ISSN0535-1405

公益財団法人

日本 国際 医学 協 会 誌

第61回国際治療談話会総会

ウィズコロナの医療体制№ 509

2022. January

Page 2

International Medical NewsThe 61st International Congress on Therapy

Medical systems with COVID-19
Opening remarks :Koichi Ito, MD, PhD (Managing director, IMSJ)Congratulatory remarks :Dr. Clemens von Goetze (Ambassador, Embassy of the Federal Republic of Germany Tokyo)
Toshio Nakagawa, M.D., Ph.D. (President, Japan Medical Association)

Medical Lectures Chair :Koichi Ito, MD, PhD (Managing director, IMSJ)Taro Kondo, MD, PhD (Managing director, IMSJ)

Lecture I: Challenge to Covid-19 vaccine
Akihisa Harada MD, Ph.D
(President & Representative Director, Pfizer Japan Inc.)

Lecture II: COVID19, a disease that took the World by the cytokine storm
Beate Heissig, MD PhD(Specially Appointed Associate Professor, Department of Research Support
Utilizing Bioresource Bank, Graduate School of Medicine, Juntendo University)

Lecture Ⅲ : Global perspective-pandemic preparedness and response
Nahoko Shindo, MD, PhD(Senior Advisor, Global Infectious Hazard Preparedness Department ,WHO Health Emergencies Programme)

Lecture Ⅳ : COVID-19 in Germany
Mathias B. Bonk, MD, MSc, DTM(Chairman of the Board, Berlin Institute of Global Health)
Chair :

Kenichi Ishibashi, MD, PhD (Chairman, Board of Directors, IMSJ)

Discourse : Based on comparison of the Japanese and German Constitution ー
Does the Japanese Constitution need change?
Prof. Dr. jur. Heinrich Menkhaus (Full Professor, Faculty of Law and Graduate
School of Law, Meiji University / Director, MICL)
Closing remarks :Kenichi Ishibashi, MD, PhD (Chairman, Board of Directors, IMSJ)ISSN0535-1405

No. 509

January 31, 2022
Published by International Medical Society of Japan,
Chairman, Board of Directors: Kenichi Ishibashi, MD, PhD
Editors: K. Ito, MD, PhD, T. Kondo, MD, PhD,
K. Ichihashi, MD, PhD, T. Murakami, PhD, R.Nagai, MD, PhD,
I. Taniguchi, MD, PhD, and T. Yamazaki, MD, PhD
3F MK Sangenjaya Building, 1-15-3 Kamiuma, Setagaya-ku,Tokyo154-0011,Japan.
TEL 03(5486)0601 FAX 03(5486)0599 E-mail: imsj@imsj.or.jp https://www.imsj.or.jp/

Opening Remarks
Koichi Ito MD, PhD
Managing director, IMSJJapan in the last weeks and I hope this success canbe sustained. But it is of utmost importance toexchange the views of the experts from both sides,
to learn from each other and combine forces tofight this difficult disease and this pandemic.

Congratulatory message

I know that the society is extremely active in
combining the knowledge of international scientists

Dr. Clemens von Goetze
Ambassador
Embassy of the Federal Republic of Germany Tokyoand physicians in this field and I wish you fruitful and

It is a great honor to speak here to the International

Congratulatory message

Medical Society of Japan and I congratulate you

successful deliberations.

on holding this year’s conference. These confere

Toshio Nakagawa, M.D., Ph.D.
President
Japan Medical Associationnces have a long tradition and since many years
they connect closely the medical worlds of Japan
and Germany.

