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Box II-5. "Health and Development" Initiative (HDI) (Outline)

1. Japan's basic position

(1) Three out of the eight Millennium Development Goals (MDGs) explicitly refer to health. Progress toward achieving those three goals is lagging.

(2) The issues related to health services in developing countries have negative socioeconomic impacts on societies, worsening poverty at the national level as a result. It is therefore extremely significant to achieve health MDGs to address poverty reduction.

(3) With the advancement of globalization, Japan has a responsibility to take measures against infectious diseases such as HIV/AIDS, avian flu, and Severe Acute Respiratory Syndrome (SARS) and to contribute to protecting people's health, not only in Japan but throughout the world.

(4) Japan has made contributions in health areas through the Okinawa Infectious Disease Initiative (IDI), Global Issue Initiative on Population and AIDS (GII), International Parasite Control Initiative (also known as the Hashimoto Initiative), and TICAD Tokyo Action Plan.

(5) With the completion of IDI in March 2005, the Government of Japan formulated the "Health and Development" Initiative (HDI) with an emphasis on contributing to the achievement of the health MDGs.

2. Basic policies

(1) Emphasizing the "human security" perspective

(2) Cross-sectoral actions

(3) Collaboration and coordination with the international community

(4) Formulation of assistance programs in accordance with various local needs in developing countries

(5) Strengthening research capacity on the ground and paying due respect to local conditions

3. Concrete measures

(1) Assistance for strengthening institutional capacity development in the health sector

(a) Strengthening health systems

(b) Capacity building for health workers

(c) Development of health facilities and strengthening of their functions

(2) Assistance in areas that reinforce the health sector and cross-cutting actions

(a) Promoting gender equality

(b) Assistance in the education sector

(c) Assistance on water and sanitation

(d) Assistance for improving socio-economic infrastructure

(3) Actions toward achieving MDGs

Goal 4: Reduce child mortality

Target 5: Reduce under-five mortality rate by two-thirds by 2015

Ensure access to safe water and adequate sanitary facilities, universal usage of oral rehydration salt (ORS), provide antibiotics, strive to improve the nutritional status by providing vitamin A and iodine, distribute insecticide-treated bed nets, provide anti-malaria drugs, carry out immunization, provide preventive education, support the improvement of the health status of infants, and support the promotion of Integrated Management of Childhood Illness (IMCI).

Goal 5: Improve maternal health

Target 6: Reduce the maternal mortality ratio by three-quarters by 2015

Support awareness raising and community education to protect maternal health, distribute contraceptives, train health staff to increase the number of skilled attendants at delivery, provide medical equipment, medicines, ambulances and supporting clinics and hospitals, improve access to health facilities, disseminate Mother-and-Child Health Handbooks, and increase prenatal health check-ups.

Goal 6: Combat HIV/AIDS, malaria, and other diseases

Target 7: Have halted by 2015 and begun to reverse the spread of HIV/AIDS

Support human resource development to facilitate prevention activities, provide such supplies as condoms, provide support to control sexually transmitted infections, promote Voluntary Counseling and Testing (VCT) (supply test kits, support human resource development for counseling and provide health care facilities), scale up anti-retrovirus therapy (ART), support treatment and care for opportunistic infections, provide assistance to prevent mother-to-child transmission and for the greater involvement of people living with HIV/AIDS (GIPA), provide care for AIDS orphans, and support the development of the health system in order to supply safe blood.

Goal 6: Combat HIV/AIDS, malaria, and other diseases

Target 8: Have halted by 2015 and begun to reverse the incidence of malaria and other diseases

(a) Malaria and tuberculosis

Support prevention education, check-ups and treatment, provide insecticide-treated bed nets, provide anti-malaria drugs, provide anti-TB drugs and test kits to support the expansion of the Directly Observed Treatment, Short courses (DOTS) strategy and develop human resources to this end.

(b) Other infectious diseases

(i) Polio

Supply polio vaccines, and technical cooperation on diagnosis, surveillance, and production of vaccines

(ii) Parasitic diseases

Support prevention, treatment, and education through schools and communities, support sanitation measures such as installing toilets, and support human resource development to control trypanosomiasis, filariasis, dracunculiasis, and schistosomiasis

(iii) Emerging diseases

Support the establishment of the worldwide surveillance system for early detection

(4) Strengthening Japan's aid implementation capacity

(a) Develop human resources domestically

(b) Seek close collaboration among ministries concerned and the establishment of networks among research institutions

(c) Strengthen collaboration between government and other stakeholders such as NGOs, universities, research institutes, and private enterprises

(d) Strengthen monitoring and evaluation systems

Note: Refer to Part 2, Chapter 3, "Main References Concerning ODA," for the full text of the "Health and Development" Initiative (HDI).

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