Official Development Assistance (ODA)
Japan officially began to engage in global development assistance in 1954 upon joining the Colombo Plan. In the years that followed, Japan initiated economic cooperation activities with countries in Asia in the form of reparations and yen loans in order to build amiable relationships with its neighbors.1
By the end of the 1960s, Japan had developed into a leading player in the foreign aid sphere alongside domestic economic growth. After the concept of Official Development Assistance (ODA) was officially introduced by the OECD in 1969, Japan began to disperse ODA2 and has come be recognized as a major donor country that integrates its unique development history into its development approaches, which often includes investment and trade activities.3
Over the years, Japan’s ODA and foreign policy has continuously emphasized the concept of “human security,” which was spearheaded by JICA’s former President Sadako Ogata and former Foreign Minister Keizo Obuchi at the turn of the 21st century.4 Human security continues to be a concept upon which Japan builds its international cooperation policies and guidelines.5 Global health has been identified as a critical component to securing human security, specifically through health systems strengthening, universal health coverage, and global health security. Despite this thematic focus, much of Japan’s ODA continues to focus on infrastructure and construction projects.6
In 1992, an ODA Charter was drafted to guide ODA priorities and development work administered using ODA. This charter was revised in 2003 and “human security” was included as a key tool of policy.7 On February 10, 2015, a new development charter was drafted and approved by the Abe Administration.8 The new charter, now called the Development Cooperation Charter, builds upon the past ODA Charter but integrates four additional principles: cooperation for peace (nonmilitary restriction), promotion of inter-sectoral partnership, support for recipient countries’ capacity for development, and gender equality and women’s empowerment.9 The Development Cooperation Charter became a source of debate because it includes a provision that allows ODA to be used to assist armed services of other countries in non-military situations. Some have argued that this provision creates a channel through which Japan can indirectly support defense activities, while others, including the government, assure the public that this provision is strictly limited to peaceful operations.10
Recently, there have been calls to streamline Japan’s global health strategy by increasing coordination between the government ministries that oversee development policy and action, including the Ministry of Foreign Affairs (MOFA), the Ministry of Health, Labour and Welfare (MHLW), and the Japan International Cooperation Agency (JICA).11 It is thought that through increased inter-agency cooperation and further development of inter-sectoral partnerships (between government, NGOs, the private sector and civil society) that development work can be carried out more efficiently and effectively.
Since 1996, global health has been explicitly discussed at every G7 Summit. The increasing diversity of global health stakeholders, the introduction of public-private partnerships, and the decreasing dominance of the World Health Organization have contributed to catalyzing the importance of G7 engagement and subsequent contributions.12
Japan, as a G7 member, has put a timely and critical global health issue onto the agenda at each summit it has hosted leading to subsequent and significant action.13 In fact, the first mention of a health-related issue in a G7 official summary statement appeared after the 1979 Tokyo G7 Summit. This statement identifies the need to support developing countries to address malnutrition and hunger.14 The official summary statement after the 1986 Tokyo G8 Summit exclusively mentions “a safer and healthier…world” and “the fight against…disease.” This was only the seventh time a direct reference to health was mentioned in an official summit statement since the G7 began meeting in 1975.
At the 2000 Kyushu-Okinawa G8 Summit hosted by Japan, G8 history as well as global health history was made when then Japanese Prime Minister Yoshiro Mori invited heads of state from Africa to be included in the meeting for the first time. It was also the first time that action on infectious diseases was propelled onto the G8 agenda.15 These actions transformed into a call to action to world leaders and resulted in the creation of the Global Fund to Fight AIDS, Tuberculosis and Malaria in 2002.16
When Japan hosted the 2008 G8 Summit in Hokkaido Toyako, the focus was turned to global health, but not without significant political investment prior to the meeting. For nearly one year prior to the summit, former Prime Ministers Mori and Koizumi appealed to the Japanese public. At the same time, Prime Minister Fukuda and Foreign Minister Koumura pressed to have global health on the G8 agenda. This activity was complemented by a Global Health Summit held by HGPI and the World Bank with cooperation from the Bill and Melinda Gates Foundation, bringing together stakeholders from various sectors to catalyze action at the upcoming summit. Internationally, the Science Council of Japan facilitated the first G8+5 statement on global health, which was distributed to all G8 leadership.17 As a result of the efforts of both the government and non-government sector, global health became a major issue on the agenda at the 2008 G8 Summit leading to a strong commitment from G8 heads of state to take further action on health systems strengthening in emerging countries.18
As Japan prepares to host the G7 Summit in Ise-Shima in 2016, there is a host of activity taking place to ensure that global health has a prime position on the meeting’s agenda.
On December 16, 2015, the Japan Center for International Exchange (JCIE), MOFA, Ministry of Finance (MOF), MHLW, and JICA organized the International Conference on Universal Health Coverage in the New Development Era, one of the first international conferences on global health since the adoption of the Post-2015 Sustainable Development Goals. At this meeting, held in Tokyo, global health leaders gathered to discuss emergency preparedness, global governance, and the 2016 G7 Summit’s role in global health. The following day, prominent global health experts participated in a round-table discussion on the proposals Japan has crafted for the 2016 G7 Summit. Using the input received, members of the global health working groups who wrote the proposals were able to make revisions in order to strengthen Japan’s message at the upcoming summit.