On behalf of the Japan Medical Association, JMA, I
would like to express my congratulations on the
I know that you are covering a broad spectrum of

opening of the 61st International Congress ofdifferent fields of medicine since decades, and this

Therapy.

year you have chosen a very pressing subject,obviously the pandemic and ways to fight it. We
recognize with pleasure that the number of Covid-19
cases have been going down tremendously in

Almost two years have passed since the COVID-19
began to rage across the world, yet the situation isstill unpredictable. As of the end of September, theState of Emergency and the Priority Preventative
Measures were both completely lifted. The number

Page 15International Medical Newsof new confirmed cases in Japan has decreased
from the peak of 25,992 on August 20th to 84 on

Grußbotschaft

November 1st in Japan, and from the peak of 5,908
on August 13th to 9 on November 1st in Tokyo.
However, in light of overseas cases where theinfection re-expanded after easing the behavioral
restrictions, we must continue to be relentless in
response to the COVID-19.
We need to build the cross-border cooperation incountermeasures against the COVID-19. As part ofthat, the Confederation of Medical Associations in
Asia and Oceania (CMAAO), JMA is a member of,held its General Assembly Taipei as an online
meeting in September. The “Taipei Statement on
Collaborative Work for Managing Novel Pathogen

Jürgen Kessing
Oberbürgermeister der Stadt
Bietigheim-Bissingen
Sehr geehrte Damen und Herren,dem 61. Internationalen Therapiekongress der Internationalen Medizinischen Gesellschaft Japans sende ich im Namen der Stadt Bietigheim-Bissingen,ihrer Bürgerschaft wie auch persönlich die besten
Grüße. Es ist mir eine besondere Ehre, Ihnen auch indiesem Jahr ein Grußwort zukommen zu lassen.

Pandemic” was adopted there. Moreover, theWorld Medical Association (WMA), JMA is a memberof, held its General Assembly London as an online
meeting in October. There, the “WMA Resolution on
COVID-19

VaccinesandInternational

TravelRequirements” was adopted.
In addition to the activities in CMAAO and WMA,JMA shares information obtained through exch
anges in the fields of global health, such as national
medical associations, the WHO Western PacificRegional Office and the Japan External Trade
Organization, JETRO, New York. JMA will continue torespond to the COVID-19 infection in cooperation
with medical associations, physicians, and other
healthcare professionals around the world.
It will be a long battle, but the COVID-19 will
eventually come to an end. Thus, we should ensurethat countries across the world will continue working
together and stay committed to the infection
control, so that the entire world wins against the
COVID-19.
In conclusion, I would like to express my sincere
wishes for the success of this congress, the continued
growth of the International Medical Society ofJapan, and the good health of all attendees.

Letztes Jahr stand Ihr Kongress unter dem Motto„Coronavirus - Infektionskrankheit: Japan und deu
tsche Maßnahmen im Vergleich“. Dieses Jahr haben
Sie das Thema „Medizinische
Systeme nach COVID-19" ausgewählt. In diesem
Jahr wird der Kongress auch erstmals eine
reine Onlineveranstaltung sein.
Die Themen, die Sie in diesem und im letzten Jahr
gewählt haben, sind angesichts derweltweiten Pandemie besonders relevant und die
Vorträge werden mit Sicherheit einenwichtigen Beitrag für die künftige Pandemiebekämpfung leisten. Die Themen zeigen auch, wie sehrsich unser Leben durch diese weltweite Pandemie
verändert hat. Sie werden uns auch in den nächsten
Jahren beschäftigen. Die Internationale Medizinis
che Gesellschaft ist gerade in diesen Zeiten unerset
zlich und spielt eine wichtige gesellschaftliche Rolle.
Erwin von Bälz wirkte Ende des 19. Jahrhundertsüber 26 Jahre an der Universität von Tokiound lehrte nicht nur, sondern lernte auch selbst viel
dazu. Er behandelte Kranke, erforschte
die Kultur und die alten japanischen Heilmethoden
und machte unter anderem auf die Heilkraft der
heißen Quellen in Kusatsu aufmerksam. Er förderte
den Austausch von Wissen, von Erfahrungen und
Kenntnissen, um für alle Völker in der Welt und die
Wissenschaften einen Mehrwert zu erzielen. In die
sem Sinne entwickelte sich die Medizin in Japan bis

