community Development Services, Sri Lanka
Tanzania National Malaria Movement Trust
Youth Advocacy Movement Trinidad and Tobago
Care and Share Foundation
VSO International
Stop AIDS Campaign
Student Stop AIDS Campaign
Africa Action
The American India Foundation
Center for Women's Global Leadership
Community HIV/AIDS Mobilization Project (CHAMP)
Global AIDS Alliance (GAA)
Health Global Access Project (Health GAP)
Ipas
Partners in HealthPathPhysicians for Human Rights (PHR)
Population Action International
Results Educational Fund (REF)
Treatment Action Group (TAG)
United States Coalition for Child Survival (USCCS)
Action Ciudadna Contra el SIDA (ACCSI) – LACCASO
Zimbabwe Association of Doctors for Human Rights
Zimbabwe Association of Church Related Hospitals (ZACH)
African Civil Society Coalition on HIV/AIDS
Africa Public Health Rights Alliance/ 15% Now! Campaign
African Council of AIDS Service Organizations (AfriCASO)
Afro Global Alliance International
Princess of Africa Foundation
Eastern African National Networks of AIDS Service Organizations
Asia and Pacific Council of AIDS Service Organizations (APCASO)
Asian Harm Reduction Network (Thailand)
Asia Pacific Network of Sex Workers (APNSW)
Action for Global Health
Red Latinoamericana de Personas viviendo con VIH/SIDA (RedLA+)
Action Aid InternationalReference Page 72
Ecumenical Advocacy AllianceFamily Care International
Global Health Council
International Council of AIDS Service Organizations (ICASO)
International Planned Parenthood Federation (IPPF)
International Treatment Preparedness Coalition (ITPC)International AIDS Women Caucus (IAWC)
International Women’s Health Coalition (IWHC)
Malaria Consortium
Open Society Institute
OXFAM International
Pathfinder International
United Youth Front International
United Methodist Church, General Board of Church & Society
World AIDS Campaign

Individuals 3
Javier Hourcade Bellocq, Board Member of the Communities living with HIV, Tuberculosis and affected by
Malaria Delegation, the Global Fund to Fight AIDS, Tuberculosis and Malaria
Elizabeth Mataka, Board Member of the Developing Country NGO Delegation, the Global Fund to Fight AIDS,
Tuberculosis and Malaria (Vice Chair of the Board of the Global Fund, Special Envoy for AIDS in Africa of UN
Secretary General)
Asia Russell, Board Member of the Developed Country NGO Delegation, the Global Fund to Fight AIDS,
Tuberculosis and Malaria
Myung-Hwan Cho, President of AIDS Society of Asia and the Pacific3

Additional Individual Signatures

Gladis Adriana Vélez Álvarez, Columbi (Columbia), Joel Bayubasire Djanda (Democratic Republic of Congo), Konjit
Kefetew (Ethiopia), Swedi Ismail Martha Mesfin (Ethiopia), Victoria Tettey (Ghana), Lena Addy, James Frimpong(Ghana), Dr Komla Ofosu (Ghana), Dr Atsu Seake-Kwawu (Ghana), Jashodhara Dasgupta (India), Ritu Kumar
Mishra (India), Dr. Manmeet Kaur (India),Benson Williesham Milimo (Kenya), Azita Amireh (Iran), Sysavanh
Phommachanh (Laos), Dr Geetha Rana (Nepal), Adamu Sa'adu Ajingi (Nigeria), Rose Iwueze (Nigeria), Dare Adeoye(Nigeria), Hajarat Suleiman (Nigeria), Dr Manzoor Butt (Pakistan), Ahmed Ali (Pakistan), Dr. John Theopista(Tanzania), Esther Opoka (Uganda), Margaret Nalugo (Uganda), Mavis Akotey, MacDonald Bubuama, Mbony
Wilson, Nchotu Regina Akwanui, Foluke Akingbade, Isaac Bwire, Crissy MupuchiReference Page 73＜Ref.11＞ Take the Leadership in Listing all Travel Restrictions for PLWHA （July 1, 2008）
July 1, 2008
Project RING, Japan AIDS and Society Association
Africa Japan Forum

Take the leadership in lifting all Travel Restrictions for People living with HIV/AIDS= Voices of Civil Society to the G8 =In the 2001, Declaration of Commitments on HIV/AIDS saw governments agree to “enact
strengthen or enforce appropriate legislation, regulations and other measure to eliminate all formsof discrimination against, and to ensure the full enjoyment of all human rights and fundamental
freedoms by people living with HIV/AIDS”. Yet, seven years after this commitment, well over 70
countries still place some form of travel restriction on those living with HIV/AIDS.

