(Directly Observed Treatment, short course), 145 million people will receive therapeutic drugs for malaria, and 108 million people will be provided with bed nets, which, in all, are expected to produce a significant impact. From 2002 till the beginning of 2005, Japan had pledged financial assistance of 265 million dollars to GFATM. As of July 2004, Japan had contributed 246.4 million dollars (for measures to fight infectious diseases, see Part II, Chapter 2, Section 3, 3-(2)).

With respect to maternal and child health, Japan has been providing support while considering it to be one of the priority issues in the health sector as support for children and women who are most susceptible to poverty. Mainly, Japan is offering support relating to children's health, maternal health, and "reproductive health." $ ^{4} $

In relation to aid for children, since polio, measles, tetanus and many other diseases which may become a cause of infant mortality are preventable by relatively low-cost intervention, such as vaccination, Japan has been supporting the dissemination of vaccination against these diseases (for the past record of cooperation relating to polio, also see Part II, Chapter 2, Section 3, 3-(2)).

Regarding reduction of maternal mortality ratio, Japan has, in the past, implemented step-by-step assistance from the viewpoint of reproductive health, such as the Technical Cooperation Project for Ensuring the Quality of Maternal and Child Health (MCH) through the MCH Handbook in Indonesia by applying Japan's experience of a mother and child health handbook, training of midwives, nurses and other personnel who engage in maternal and child health, and promotion of family planning and sexual education. However, to reduce maternal mortality directly, provision of appropriate medical services, including emergency obstetric care, is also necessary. The reduction of the maternal mortality ratio is thus the goal that is most difficult to achieve of the three MDGs relating to the health sector. Therefore, Japan has been implementing assistance in this sector in cooperation with UNICEF, the United Nations Population Fund (UNFPA), and the international NGO, International Planned Parenthood Federation (IPPF), on the basis of movement toward concentrating assistance on the UNICEF-led establishment of emergency obstetric care service. In fiscal year 2003, Japan implemented the "Project for Support to Strengthening of Emergency Obstetric Care" (construction of obstetric facilities and improvement of medical equipment) in Bangladesh and the "Project for Improvement of Medical Equipment for Sir J.J. Hospital and Cama & Albless Hospital" (renewal and suppliance of medical equipment for the obstetrics department) in India, as well as reproductive health support (educational activities for reproductive health/rights and provision of medical equipment) by the Trust Fund for Human Security in Eritrea and Senegal. Furthermore, in Tunisia, Japan implemented the "Strengthening of Reproductive Health Education in Tunisia" mainly composed of support for preparing reproductive health educational materials and the planning and provision of seminars and workshops in cooperation with NGOs.

Efforts in the field of infectious diseases and maternal and child health do not work sufficiently unless a health system that functions effectively across the country is established. In the international community, the focus tends to be placed on direct measures against diseases, such as measures against HIV/AIDS through provision of antiviral agents to patients. However, Japan recognizes that the establishment of public health in developing countries plays a very important role in the development of developing countries in the same way as direct measures against diseases. Therefore, Japan supports the strengthening of local health care and preventive activities from the viewpoint of "Primary Health Care," that is, equal provision of basic health services to more people, as well as the improvement and reform of the health system in the entire country, including establishment of a health system that matches the actual conditions of developing countries, training of personnel to be engaged in health care, and improvement of health-related infrastructure.

As for other examples of such support, in fiscal year 2003 Japan implemented the "Project for the Development of Human Resources in Health" (quantitative expansion and

Seminar for capacity building of medical personnel (Project for Strengthening of the Local System of Integral Health Care of Granada: Nicaragua)