Page 16

International Medical News

heute zu einer fortschrittlichen, gerade in der For
schung starken Wissenschaft.
Die Internationale Medizinische Gesellschaft Japans
hat diesen Anspruch Erwin von Bälz‘ auf Begegnung,Austausch und freundschaftliche Beziehungen vorüber 60 Jahren aufgegriffen und ihm durch die
Kontaktaufnahme zu Bietigheim-Bissingen, dem
Geburtsort Erwin von Bälz‘, eine neue Richtung
gegeben. In der Tradition Erwin von Bälz‘ nutzen wir
heute die Chancen zum gegenseitigen Kennenl
ernen, zum Austausch von Ideen und Kultur undstärken damit die weltweite Völkerverständigung
und den Frieden. Das Vermächtnis Erwin von Bälz‘ ist
bis heute lebendig und wir wollen es auch in Zukunftweiter pflegen.

Grußbotschaft

Markus Baier
Bürgermeister der Alten
Hansestadt Lemgo

Sehr geehrter Herr Dr. Kenichi Ishibashi,sehr geehrte Damen und Herren der Internationalen
Medizinischen Gesellschaft Japans,
im Namen von Rat und Verwaltung der Alten
Hansestadt Lemgo grüße ich Sie zu Ihrem 61,
Internationalen Therapiekongress. Auf diesem

Vor allem der Jugend widmen wir unsere Städte
partnerschaft mit Kusatsu, die die Freundschaft
fortsetzt. Nächstes Jahr werden wir mit Kusatsu unser
60-jähriges Partnerschaftsjubiläum begehen, das
unsere Verbundenheit über Grenzen hinweg festigt.

Wege wünsche ich dem ersten Online-Kongress„Medical systems after COVID 19" einen guten underfolgreichen Verlauf.
Die Pandemie dauert jetzt schon 1 1/2 Jahre an
und es ist noch immer kein Ende absehbar. Diese

Die Internationale Medizinische Gesellschaft Japans
bildet auch heute noch ein wichtiges
Bindeglied für den wissenschaftlichen, insbesondere
medizinischen Austausch zwischen
Japan, Deutschland und vielen anderen Ländern
dieser Erde. Hier danken wir derinternationalen Medizinischen Gesellschaft Japans
und wünschen den diesjährigen
Beratungen des Internationalen Therapiekongresses
einen guten Verlauf.
In diesem Sinne wünsche ich der Internationalen
Medizinischen Gesellschaft Japans weiterhin
erfolgreiches Wirken und ein gutes Gelingen
anlässlich ihres diesjährigen Kongresses. Die Stadt
Bietigheim-Bissingen wird ihren Freunden in Japan
stets eng verbunden bleiben.
Mit freundlichen Grüßen,Pandemiebedeutet für die Menschen eine große Heraus
fordung, da immer neue Situationslagen eine
gewisse Flexibilität erfordern, auch für die Medizin.
In der Forschung sowie auch die Wissenschaft
müssenneue

Erkenntnisse

gewonnenaustauschen dieser Daten ist von enormer
Wichtigkeit für die ganze Menschheit.
Sehr geehrter Herr Dr. Ishibashi, über ein persönliches
Kennenlernen in der Geburtsstadt von Engelbert
Kaempfer würde ich mich auch sehr freuen. Es wäre
uns eine große Freude, Sie und eine Delegation derInternationalen Medizinischen Gesellschaft Japans
in naher Zukunft in der Alten Hansestadt Lemgo
begrüßen zu dürfen.
Mit freundlichen Grüßen
Ihr

Jürgen Kessing
Oberbürgermeisterundausgewertet werden. Die Weitergabe und das

Markus Baier
Bürgermeister der Alten Hansestadt Lemgo

Page 17

International Medical News

Grußbotschaft

Denn hier bei uns in Karlsruhe sind japanische
Lebensart und Kultur in vielfacher Weise präsent.
Dies ist vor allem das Verdienst der sehr engagierten
Deutsch-Japanischen Gesellschaft in der Fäche