These restrictions are discriminatory, contributing to the stigmatization of people living with
HIV/AIDS and are contrary to the commitments made through the 2001 Declaration ofCommitment on HIV/AIDS and the 2006 Political Declaration. Furthermore, they undermine HIV
prevention and other efforts to stop the epidemic.
At the 2008 UN high level Meeting on AIDS in New York, 344 organizations signed a letter on
HIV-related Travel Restrictions addressed to the UN Missions and Heads of State in Countries with
Restrictions. In solidarity, we call on the leaders of the G8 to:・ Take the leadership to abolish all HIV-specific travel restrictions
・ Ensure access to HIV prevention, treatment, care and support for mobile populations, bothnational and non-national
・ Take up the issue of travel restriction with other governments where they are applied to yourcitizens seeking to travel
・ State in the G8 common action framework on global health, a commitment to remove all travel
restriction (denial of entry, stay and/or residence) of the people living with HIV/AIDS

Contact:
Masaki Inaba/Ogawa Aki
c/o Africa Japan Forum, 2nd Floor, 1-20-6 Higashi-Ueno, Taito-Ku, Tokyo 110-0015 JAPANReference Page 74＜Ref.12＞ Score Card on Global Health, Hokkaido Toya-ko Summit （July 9, 2008）
Score Card on Global Health, Hokkaido Toya-ko Summit 2008 (as of July 16, 2008)
Global Health Committee
2008 Japan G8 Summit NGO Forum
This score card shows the independent evaluations of the outcomes of G8 Toya-ko Summit on global health.
CONTACT: Masaki Inaba (Chair, Global Health Committee, G8 NGO Forum) 090-1264-8110, masaki.inaba@gmail.com
Sumie Ishii (Chair, Poverty and Development Unit, G8 NGO Forum) 090-5423-6655, sishii@joicfp.or.jp

2008 G8 Hokkaido Toya-ko Summit
Report Card （Global Health）
NAME: G8 Countries (US, UK, Italy, Canada, Germany, Japan, France, Russia)
Curriculum

NumberContent

1(Global Health Overall) Political commitment and financial resources necessary to attain the Millennium Development Goals (MDGs) by
2015 : Can we achieve MDGs by 2015?

B+

2-1

(MDG 4) Decreasing the child mortality rate and improvement of nutirition and coverage of immunization, which requires an increase of
USD 10.2 Billion annually, together with MDG 5(improving maternal health): Can we protect children?

C

2-2(MDG 5) Improving maternal health and commitment to the realization of Universal Access to Reproductive Health Services, which requires
an increase of USD 10.2 Billion annually, together with MDG 4 (decreasing child mortality): Can we improve maternal health?

C

3(MDG4/5) Recognition of the importance of continuum of care, commitment for increased proportion of births attended by skilled births
attendants, and prevention of mother to child transimission of HIV, which requires an increase of USD 10.2 Billion annually for both MDG 4
&5

B

4

(MDG 6) Comprehensive financial and action plan for the attainment of Universal Access to Prevention, treatment and care by 2010: Will
the G8 seriously commit to fighting HIV/AIDS?

C

5(MDG 6) Political commitment towards the removal of travel restrictions (denial of Entry, Stay and/or Residence) of HIV+ persons(MDG 6)
HIV : Can they protect fundamental human rights of freedom of movement and residence for all?

D

6

(MDG 6) Address the urgency of the emerging HIV/TB co-infection, multi-drug resistant (MDR) and extensively drug-resistant (XDR) TB,
and the need to commit and support Global Plan to Stop TB : Can we respond to current and emerging global health concerns?

