According to UNFPA forecasts, the world population will reach 5.93 billion people in 1998, and is expected to grow to 8.04 billion by the year 2025. Population pressures will have an increasingly serious impact on human society in the years ahead.

By UNAIDS estimates, about 30.6 million people worldwide were infected by HIV as of the end of 1997. In 1997 alone, 5.8 million additional people were infected by HIV, and 2.3 million died of AIDS. The developing world accounted for over 90 percent of all people infected by HIV as of the end of 1997. The AIDS epidemic has become a barrier to progress in the developing world, and could have a serious impact on the ability of many countries to maintain a healthy and stable living environment.

To address these and related issues of global scale, in February 1994 Japan announced, as its own independent initiative, the Global Issues Initiative (GII) on Population and AIDS. The GII is designed to provide developing countries with a total of US$3 billion in ODA funding for projects in the field of population and HIV/AIDS during a seven-year period from FY 1994 to FY 2000. It is focused on reproductive health ¹³ , and incorporates a comprehensive approach that includes direct cooperation in population and family-planning, basic health-care services for women and children, primary education, and the empowerment of women. ¹⁴

In striving to attain its GII goals, by 1997 Japan had dispatched project formulation missions to 14 countries, including all priority countries ¹⁵ , and pursued efforts in project discovery and formulation. It is committed to promoting this initiative with the collaboration of other leading donor countries and multilateral institutions. Additionally, in view of the importance of collaborating with NGOs, Japan has sought and received help from various NGOs in deploying its survey teams abroad (in 11 countries including Thailand, Bangladesh, and Vietnam). As a result, Japan has already disbursed approximately US$2.4 billion, or four-fifths, of the sum in GII funding it planned to spend over the entire seven-year period.

In 1988, the WHO declared the global eradication of polio a target for achievement by the year 2000, and in 1990, participants at the UNICEF-sponsored World Children's Summit adopted the goal of boosting the infant vaccination rate to 90 percent. In May 1994, Japan added children's health to the Japan-U.S. Common Agenda, and is now working with the U.S. toward goals in that area.

One key underpinning of cooperation in the children's health field is the assistance provided for polio eradication and children's vaccination plans that the WHO and UNICEF have been pursuing. Japan has been aiding that drive with priority on action in East Asia and the West Pacific. Since FY 1993, it has provided about 2.8 billion yen (approximately 35 percent of the aid total these regions have received for polio eradication) in funding for polio vaccine supplies, the acquisition of cold- chain equipment for vaccine storage and transport, and the acquisition of equipment for surveillance. As a result of this drive, polio has been almost entirely eradicated from East Asia and the West Pacific Region. ¹⁶

The successes registered in those regions have prompted a regional shift in the priority of polio eradication-related aid to South Asia and Africa. At the ninth UNCTAD general conference, which convened in South Africa in April 1996, Japan announced plans to actively assist the drive to eradicate polio from Africa by the year 2000. ¹⁷

By WHO projections, the number of tuberculosis patients is destined to rise worldwide unless serious action is taken to stop the spread of the disease. ¹⁸ As a reemerging disease, tuberculosis constitutes a major public health problem in many parts of the world. The WHO has proposed the utilization of a strategic package based on the DOTS method, an approach that recent case studies have shown to be highly effective against tuberculosis. ¹⁹

The WHO has also set various targets for achievement in the battle against tuberculosis, including a tuberculin carrier detection rate of 70 percent, a cure rate of 85 percent, and the establishment of systems capable of maintain- ing those levels. The focus of technology transfers for this purpose has begun shifting from purely treatment-oriented techniques to the management of comprehensive programs against tuberculosis. Japan to date has provided various countries in the Asia-Pacific region with assistance aimed at fighting tuberculosis.

Parasitic diseases, such as malaria and schistosomiasis, are among the most serious health threats confronting people living in tropical regions. Every year, over 500 million people worldwide contract malaria, and about 2 million die of the disease. On top of that, as many as 3.5 billion people are estimated to be infected by soil-transmitted parasites. These diseases not only pose a direct threat to human life. They also harm childhood development and undermine the ability of adults to work, and in that sense have a negative impact on economic activities, economic progress in developing countries, and opportunities to lead a normal life as a responsible, active member of society.

At the Denver Summit that met in June 1997, Japan underlined the importance of parasite control, and stressed the need for international cooperation in this area. That prompted the Japanese Ministry of Health and Welfare to take the initiative by setting up a working group on global parasite control, and formulating "The Global Parasite Control Strategies for the 21st Century" (a report on global parasite control).

In May 1998, then-Prime Minister Hashimoto disclosed details of that report at the Birmingham Summit, underlined the gravity of the issue, and proposed various steps to come up with more effective international measures against parasitic disease. In particular, he called for the establishment of centers for training and research activity in Asia and Africa, and urged that networks including those facilities be set up in collaboration with WHO and the G8, and utilized for training and information sharing on programs to fight the spread of parasitic disease. The summit ultimately issued a communique incorporating provisions for stronger G8 mutual cooperation on issues concerning infectious and parasitic disease, and support for WHO's efforts in those areas.

MoFA and the Ministry of Health and Welfare have since begun making preparations for establishment of the proposed centers and networks.