Dr.Frank Mentrup
Oberbürgermeister der Stadt
Karlsruherstadt, die sich mit großem Erfolg für Verständnis und
Freundschaft zwischen Deutschland und Japansowie für die Förderung kultureller und wissensc
haftlicher Beziehungen einsetzt. Seit 1994 ist die

Grußbotschaft von Oberbürgermeister Dr. Frank

Deutsch-Japanische

Gesellschaft

Patin

des

Mentrup für den 61. Internationalen Therapiekongress

Japangartens im Karlsruher Zoologischen Stadt

der Internationalen Medizinischen Gesellschaft

garten, dessen Geschichte auf das Jahr 1914

Japanszurückgeht, als ein Karlsruher Arzt eine Steinleuchte
und verschiedene Samen aus Japan mitgebracht
Gesellschaft

hatte. Mit seiner Pagode, seinem Steinlöwen, demJapans übermittle ich zu ihrem 61. Internationalen

Shinto-Schrein und vor allem dem im Jahr 2018 neu

Therapiekongress im Namen der Stadt Karlsruhe,erbauten Teehaus verströmt der Garten das Flairihres Gemeinderats und ihrer Bürgerinnen und

des - für uns - Exotischen. Der Gang durch das rote

Bürger und auch ganz persönlich die besten„Torii“ führt mit einem Schritt in eine andere Welt.

Wünsche. Zum ersten Mal wird in diesem Jahr der

Gleichzeitig ist der Japanische Garten für die

Kongress als reine Onlineveranstaltung mit Web-

Karlsruherinnen und Karlsruher – fast wie selbstve

Vorträgen aus Japan und Deutschland stattfinden,

rständlich – ein Stück Ur-Karlsruhe. Dieser unaufger

bedingt durch die Corona-Pandemie. Nicht vonegte Umgang mit dem Anderen, diese harmonische

ungefähr ist das Thema des Therapiekongresses inIntegration des vermeintlich Fremden spiegeln diediesem Jahr „Medizinische Systeme nachweltoffene Atmosphäre wider und die Neugier auf

COVID-19“.

Neues, die unsere Stadt seit jeher auszeichnet.

Die intensiven Verbindungen mit der Stadt Karlsruhe

Ich wünsche der Internationalen Medizinischen

freuen mich ebenso wie die engen Bande, die es

Gesellschaft Japans für die Zukunft viel Erfolg undzwischen der deutschen und der japanischen

dem 61. Internationalen Therapiekongress auch im

Medizin seit langem gibt. Dafür stehen namhafteneuen Format einen erfolgreichen Verlauf und guteÄrzte wie Dr. Erwin von Bälz und Dr. Engelbert

Ergebnisse.

Der

Internationalen

Kämpfer.

Der

Medizinischen

ehemalige

Präsident

derInternationalen Medizinischen Gesellschaft Japans,
Professor Dr. Choei Ishibashi, hat sich, ebenso wie
später sein Sohn Chosei und heute sein Enkel Dr.

Dr. Frank Mentrup

Kenichi Ishibashi, stets aktiv für die guten BeziehungenOberbürgermeisterzwischen den Medizinerinnen und Medizinern
Japans und denen der Fächerstadt eingesetzt. Ich
wünsche mir daher sehr, dass diese Tradition mit
dem Therapiekongress 2022 in Karlsruhe wieder
fortgesetzt werden kann.

Page 18

International Medical News

Congratulatory Telegram
Kenro Hori MD
President, Japan Dentist Association

Lectures on Medicine
Lecture I
Challenge to Covid-19 vaccine

Please accept our sincere congratulations on the
success of the 61st International Congress on
Therapy.
We truly wish further development of your Society
and the health of your members.