B

7(MDG 6 & Health Systems) The fulfillment of the USD 60 Billion pledge made at the 2007 G8 Summit in Heiligendamm for the three
infectious diseases and Health System Strengthening by 2010. Commit fully to fully fund the Global Fund to fight AIDS, TB and Malaria so it
grows to the size of USD 6-8 Billion by 2010: Can the G8 fulfill its commitments?

8(Health Systems/Health Care Workers) Firm and time bound targets and financial commitments necessary to increase the number ofhealth workers in developing countries: Can there be a numerical target and financial commitment?

9(Health Systems) The realization of Universal Access to comprehensive primary health care, including the removal of user fees indeveloping countries, and increase developing countries' health spendings by lifting/relaxing IMF macroeconomic restraint policies: Can werealize health for all?
(Follow Up Mechanism) Global health as a permanent agenda of the G8. To hold the G8 accountable, a mechanism that will annuallymonitor and evaluate the progress towards the attainment of global health commitments: Can they create a mechanism that will make themkeep their promises?

A-

10

FinancialCommitment

Comprehensive
Grade

D

F
D

Details/Comments

C

Good Points: the political will to select "health" as a major agenda as the most off-track targets of MDGs
and organized a series of G8 Health Experts Meetings to issue the final outcome document as "Toya-ko
Framework". Challenges: No mention about 0.7% target, and strong resistance from some G8
governments to include Gleneagles Commitment to increase ODA to 50 billion annually.

C

Good Points: Clear mentions about nutrition and immunization. Challenges: No mention at all on financial
issuesD

Good Points: SRH was written as a prioritized agenda. Challenges: a backward from TICAD Action Plan
which included Universal Access of SRH. No financial commitments at all.

C

Good Points: Clear targets in skilled birth attendants and mentions on PMTCT. Challenges: No financial
commitment at all

D

Good Points: Concrete and clear mentions on gender, vulnerable groups etc. on especially prevention.
Challenges: No financial plans to disburse necessary budget to achieve UA.

D

Good Points: raised the issue in the G8. Challenges: It is necessary to mention legislative reform to abolish(or relax) travel restrictions but no clear mentions about it. We expect the G8 "follow" this issue and
"
it"
Good
Points:Strong mentions on MDR/XDR-TB and HIV/TB Co-infection. Challneges: No financial

D

C

D

D

B

D

C-

Good Points: clear set of the deadline. Challenges: If it is disbursed by 5 years it may mean decrease of thefinancing to the 3 diseases and HSS. Ambiguous explanation, such as "The 3 infectious diseases" to just"infectious diseases" and "health system strengthening" to "strengthen health"Good Points: firstly mentioned on this issue and set clear target "2.3/1000" Challenges: No mention about"4.1/1000" and "doubling HCW in Africa". Ambiguity on stoping brain drain.

B-

D

C-

Good Points: clear mention about children's access to "basic health care services", including free ofcharge. Challenges: No mention about improving access of PHC to women and vulnerable groups.

A-

Good Points: a clear mechanism to evaluate the progress of G8 governments each. Challenges: Unknown
if the future host countries can work along this mechanism. We put the high score with our expectation.

commitments except 60 billion of Heiligendamm. No mention about TB in G8 Communique.

10

Evaluation

Letter
Grade

General

ExcellentA

Deserving of high praise

Full financial and political commitment with a time bound concrete action and financial plan. Satisfactorytarget

C-

Good

B

Positive/active direction(1) acceptable (but still lacking) financial contribution target (2) Targets are acceptable, concrete andtime bound action plan for the attainment has a positive outlook

AverageC

Contains some inadequate/insufficient points

financial contribution is lacking, target timeline is ambiguous/unclear, problems with planning

Below Average

D

Very problematic, highly inadequate/insufficient

contains only the issue or analysis of the issue, no clear of concrete financial and action plan. No timetarget.

