Japan's Official Development Assistance White Paper 2006
Main Text > Part II ODA DISBURSEMENTS IN FISCAL YEAR 2005 > Chapter 2 Details about Japan's ODA > Section 2. Measures for Each of the Priority Issues > 3. Addressing Global Issues > (2) Infectious Diseases
(2) Infectious Diseases
Infectious diseases such as HIV/AIDS and tuberculosis not only pose a threat to the health of individuals in developing countries, but also act as a serious hindrance to the economic and social development of these countries. Moreover, because the advancement of globalization has facilitated the movement of people and goods, it has become more likely that infectious diseases will spread to other countries across borders. Infectious diseases have thus become a global issue that must be tackled through international cooperation.
Recognizing the importance of measures against infectious diseases, Japan announced the Okinawa Infectious Diseases Initiative (IDI) at the G8 Kyushu-Okinawa Summit held in July 2000. The IDI set a target of US$3.0 billion over five years from 2000, Japan carried out comprehensive measures to fight against infectious diseases in developing countries through bilateral and multilateral assistance. Disbursements through the IDI, which was completed in FY2004, reached a total of approximately US$5.8 billion, greatly exceeding the target amount. Then, in June 2005 after the completion of the IDI the Government of Japan announced the Health and Development Initiative (HDI). The objective of the HDI is to contribute to the achievement of the health-related MDGs. The Government announced that through the HDI it planned to provide comprehensive assistance amounting to approximately US$5.0 billion over five years to the health sector, including measures against infectious diseases.
Chart II-17 Disbursements for the Okinawa Infectious Diseases Initiative (IDI) (FY2000-2004)
The efforts by the international community for measures against infectious diseases led to the establishment of the Global Fund to Fight AIDS, Tuberculosis, and Malaria (GFATM, hereafter referred to as the Global Fund). The Global Fund realizes a wide-ranging public-private partnership that transcends the traditional framework of inter-governmental cooperation. To date Japan has donated a total of US$476.34 million to the fund. Overall the Global Fund has approved a total of US$5.6 billion in 132 countries to support approximately 400 projects.33 Through the provision of this funding the following results are expected by 2010: (1) provision of anti-retroviral treatment (ARV: an anti-AIDS drug) to 1.8 million people; (2) HIV counseling and testing for 62 million people; (3) basic care and support for 1 million AIDS orphans; (4) provision of tuberculosis treatment (Directly Observed Treatment, Short course (DOTS)) to 5 million people; (5) distribution of 109 million insecticide-treated bed nets; and (6) provision of Artemisinin-based Combination Therapy (ACT: an anti-malaria drug) to 264 million people.
Chart II-18 Mosquito Nets Provided to Counter Malaria
Furthermore, in cooperation with the relevant international organizations including WHO, FAO, and the Office International des Epizooties (OIE, or the World Organisation for Animal Health), Japan has taken various measures to fight against new infectious diseases such as Severe Acute Respiratory Syndrome (SARS) and the avian influenza in recent years.
In addition, a large number of measures against HIV/AIDS and other infectious diseases are being implemented through funds established with contributions from Japan. These funds include the United Nations Trust Fund for Human Security; the Japan Trust Fund (JTF) for HIV/AIDS of the International Planned Parenthood Federation (IPPF), which is an international NGO; the UNESCO Japanese Funds-in-Trust for the Capacity Development of Human Resources and Special Trust Fund for AIDS Education; and the World Bank Japan Social Development Fund.
The specific efforts in FY2005 for each major infectious disease are as follows (see Chapter 2, Section 2 for details on health-related measures other than those against infectious diseases).
It is estimated that approximately 40 million people are infected with HIV worldwide. In this area of assistance to developing countries, based on the HDI, Japan has been contributing to HIV/AIDS prevention activities for young people and high-risk groups, voluntary counseling and testing (VCT) activities, and the development of AIDS testing and diagnostic systems, among other measures.
In Senegal, in cooperation with the country's Ministry of Youth and Ministry of Health and UNFPA, USAID, and a US NGO, Japan has been implementing the Project for STI/HIV Prevention among Youth in Senegal which provides assistance for the introduction of VCT for young people at youth counseling centers and promotes changing the sexual behavior of young people. This project commenced in 2005 and is planned to run for two years. JOCV members are deployed to the youth counseling centers. Japan has also dispatched a group of JOCV members to Jamaica to promote AIDS prevention education in schools and, in partnership with UNESCO, has been promoting understanding of HIV/AIDS among school officials and staff there. In Myanmar Japan is implementing the Major Infectious Diseases Control Project with the objective of strengthening measures to combat HIV/AIDS, malaria, and tuberculosis. This project commenced in January 2005 and is planned to run for five years. It includes anti-HIV/AIDS measures such as assistance for stronger prevention of infection through blood transfusions, as well as assistance to strengthen the management capacity of the AIDS and Other Sexually-Transmitted Disease Control Teams established nationwide in regions with a high risk of infection. Assistance for stronger prevention of infection through blood transfusions includes the establishment of a blood donation volunteer network primarily among university students, enhancement of the blood donor data bank, and the strengthening of testing functions.