Nobuo Yamamoto MD
President, Japan Pharmaceutical Association

Akihisa Harada MD, Ph.D
President & Representative Director
Pfizer Japan Inc.
From the beginning of 2020, the pandemic thatinvolved the world at risk, the number of infected
people increased day by day, and it became
severe and the socio-economic activity fell into a

I'm delighted that the 61st International Congresson Therapy is such a grand event.
Through events and lectures such as these, yourassociation contributes to both the improvement ofhealth care in Japan and the development ofinternational medical exchange as well. I truly
respect everything you do.
I hope your association will continue to prosper andgrow.

state of being unable to remain. In January 2020,
the entire gene sequence was released from Chinaas "SARS-CoV2", and WHO named this viral infection"COVID-19". After that, research institutes andpharmaceutical companies around the world
began research and development of vaccines andtherapeutic agents to challenge this pandemic. In
order to challenge this pandemic as an industry,
pharmaceutical companies actively exchanged
information with other companies regarding
COVID-19, even among competing companies inIntroductory Message fromthe Chair
Taro Kondo MD, PhD
Managing director, IMSJ

normal times. In addition, since venture companies
are actively investing research resources in this area,large companies are promoting the provision ofdevelopment know-how to such venture com
panies, and the surplus of the production capacity

Since the announcement of the COVID-19
pandemic in March 2020, people's lives havechanged all over the world.
People have to live their lives while feelingsurrounded by life-threatening infectious diseases
every day. The vaccine that was developed has
been widely inoculated and Japan has overcome
the fifth wave.
There are a wide variety of issues such as diagnosis
and treatment, the medical system, after effects,
virus mutations, and social life.
At today's Congress, we invited four speakers fromJapan and Germany. I'm sure that we can shareand renew our knowledge by listening to theirpresentations.

of large companies was provided to those small
companies` antiviral drugs and vaccines asset
production. In 2020, it was seen among US R &D-type companies that the industry was united totake on the challenge of this pandemic, which is
not normally seen, in order to counter the pandemic
that threatens society. I think we also have a lot tolearn. We have more than 200 such projects withother companies and other ventures. After that, avaccine with a new mechanism was developed
within a year, and it is becoming a step to regainthe "normal life" of society. This success allowed thevaccine to be launched in this short period of time,
starting all the normally sequential processes at thesame time, without omitting the entire development

Page 19

process. However, it was not only the efforts of one
company that succeeded in the phase III clinicalInternational Medical News

reassurances like wearing a mask given the airborne
transmission of the virus.

trials at 150 medical institutions around the world inthis short period of time, but also the power of many
people who believed that they would overcome
this pandemic. This vaccine development inspiredby challenge against COVID-19 encouraged thecohesiveness of the industry that supported it, andvolunteers who participated in clinical trials, medical
professionals, and regulatory agencies. The courageof many people contributed to bring Science toreal-world application in medical setting. In this talk,I would like to introduce the background of vaccine
development and our challenges to the pandemic.

Lecture II
COVID19, a disease that took the Worldby the cytokine storm
Beate Heissig, MD PhD
Specially Appointed Associate Professor
Department of Research Support Utilizing
Bioresource Bank
Graduate School of Medicine, Juntendo University
Storms increase in a world struggling with climatechange. Preparedness is protection.
The coronavirus disease 2019 (COVID-19) pandemic
caused by the severe acute respiratory syndrome
coronavirus 2 (SARS-Co-2) in the most severe cases
presents with clinical symptoms of acute respiratory
distress syndrome and hyper-inflammation withfeatures of cytokine storm syndrome. Our groupstudies the role of coagulation- and fibrinolysisassociated factors in the regulation of the cytokine
storm in severe cases of inflammation. It will be
important to understand the role of those factors in
the patho-mechanism of COVID-19 giving a window
for treatments.
The COVID-19 pandemic has taken the world bystorm. Governments quickly reacted to contain the
spread of the virus ranging from lockdowns, overschool closures, to basic hygiene standard

