16 th March 2009 Ministry of Foreign Affairs of Japan

1. Japan’s Policy and Global Health -External financing for health care- 16th March 2009 Ministry of Foreign Affairs of Japan

2. Global Health in the context of Foreign Policy • Growing attention on Global Health in the 21st century • 3 MDGs related to health issues • To address health issues… • Participatory approach • Multi-sectoral input • Dialogue between G8 Health Experts and H8 • Takemi Working Group • New dimensions of foreign policy • A comprehensive approach 1

3. Japan’s Initiative in 2008 • TICADⅣ • Compiled the “Yokohama Action Plan” • Established TICAD Follow-up Mechanism • Additional pledge to the Global Fund (US$ 560 million) • Training of 100,000 health workers • Save the lives of 400,000 children • G8 Hokkaido Toyako Summit • Endorsed the “Toyako Framework for Action on Global Health” • Agreed to establish a follow-up mechanism to monitor our progress on meeting our commitments • Actions to be Taken • 1.Health Systems Strengthening • 2. Maternal, Newborn and Child Health • 3. Infectious Diseases (HIV/AIDS, Tuberculosis, Malaria, Polio, NTD) • 4. Cross-Sectoral Approach • 5. Resources 2

4. Global Health Framework for Action- A Comprehensive Approach- Development of Framework for Action suitable for 21st Century (The Human Security perspective, participatory approach） Polio HIV/AIDS TB Malaria Other Infectious Diseases (NTD, measles etc.) Non-infectious Diseases UN/International Organizations Developing Countries Focus on women and children Maternal, Newborn and Child Health Private Sector NGOs G8/Developed Countries Health Systems Strengthening Expansion of community health Human Resource Development of Health Workers Newly Emerging Donors Academia Gender Water and Sanitation Education Infra- structure 3

5. Approaches for Health System Strengthening • A better balanced-approach between… • Disease-oriented approach (vertical) and • Strengthening of health systems (horizontal) • Three major components identified for health system strengthening • Health workforce • Health financing • Health information • Takemi working group • Provide policy recommendations for G8 in the context of human security • Participatory approach: Academia , NGOs, 3 relevant ministries, Government aid agencies Health Workforce Health System Strengthening Health Information Health Financing 4

6. Economic Crisis and Global Health • Maintain the commitment for the health sector • Health and Development Initiative (HDI) • Pledged: Approx. US$ 5 billion for 5 years (2005-2009) • Disbursement: Approx. US$ 4.5 billion for 3 years (2005-2007) • Global Fund （As of February 2009) • Provided: US$ 846 million • Pledged: US$ 560 million from 2009 for coming years • Raise awareness for the global health issues • Intensive discussion on “Innovative Financing Mechanism” • Better allocation and use of inputs within developing countries 5

7. Next Agenda for 2009 • Sustain momentum in global health politics • Japan’s initiative in drafting WHO resolution, “Primary Health Care, including Health System Strengthening” • Approved by the WHO Executive Board in February 2009, to be submitted to the Sixty-second World Health Assembly in May 2009 • Translate the policy recommendations to the G8 into concrete actions for strengthening health systems at G8 La Maddalena Summit and beyond • Close cooperation and coordination with stakeholders in the global health • WHO, World Bank, UNICEF, UNFPA, UNAIDS, The Bill and Melinda Gates Foundation, GFATM, GAVI, Academia, NGOs… 6

8. Towards the ECOSOC • "Implementing the internationally agreed goals and commitments in regard to global public health” • Japan’s high-level will make national voluntary presentation (NVP) at the ECOSOC Annual Ministerial Review in July 2009 7