## (2) Health, Welfare, and Population

A large number of people living in developing countries cannot access basic health services that are usually available in developed countries. As immunization and sanitation have not been set in place, more than 25,000 children under five years old die every day due to causes such as infectious diseases, nutritional disorders, and diarrhea $ {}^{\text{(Note 12)}} $ . Moreover, more than 500,000 pregnant women lose their lives every year due to the lack of emergency obstetric care by skilled birth attendants like midwives.

Conversely, in line with its continuing steady rise, the

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At the G8 Kyushu Okinawa Summit in 2000, Japan took up the issue of infectious diseases as one of its main themes for the first time in the history of the summit meetings. In 2005 Japan formulated the Health and Development Initiative (HDI), which aims to contribute to the achievement of the health-related Millennium Development Goals (MDGs). Under HDI, Japan takes a comprehensive approach that includes fighting against infectious diseases, maternal, newborn and child health care, and strengthening health systems. It also provides support that takes into consideration coordination with sectors that are closely related to health, such as water and sanitation and also basic education. Moreover, Japan takes initiatives through the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund) in order to tackle HIV/AIDS, tuberculosis, and malaria. As of March 2009, Japan has contributed about US$1.04 billion to the Global Fund.

## ▶ See page 56 for details on infectious disease countermeasures

Regarding maternal and child health, Japan supports the fostering of healthcare professionals working on the front lines, improves and provides equipment for obstetrics facilities, and carries out initiatives related to improving the quality of emergency obstetric care in order to improve the health of women during pregnancy or labor. It also works to improve access to medical institutions by developing infrastructure, disseminate Maternal and Child Health (MCH) world’s population is expected to reach 9.2 billion people by 2050 (Note 13). In general, among the developing countries there continues to be a tendency for poor countries to have a higher population growth rate, which leads to poverty, unemployment, food shortages, underdeveloped education, and environmental deterioration. From this perspective, maternal, newborn and child health care reproductive health (Note 14) including family planning and HIV/AIDS control, which can have an enormous impact on population issues, have become pressing challenges.

Handbooks which incorporate the perspective of continuum of care, disseminate medical checkups for women during pregnancy and labor and support their health management, and reduce child mortality and morbidity. Regarding family planning, Japan provides support for efforts like educational activities and the distribution of contraceptives for preventing unwanted pregnancies and premature births, focusing on education for adolescents in particular. In terms of specific initiatives, Japan provided community education to prevent infectious diseases from unsanitary water, childbirth and postpartum care designed to reduce the mortality rate of women during pregnancy and labor and newborns, and support for reproductive health education such as family planning. These initiatives were carried out through the United Nations Population Fund (UNFPA) from March to November 2008, and targeted approximately 82,000 women in Ethiopia.

At the G8 Hokkaido Toyako Summit in July 2008, Japan raised the importance of this comprehensive approach and forged consensus among the G8. It also announced the Toyako Framework for Action on Global Health (Note 15) by the G8 health experts. Japan also gave traction to international discussions in the health sector, such as holding an international conference on the three major communicable diseases in May 2008 and an international conference on strengthening health systems in November through public-