Vulnerabilities in health systems, local or central
governments, and global science collaborations
have emerged during the pandemic.
How prepared was the scientific community for thispandemic? Here, a definition of scientific prepare
dness (adapted from the frameworks of the Assistantsecretary for preparedness and response within the
United States Department of Health & Human
Services): Science preparedness is a collaborative
effort to establish and sustain a scientific researchframework that can enable emergency planners,
responders, and the community to better prepare
for, respond to, and recover from major publichealth emergencies or disasters.
The basis are collaborations between government
agencies, the private sector, academic institutions,and community organizations on a national andinternational scale.
A sound research infrastructure to tackle a disasterlike the COVID-19 pandemic includes:
・Rapid Institutional Review Board
・Pre-identified Scientific Research Networks
・Reliable and Accessible Data and Material
Sources for Preclinical and Clinical Studies
・Static and Dynamic Funding Streams between
countries
To achieve this level of scientific preparedness on
an international scale, strong ties between countries
should be established.
Germany and Japan have a long history ofcollaborations and scientific exchange dating backto the late 19th century. Germany welcomed many
young Japanese physicians to study with worldleaders in medicine like the pathologist Rudolf
Virchow (1821–1902), or the bacteriologist RobertKoch (1843–1910). A famous example was Dr.
Shibasaburo Kitasato, a scholar of Robert Koch, thefounder of the Institute of Infectious Diseases, later
renamed The Institute of Medical Science, The
University of Tokyo. Today, Germany and Japan
have one of the best health systems in the world,and given similar scientific standards, scientists andPage 20

International Medical News

physicians from Germany and Japan are a perfectmatch to set up a sound international research
infrastructure. Following are thoughts andexperiences on research preparedness during the
COVID-19 pandemic:
・Rapid Institutional Review Board.
The usually time-consuming process of approving apreclinical or clinical studies if it is national orinternational should be could help to react faster to
new disasters.
・Pre-identified Scientific Research Networks
According to Maher et al. (Nature, June 16, 2021),
international collaborations on COVID-19 only rose
within the first few months of the pandemic
compared to non-COVID-19 research. Of interest,
one-third of those collaborating internationallyduring the pandemic were born in another country
and just reconnected with colleagues. Anotherthird were collaborating with someone who had
worked in one capacity or another in the UnitedStates.
These study results show that international
collaborations are borne out of the experience of
having worked in a different country beforehand. It
is therefore vital to reinstate medical scholarly
exchange between Japan and Germany togenerate a viable network necessary for scientificpreparedness.
・Reliable and Accessible Data and Material
Sources for Preclinical and Clinical Studies
Access to excellent basic science facilities, clinicalsamples, and reliable clinical data are necessary toanswer the big questions in medicine. Cell lines arepatient, but patient samples are the key to a realistic
understanding of what happens in the patient. At
Juntendo University, we established a department
to use bioresources to promote medical research.
We collected COVID-19 patient samples andsamples from individuals after vaccination.
Bioresource banks can quickly provide valuable
clinical data and patient material to the global
scientific community. Receiving long-term funding
for biobanks like ours will be another step to scientificpreparedness.Having modules in place to conduct
international rather than national clinical studies isanother level of scientific preparedness.

Storms will come more often. Scientific preparedness
can help us to react faster.

