worldwide, which was less than the previous year, but the number of people living with HIV continues to rise. $ ^{43} $ More than two thirds of those who are HIV positive and more than three quarters of deaths caused by AIDS in the world are concentrated in Sub-Saharan Africa. $ ^{44} $ For tuberculosis, 2 billion people, approximately one third of the world population, are infected, and in 2006 it was responsible for 1.66 million deaths. $ ^{45} $ Half of the cases occurred in Asia, and the rate of people exhibiting symptoms or dying is increasing in Sub-Saharan Africa. It is said that approximately 247 million people around the world live in a region at high risk of malaria, and that the number of deaths each year exceeds 1 million people. $ ^{46} $ Because the acceleration of globalization has facilitated the movement of people and goods, infectious diseases are more likely to spread to other countries across borders. Infectious diseases have thus become a global issue that must be tackled through international cooperation.

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In 2005, the government of Japan announced the Health and Development Initiative (HDI). The objective of the HDI is to contribute to the achievement of the health-related MDGs. Under this initiative, the government has been providing comprehensive assistance amounting to approximately US$5.0 billion over five years from 2005 to 2009 for health issues, including measures against infectious diseases. Furthermore, in order to crystallize HDI in Africa, Japan has been promoting Asia-Africa cooperation and other cooperation in fields such as the fight against the three major communicable diseases and parasitic diseases, based on the African Infectious Diseases Action Plan drawn up in 2006.

The efforts by the international community for measures against infectious diseases led to the establishment of the Global Fund to Fight AIDS, Tuberculosis, and Malaria (GFATM, hereafter referred to as the Global Fund) following the G8 Kyushu-Okinawa Summit held in 2000. To date Japan has contributed a total of US$846.18 million to the fund. Moreover, as a member of the Executive Board since the Global Fund was first established, Japan has been contributing to its effective and efficient management.

In addition, a large number of measures against HIV/AIDS and other infectious diseases are being implemented through funds established with contributions from Japan. These funds include the United Nations Trust Fund for Human Security; the Japan Trust Fund (JTF) for HIV/AIDS of the International Planned Parenthood Federation (IPPF), which is an international NGO; the UNESCO Japanese Funds-in-Trust for the Capacity Development of Human Resources and Special Trust Fund for AIDS Education; and the Japan Social Development Fund.

See page 69 on health-related measures other than those against infectious diseases.

## HIV/AIDS

Japan contributes to HIV/AIDS prevention activities, Counseling and Testing (CT), and management of the HIV/AIDS survey and diagnosis system, while giving due consideration to strengthening the entire healthcare system. In FY2007, Japan offered grant aid to provide HIV testing kits to Tanzania, which is ranked high in terms of estimated rate of infection and number of patients, even among African countries. $ ^{[47]} $ In Tanzania, Japan has been also implementing a technical cooperation project to strengthen the organization of the National AIDS Control Program (NACP). These two cooperative projects are expected to complement each other. FY2007 sees new initiatives that started in Zambia, Senegal, and Jamaica. In Zambia for instance, Japan implemented a technical cooperation project to assist the virus laboratories at the University Teaching Hospital in Zambia as well as tertiary hospitals and laboratories of provincial hospitals in establishing the HIV/AIDS Laboratory Quality Assurance System in accordance with the Operational Plan for the National Laboratory by the Government of Zambia. In addition, Japan works on anti-AIDS measures in tandem with loan aid projects for large-scale infrastructure development, taking into account the possibility of the increased risk of HIV infection due to the employment of migrant workers for those projects.

## • Tuberculosis

In the past, tuberculosis (TB) was the major focus of Japan’s own efforts to combat infectious diseases. Therefore, Japan has a high standard of research, survey, and treatment techniques in the field of tuberculosis, and has provided support to developing countries using its extensive experience. In FY2007, Japan sought cooperation focusing mainly on the promotion of short-term chemotherapy