humans, Japan is providing support for measures to build a cooperative framework to tackle highly pathogenic avian influenza and to promote disease surveillance of wild birds for the Asia-Pacific region through the World Organization for Animal Health (OIE: Office International des Epizooties).

For global polio eradication, Japan supports the provision of polio vaccines through UNICEF to mainly four countries that have been designated as countries of prevalence: Nigeria, India, Afghanistan, and Pakistan. Moreover, in April 2009 a major outbreak was confirmed in Tajikistan and the surrounding countries. In order to deal with this situation, Japan decided to support the provision of US$200,000 worth of polio vaccines through UNICEF.

When it comes to neglected tropical diseases, Japan also takes a leading role in engaging in full-scale measures against Chagas' disease in Latin America, and contributes to decreasing the risk of infection by supporting the establishment of systems for measures against the vector insect. In regard to filariasis, Japan provides antiparasitic drugs and educational materials and carries out education and prevention activities via JOCVs, and thus aims to achieve a drastic reduction of the number of new patients and maintain its non-epidemic status.

## ⚫ Afghanistan: Tuberculosis Control Project

In Afghanistan, which is one of the countries with the worst health conditions in the world, infectious diseases constitute the number one cause of death, with tuberculosis accounting for a large proportion. This project, which has been implemented since 2004, aims to improve tuberculosis treatment services. It supports initiatives like strengthening the capacity of the National Tuberculosis Program (NTP) and improving tuberculosis inspection techniques through the dispatch of Japanese experts and the provision of equipment. As a result, the discovery rate for tuberculosis patients has reached 73% and a rate of treatment success of 89% has been achieved, as high quality tuberculosis treatment services are disseminated.

Laboratory technicians undergoing training at the National Tuberculosis Institute in order to improve tuberculosis inspection techniques

## ● Zambia: Project for Scaling Up of Quality HIV and AIDS Care Service Management

In Zambia, where the rate of HIV infection is high at 14.3% (2007), expanding AIDS treatment known as antiretroviral treatment (ART) and reducing the number of deaths are among the top priorities. Since 2006 Japan has supported the creation of a Mobile ART Model so as to be able to implement ART even in rural areas with limited human and physical resources. This has been done through the Integrated HIV and Care Implementation Project at District Level, a forerunner project (Note 25). By means of excellent access and high quality service the Mobile ART Model has kept the treatment dropout rate low, and has also proven that the Zambian Ministry of Health is capable of providing treatment on its own. Beginning in FY2009 the targeted area was widened for the implementation of the project in an attempt to further expand its results. The expansion of Mobile ART to the entire country through the use of the Global Fund to Fight AIDS, Tuberculosis and Malaria is scheduled for FY2010 onward.

An assistant doctor who periodically makes the rounds from group hospitals every other week to prescribe ART at rural health centers