qualitative improvement of education for health personnel) in Senegal and "Lusaka District Primary Health Care Project" (establishment of a system to manage Primary Health Care by residents' organizations and health center staff) in Zambia.

In assistance in the health sector, collaboration with wide-ranging partners in the international community has been promoted in each stage of policy dialogue and the planning, implementation, evaluation and monitoring of projects. The Ministry of Foreign Affairs regularly holds informal talks with Japanese health-related NGOs to exchange opinions and information, and entrusts NGOs to conduct various studies that contribute to the implementation of assistance. Japan has continued to cooperate with UNICEF to eradicate polio since the beginning of the 1990s, but cooperation with UNICEF has recently expanded to other fields such as vaccination against measles, tetanus and other infantile infectious diseases, distribution of therapeutic agent for malaria and bed nets, and provision of safe water. Japan issued the "USAID-Japan Partnership for Global Health" $ ^{*1} $ in June 2002 with the United States, and since then, it has been promoting cooperation with the USAID to improve the health status in developing countries. Japan and the United States collaborate in projects in each area of Africa, Asia and Latin America, such as VCT (Voluntary Counseling and Testing) activities in Kenya and HIV prevention on the border of Tanzania. JICA and USAID also conduct personnel exchanges. Japan-U.S. joint project formulation study teams were also dispatched in Honduras and Bolivia in April 2003. In addition, consultation was held to monitor the progress of the USAID-Japan Partnership in June 2003.

Furthermore, the Association of Southeast Asian Nations (ASEAN) held the "ASEAN and Japan High Level Officials Meeting on Caring Societies," which was aimed at developing welfare and medical personnel in Asian countries, in Tokyo in November 2003. For the meeting, high level administrative officers in charge of welfare services and health/medical policies were invited from 10 ASEAN countries to discuss the role of human resources development in welfare/medical services in each country. At the meeting, participants adopted development of welfare and medical personnel as a theme and agreed to discuss it on a regular basis in the future.

On many occasions, there have been international consultations toward achieving MDGs in the health sector. In May 2003, the World Bank, Canada and the United Kingdom cooperatively held the meeting "Harmonized Action on the Health, Nutrition and Population MDGs" in Ottawa. This meeting was held to specifically discuss goals in the health, nutrition and population sectors in relation to what action the international community should take to achieve MDGs. Japan advocated the idea that a framework for harmonized action should be formulated on the basis of four points: (1) the ownership and leadership of the governments of developing countries are further required; (2) a country-specific approach is fundamental since the establishment of a health system and the reform of health administration are necessary; (3) it is important to promote both a region-specific approach and South-South cooperation since infectious diseases are cross-border issues and regional responses are also necessary; and (4) it is important to utilize various modality of assistance that match the actual conditions of each country and region. Moreover, Japan emphasized the importance of improving the capacity of on-site personnel to utilize assistance fund effectively, especially, the importance of promoting human resources development in the health sector in line with a long-term plan for at least ten years, at the "High-Level Forum on the Health MDGs" which was held in Geneva in January 2004 to review progress toward achieving MDGs in the health sector and discuss measures to promote future actions. Japan will promote cooperation with the international community as well as transmit its own ideas through active participation in such meetings in the future.

## (3) Water and Sanitation

According to the "Global Water Supply and Sanitation Assessment 2000 Report" prepared by the World Health Organization (WHO), the population without access to safe water from a water supply system or wells is approximately 1.1 billion, of which approximately 0.7 billion are in Asia and approximately 0.3 billion are in Africa. In addition, approximately 2.4 billion across the world do not have access to basic sanitation facilities including a sewage system, of which

## $ ^{*} $ I: USAID-Japan Partnership for Global Health

This is a document in which Japan and the United States agreed again to collaborate in activities in the health care sector on the basis of the fact that both countries collaborated well especially in the health sector under the Common Agenda for Cooperation in Global Perspective in 1993. Specifically, the document stipulates personnel exchanges between USAID and JICA and promotion of collaboration both on a headquarters level and on a local level.