FailureF

Missing/ completely lacking, thus impossible to evaluate

No mention of issue

General Score
Substance

B-

FinanceD

On wording and arrangement

On numerical targets, financial commitment, timelines, action and financial plans＜Ref.13＞ Final Press Release from Civil Society（July 9, 2008）

PRESS RELEASEWill Toya-ko Leave Its Mark in the Book of Global Health Legacies?
The answer lays in the future leadership of Japan
Global Health Committee, 2008 G8 Summit NGO ForumThe success of the Okinawa Summit, once more: carrying the anticipation of civil societies working for global health,the G8 Hokkaido Toya-ko Summit officially convened. On July 9, 2008, two documents was released: theCommuniqué on Development and Africa by the G8 leaders and the Toya-ko Framework for Action on Global Health,a report by the G8 Health Experts group.
Holding the legacy of brining forth HIV/AIDS and other infectious diseases as a major agenda item within global healthat the Okinawa Summit, this Toya-ko Summit attempted to attain health related Millennium Development Goals byshedding light to not only the infectious diseases, but to issues that still lack adequate measures and action such as
maternal and child heath and health workers shortage in developing countries. In November of last year, Foreign
Minister Masahiko Koumura has called for a stronger engagement of the international community in Global Health bycreating a common framework for action on Global Health. This lead the Japanese Government to creating and holding
G8 health experts group that has met three times since this February, setting the stage for the Toya-ko Summit.
“At this Toya-ko Summit, we should take special note that cooperation between the government and civil society has
further developed throughout this health policy making process,” said Sumie Ishii, the chair of the G8 NGO Forum
Poverty and Development Unit, “Japanese NGOs has made large contributions to the policy making process for the G8
Toya-ko Summit”.
However, the communiqué, as well as the framework for action, released at the Toya-ko Summit does not answer to the
expectations of the civil society. On the issue of healthcare worker shortage in developing countries, the G8 countries
has agreed to work towards the increasing health workforce coverage of 2.3 health workers per 1,000 people. However,progress on this issue was very limited, as this agreement came without any financial commitments to attain this target.
On the issue of Maternal and Child health, which was perceived to make great progress, however, due to the differenceof opinions among member countries, prevented any bold and concrete commitments to be made. The greatest barrierthat the G8 countries could not overcome was the lack of their financial commitment to health.
Last year at the Heiligendamm Summit, the G8 countries committed to USD 60 Billion to fighting the three major
infectious diseases and Health System Strengthening over the coming years. The time limit for achieving this goal was
set for 5 years in this G8 communiqué. However, when calculating the total financial contributions necessary forvarious international mechanisms/organizations in the next 5 years to fighting the three infectious diseases and healthsystem strengthening, a total of USD 170 Billion will be necessary. If the contributions of the eight major countries stopat 60 Billion, the current effort in fighting the three major infectious diseases and health system strengthening will only
regress.
“The Framework for Action contains much about what the G8 ought to do, but without the necessary money, Africa,
moreover the world, will not achieve heath related MDG goals,” stated Masaki Inaba, chair of the Global HealthCommittee of the G8 NGO Forum Global Health Committee, “the G8 are expected to provide the financial contribution,
yet at this G8 Summit, they have failed to do so”.
To evaluate the G8 on its progress in tackling global health issues, NGOs has created a report card, with five scores
ranging from A to F. The overall score of the G8 was a C-. The only issue that received an A- is accountability. At the
G8 Toya-ko Summit, the G8 countries agreed upon a mechanism to review their progress in meeting past commitments.
However, there was no guarantee that this process will be carried over to Italy, Canada and beyond, nor was there any
guarantee that this mechanism will be used effectively. In the end, this mechanism will be useless if it does notcontribute and benefit the health those living in the developing countries. Thus, civil society has given the A- with acertain hope. Whether the G8 Toya-ko Summit will leave its mark in the legacies of achievements in global health - itwill all depend on the leadership of Japan.

Survival Kit
Global Health and the G82008 G8 Toya-ko Summit Process& Experiences of Civil Society

Published● September 2008
Publisher● Japan AIDS and Society Association/
Africa Japan Forum
Chief Editor●Masaki Inaba
Phone●03-3834-6902
FAX●03-3834-6903
E-mail●project.ring@gmail.com
Web●http://www.project-ring.jp/index.html