Lecture III
Global perspective-pandemic
preparedness and response
Nahoko Shindo, MD, PhD
Senior Advisor
Global Infectious Hazard Preparedness Department
WHO Health Emergencies Programme
Two years have passed since the first report of
COVID-19 at the end of 2019. The global epidemicof COVID-19 is still ongoing. The number of patientsis increasing especially in Europe and the UnitedStates due to the start of new academic year,
international travel and the resumption of socioeconomic activities. According to WHO's data,vaccines have already been received more than 1billion times; however, there are countries where thevaccination rate is below 40%, mainly in low-income
countries such as those in Africa. Equal provision of
vaccines is an urgent issue in terms of global
epidemic control.
Japan has the lowest COVID-19 mortality rate
among developed countries. It is worth noting thatin an overwhelmingly super-aging society, Japan
was able to protect its vulnerable people andsuppresstheimpactof

COVID-19

without

conducting a major lockdown. The recent drastic
decrease in the number of patients is thought to be
due to the following reasons: good hygiene
practices have been thoroughly implemented, andpublic health interventions (the cancellation or
postponement of large-scale gatherings, the settingofoccupationalguidelines,

andperforming

infection control measures at medical institutions)were effectively implemented.
Moreover, vaccination was conducted quickly, anda sense of crisis permeated even among groups
with limited access to public health messages also
known as the "information pocket", owing to news
that reported the death of young people at homePage 21

International Medical Newsand people who were stuck inside of ambulances

Germany. This also applies to several neighboringand not able to enter medical institutions, as well as

countries such as Austria, Belgium, Denmark, or thesocial media communications.

Netherlands. One of the main reasons for these

According to information collected worldwide by

developments are the insufficient vaccination rates,

WHO, about 170 "pandemic leads" are detected

often due to either a lack of political leadershipeach year. In addition, a major incident related toand/or an ongoing distrust in politicians, public

infectious disease has occurred almost every 4-5

health authorities and scientists. This presentation

years since the beginning of the 21st century. Many

will provide you with an overview of the developmentof the newly re-emerging infectious diseases,of the COVID-19 pandemic in Germany over time,

including COVID-19, have been animal-origin

the current situation, important factors contributing

pathogens. Environmental changes on the earth

to these as well as challenges, opportunities, andcaused by a variety of reasons are affecting thepossible solutions.

outbreak and spread of these zoonotic infectious
diseases. Large-scale epidemics and pandemics ofinfectious diseases will surely continue to occur inthe future. It is necessary to create crisis management

Introduction of speaker of
discourse
Kenichi Ishibashi, MD, PhD
Chairman, Board of Directors, IMSJ

measures and business continuity plans with thesefacts in mind.

Prof. Dr. jur. Heinrich Menkhaus, a full professor at

Lecture IV

Meiji University's Faculty of Law Graduate School

COVID-19 in Germany
Mathias B. Bonk, MD, MSc, DTM
Chairman of the Board
Berlin Institute of Global Health
Almost two years after the first COVID19 cases havebeen reported and despite a wide range of often
drastic measures such as lockdowns, the pandemic
is far from being over and Europe and Central Asia
are now at the epicenter of it again (WHO,November 4, 2021). In Germany with its 83.2 million
inhabitants 5.045 million cases have been diagnosed
so far and 97.715 people have died due to or with
COVID19 (RKI, November 15, 2021). While Germanyof Law, will give a lecture entitled "Based oncomparison of the Japanese and German Con
stitution - Does the Japanese Constitution needchange? "Dr. Menkhaus has had a long relationship with our
foundation since he was a professor at the Universityof Marburg's Center of Japanese Studies in Ger
many, 17 years ago.
When our foundation members visited Germany, hevery kindly took care of us.

Discourse
Based on comparison of the Japaneseand German Constitution-Does theJapanese Constitution need change?

has been lauded for its successful response at the
beginning of the pandemic, it is now in its 4th wave
with an exponential growth of cases (up to about
50.000 / day) and a growing number of daily deaths.
While there are only limited restrictions such as com

Prof. Dr. jur. Heinrich Menkhaus
Full Professor, Faculty of Law and Graduate Schoolof Law, Meiji University
Director, MICL

pulsory mask wearing in shops, but no lockdowns or
school closures, in place right now, the hospital

It is of course possible to compare the German andcapacities, especially in intensive care units, are

the Japanese constitutions as both states havereaching their limits in more and more regions in

written constitutions. But to use the German one asPage 22

International Medical Newsa model for change of the Japanese one might for

the Federal State as such.

