period from FY2000 to FY2004 based on the comprehensive support package against infectious diseases called the Okinawa Infectious Diseases Initiative (IDI). The G8 Kyushu Okinawa Summit stimulated international concerns about the infectious disease problem, and the increased concerns led to the establishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria in 2002. In addition, Japan announced the Health and Development Initiative (HDI) at the High-Level Forum on Health MDGs in Asia and the Pacific held in 2005, and expressed its intention to provide US$5 billion over the five-year period from FY2005 to FY2009. Based on this initiative, Japan, with the perspective of human security, has provided comprehensive support, which includes strengthening health systems as well as cross-sectoral assistance such as supporting gender equality, education, water and sanitation, and infrastructure development like building hospitals, in addition to efforts directly targeted at the three health-related MDGs.

In addressing health issues in developing countries, strengthening health systems is essential in addition to direct disease controls. Based on this belief, Japan provides assistance like adjusting health systems to the local conditions in developing countries, strengthening regional health systems, enhancing preventive action, fostering human resources in the health sector and developing health infrastructure. In Tanzania, Japan selected the Morogoro Region as a model district, and assisted capacity building of health administrative officials that handled the formulation, monitoring and evaluation of local health programs. $ ^{24} $ This received high praise from the government of Tanzania as an exemplary model to improve a regional health administration system, the managerial capacity of which had hampered the development of local health service in Tanzania. The experience in the Morogoro Region is now applied to other regions across Tanzania to strengthen regional health administration as a whole. $ ^{25} $

## Support for Maternal and Child Health

Issues surrounding maternal and child health encompass a wide range of aspects from health care services, health care systems, and public health to the social environment that surrounds women who are to carry and nurture children. In developing countries, especially least developed countries (LDCs), urgent attention is needed to improve the health of women during pregnancy and labor, reduce infant mortality and illnesses, and promote measures against HIV/AIDS and other sexually transmitted diseases. The Yokohama Action Plan of the TICAD IV in May 2008 declared that Japan would support the improvement of 1,000 hospitals and health centers. Japan, in FY2007, reinforced medical facilities and equipment at Lagune Maternal and Child Hospital, the largest hospital of its kind in Benin, with the aim of providing appropriate and sanitary medical service. $ ^{26} $

See Part II Chapter 2 (page 32) on Japan’s assistance for the health sector in Africa.

To improve the health of mothers during pregnancy and labor, Japan provides assistance in training personnel engaged in maternal and child health care services such as midwives and nurses, developing emergency obstetrical care systems, and securing physical and social access to emergency obstetrical care facilities (e.g. road development and the creation of a social environment in which women can receive proper obstetrical treatment). On top of this, Japan works toward providing assistance in order to reduce unwanted pregnancies by providing education and information on family planning and birth control methods, distributing contraceptives, and promoting the education of adolescents.

To reduce infant mortality and diseases, Japan provides assistance for vaccination against diseases that could lead to deaths of infants such as polio, measles, and tetanus, as well as malaria control by distributing mosquito nets. Assistance is also provided for developing basic health services that aim to promote universal usage of Oral Rehydration Salt (ORS) to combat childhood diarrhea in children. In order to combat the serious issue of mother-to-child transmission of HIV/AIDS, Japan carries out support that draws on multiple facets and comprehensive approaches, taking into account access to health services and information. Examples of this are measures to combat infectious diseases and Voluntary Counseling and Testing (VCT) activities for health management relating to pregnancy and labor, among others. One specific project, for instance, is assistance to improve reproductive health conditions in the Aleppo Governorate of Syria since FY2006.

## Collaborations with Relevant Entities

Since 2002, Japan has been carrying out collaborations including personal exchanges and joint studies/evaluations with the United States Agency for International