Opening Remarks by H.E. Mr. Ichiro Aisawa,
Vice Minister of Foreign Affairs of Japan
at the High-level Forum on Health MDGs in Asia and the Pacific

Your Excellencies, distinguished colleagues,
Ladies and gentlemen,

It is my great pleasure to welcome you and open the High-level Forum on Health MDGs in Asia and the Pacific. I would also like to express my sincere gratitude to the World Health Organization, the Asian Development Bank and the World Bank with whom we have prepared this Forum.

As you are aware, 2005 is an important year in which the international community will review the progress on the Millennium Development Goals (MDGs) and take further actions needed to achieve the MDGs. Among the 8 MDGs, 3 goals are related to health, a reflection of the crucial importance of health to promote freedom from sickness and poverty.

A general overview of the situation regarding in Asia and the Pacific shows that there is relatively good progress on poverty reduction. Rising incomes have brought about improvements in health-related indicators such as nutrition, life expectancy at birth and child mortality. In this connection, I would like to pay tribute to the participants for making progress on health despite various difficulties.

On the other hand, it is also true that the Asia- Pacific region, which accounts for about two thirds of the world's poor population, is still confronted with various challenges. Many people are under miserable conditions without access to adequate health services. It is an urgent challenge to address disparities among and within countries. This region also accounts for 55% of the death toll from tuberculosis. It is predicted that the number of HIV/AIDS positive in the region will increase up to 20 million people within 10 years. In addition, emerging infectious diseases such as SARS (Severe Acute Respiratory Syndrome) and avian flu are becoming a new threat in recent years.

This Forum aims to strengthen actions at the country level and regional cooperation by sharing good practice and discussing regional cooperation. In view of the need to take cross-sectoral actions in health as well as other related areas in order to make progress on the health MDGs, it is significant that we have the participation of ministers in charge of health, development and finance.

Japan is among the largest donors in the sectors that are closely related to the MDGs such as health, water, education and environment, and it is committed to actively contribute to the achievement of the MDGs. Japan has decided to convene this Forum because, in the effort to support the developing countries, sharing of experiences is just as important as cooperation on the ground.


At this Forum, we will first have an overview of progress on the health MDGs in the Asia-Pacific region. After this, we will address four key themes, namely, resources, health systems, cross-sectoral actions and equitable access.

Needless to say, ensuring necessary funding and its effective use is fundamentally important for strengthening our efforts. Generally speaking, it is remarkable that countries in the Asia-Pacific have funded a major part of their health expenditures through domestic resources. However, in many countries further increase in resources is required through efforts such as tax reform, health insurance and additional budget allocation to the health sector.

The international community must also strengthen its support to the efforts of the developing countries. Japan has implemented assistance under the Okinawa Infectious Diseases Initiative amounting to 4.1 billion US dollars in the four years between 2000 and 2003. A large part of this assistance was directed towards Asia and the Pacific. In order to strengthen its contribution to the health MDGs, Japan will implement the "Health and Development Initiative". Japan will further enhance its support to the efforts of the developing countries to achieve the health MDGs based on ownership and partnership.

At this Forum, we have the presence of donor countries and organizations which account for about 80% of ODA in the Asia-Pacific region. It is my hope that these donors will also strengthen their cooperation. In this connection, I would like to emphasize the effectiveness of South-South cooperation. South-South cooperation can effectively transfer technology and know-how more suited for the recipient country. Several countries in Asia and the Pacific are promoting South-South cooperation. Japan highly appreciates such efforts. Japan actively supports South-South cooperation as an important activity under its ODA Charter. To cite one example, Japan supports cooperation provided by Thailand in the area of parasitic diseases and HIV/AIDS to other countries in the Mekong region. I hope that South-South cooperation will expand further and other donors will strengthen their support to such cooperation.


To achieve the health MDGs, it is essential that we adopt effective interventions and strengthen capacities for implementation together with infrastructure development. Japan's huge progress in the health situation after the war was made possible not only by funding but also due to such efforts as capacity building of health workers, effective collaboration of government and the local community, and development of social and economic infrastructure. Based on such experience, Japan, for instance, attaches importance to building human resources that support the health systems of developing countries. Under the Okinawa Infectious Diseases Initiative, Japan provided training to more than 15,000 personnel in health-related sectors of 146 developing countries during the 4 years between 2000 and 2003.


To achieve effectively the health MDGs, we need to promote cross-sectoral actions in the health-related areas such as poverty reduction, education, water/sanitation and infrastructure along with actions in the health sector. In Japan, cross-sectoral actions such as the use of Maternal and Child Health (MCH) handbooks, school health program, clean water supply and development of health systems have contributed considerably to drastic reduction in child mortality and extension of life expectancy at birth to highest levels. In addition, preventive activities against parasitic diseases in primary schools played an important role in containing the spread of parasitic diseases in Japan. Based on such experience, Japan's Health and Development Initiative emphasizes effective collaboration between assistance in the health sector and assistance in other closely related areas.


Despite improvements in health indicators for the country as a whole, there are cases in which the situations of certain poor areas or for people who are disadvantaged such as women or minority groups have not improved. In the effort to achieve the health MDGs, the problem of disparities arising from a various reasons such as income, gender, geography or social factors must be addressed. As part of such efforts, it is extremely important to promote women's empowerment, gender equality and access to reproductive health services in accordance with the Beijing Platform of Action and the ICPD Program of Action. Japan is committed to make further efforts to address disparities in the health sector based on the perspective of human security.


I am convinced that the results of the Forum will be an important contribution to the major international conferences such as the Mid-term Review of the United Nations Millennium Declaration by presenting the viewpoint of the Asia-Pacific region. While the effective approaches and lessons learned coming out of the discussions cannot be simply transferred to other countries and regions, I believe that they will provide important ideas for countries in the Asia-Pacific region and also for other regions including Africa. Therefore, in order to make this Forum meaningful, I would like to kindly ask all the participants to have frank and active discussions today and tomorrow.

Thank you.

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