a number of reasons not be the best idea. Too
different are the underlying histories and too

As a result it is not surprising that the Germandifferent the very principles that guide the twoconstitution, which was promulgated in 1948 andconstitutions. To give just a simple example,

therefore is only a little younger than the Japanese

Germany is a federal state, Japan a centralized

one, has been revised 63 times up to date, while theone, Germany is a republic, Japan more a mon

Japanese constitution of 1946 was not changed

archy, although the Japanese constitution does noteven once. This is of course due to the very highstipulate the head of stateand Germany has torequirements for constitutional change in Japan,

integrate itself into building a new state, the EU,

but it has led to a visible disparity between the facts

something not visible in East Asia.

and

It is better to look for guidance in the theoreticalfundamental loss of trust in the validity of legal

discussions of what needs to be written in a

regulation.

their

legal

regulation,which

causesaconstitution and what the typical judicial terms usedinconstitutions

mean.

In

this

respect,

both

There are some features in the current Japaneseconstitutions have their shortcomings and bothconstitution that offer food for thought in Germany.

need constant change. Let´s just have a look at the

For example, the public vote on the cabinet

regulations in both constitutions on the basic

appointed judges of the Japanese Supreme Court

features that constitute a state. No mention of the

could be introduced to the German constitution toterritory in both and almost no mention of how to

improve the guiding principle of democracy andgain citizenship. The Japanese constitution entrust

the autonomy of the administration of the Japanese

this question completely to a separate law and theSupreme Court over all affairs of the judiciary inGerman constitution restricts itself to the prohibition

Japan could, being taken over in Germany upgradeof extradition of German citizens, without giving

the separation of powers as part of the guiding

even a hint of how citizenship is to be acquired.

principle of Rule of Law in the German constitution.

The same situation is to be found when it comes to

There might also be some features in the German

the more formal regulations of name of the state,

Basic Law that could help to improve the Japaneseflag, anthem, symbol and spoken and written

constitution. On the basis of the necessity oflanguage. In the Japanese constitution there is no

executing democracy as a guiding principle there

mention of either and the German one only says

should not be the possibility to close the lower houseabout the flag, that it has three colors, namelyof the parliament by sole decision of the prime

black, red and gold.

minister, because the political party to which theprime minister belongs should not be able to takeAs far as the guiding principles of the state areadvantage of a favorable view of his party among

concerned the picture does not look much better.

the voters. Again to strengthen the principle of

Democracy, Rule of Law, Welfare State etc. are notdemocracy it might be recommendable to enlarge

even mentioned in the Japanese constitution,

the parliamentary control of cabinet decisions by

although Japan of course claims that is following

creating the necessity of parliamentary consent as

this principles. In Germany the very important Rulethis is done in the German constitution e.g. for theof Law is mentioned only in Art. 28 of the Basic Law,

deployment of the armed forces.

where it does not belong, because this article
stipulates the guiding principles for the constitutionsof the states that created Germany as a Federal
State, but of course the Rule of Law also governs

Page 23

International Medical News

Closing Remarks
Kenichi Ishibashi, MD, PhD
Chairman, Board of Directors, IMSJ
We appreciate that many people participated in
the

61st

International

Congresson

Therapyorganized by our foundation. We would like to thankDr. Harada, Dr. Heissig, Dr. Shindo, and Dr. Bonk fortheir very thoughtful lectures on the COVID-19
infection. In early spring, we planned the theme ofthis congress to be the "Post-Corona Medical
System", assuming that the corona infection would
have subsided. However, the situation has become
contrary to our expectations, so we had to change
the theme to "Medical systems with COVID-19" onshort notice. Now, there are concerns about a sixthwave of COVID-19 infections in Japan. We hopethat today's lecture will be useful to everyone intheir daily lives immediately, as well as for medical
treatment in how to deal with this virus from now on.