In addition, Japan works on anti-AIDs measures, in the implementation of large-scale infrastructure development projects financed by yen loans, taking into account the possibility of the increased risk of HIV infection due to the employment of migrant workers for those projects. One example of the efforts made by Japan in FY2005 is the educational campaign and distribution of condoms to workers involved in construction work for the Delhi Mass Rapid Transport System Project in India (see Column II-5 for specific anti-HIV/AIDS measures).
Column II-5 The Bridge of Hope Connecting Thailand and Laos: A Yen Loan Project Takes Steps against AIDS
In order to expand the use of the Directly Observed Treatment, Short Course (DOTS) strategy,34 Japan has been providing anti-tuberculosis drugs and testing equipment particularly to the most seriously affected countries, including those designated by the WHO as tuberculosis priority countries. For example, Japan dispatched experts to countries including Cambodia, Myanmar, and the Philippines, and provided assistance through training, guidance, and the creation of guidelines to establish local programs for combating tuberculosis and strengthen their activity bases. Through these efforts, Japan has been contributing to the expansion and dissemination of DOTS.
Furthermore, in recent years the number of people infected with HIV that subsequently suffer from tuberculosis has been increasing. In Zambia, as HIV/AIDS has become prevalent, the number of tuberculosis patients has increased, with 70% of tuberculosis patients being those infected with HIV. In order to simultaneously advance anti-HIV/AIDS measures and anti-tuberculosis measures in Zambia, Japan began by providing assistance to Zambia University Teaching Hospital to enhance virus and tuberculosis testing technologies and develop a nationwide testing system. Building on this foundation, in FY2004 the Government began to dispatch experts to Zambia's National AIDS Committee. The experts have been providing assistance to enhance the central government's ability to analyze the aid situation and coordinate aid. Primarily they have been providing assistance to donors and medical facilities for mapping surveys. Moreover, through grant aid such as the Project for Infectious Diseases Control, Phase II (FY2004), Japan has been providing assistance for the procurement of the equipment and supplies necessary for HIV/AIDS and tuberculosis testing and for the expansion of services.
A medical worker checking the drug compliance of a patient (Project for Tuberculosis Control, Cambodia) (Photo: Japan Anti-Tuberculosis Association)
In order to contribute to combating malaria in Africa, Japan announced its intention to provide 10 million long-lasting insecticide-treated nets (LLITNs) by 2007. The use of such nets is expected to prevent the deaths of up to 160,000 children in Africa. As of the end of FY2005 Japan had provided more than half of the target number of nets. Specifically, in cooperation with UNICEF, it provided LLITNs to Côte d'Ivoire, Ethiopia, the Democratic Republic of the Congo and other countries in FY2005, including approximately 340,000 nets to Sudan.
Procured equipment to prevent malaria, such as mosquito nets and pesticides (Senegal) (Photo: Japan International Cooperation System [JICS])
Polio is on the verge of being eradicated from the entire world. For example, WHO declared the western Pacific region a polio-free area in 2000. Through cooperation with UNICEF and WHO, Japan has been providing active assistance for the dissemination of polio vaccinations in the South Asian and African regions, where polio has not yet been eradicated. In the G8 Evian Summit in 2003 Japan pledged assistance of US$80 million over three years for the eradication of polio, and during FY2005 this target was reached. The amount Japan pledged was the second largest contribution after that of the US. Furthermore, Japan, in concert with other G8 countries, is calling on the international community for support to eradicate polio. Specifically, Japan extended assistance to the Polio Eradication Programme (provision of polio vaccinations) for Egypt, India, and Pakistan, and assisted with vaccination programs in Ethiopia, Ghana, Sudan, Sierra Leone, Nigeria, Zimbabwe, and other countries.
E. Parasitic Diseases
Japan has been making efforts to control parasites through the development of human resources, using the International Parasite Control Centers that have been established in Thailand, Kenya, and Ghana as bases. For example, the Asian Center for International Parasite Control (ACIPAC) in Thailand has accepted more than 100 trainees from neighboring countries. The trainees are all parasite control or school health officials. Furthermore, Japan provides assistance for sanitary measures through schools and local communities. These measures include assistance for prevention and treatment, educational campaigns, and the installation of toilets. The measures are designed to combat Chagas disease, duracunculiasis, filariasis, schistosomiasis, and other parasitic diseases. In particular, in cooperation with WHO Japan has been making efforts to eradicate filariasis in the western Pacific region with the objective of achieving this by 2010.
F. Emerging Infectious Diseases
Recent years have seen outbreaks of newly emerging infectious diseases like SARS and avian influenza, which have become a global issue. The occurrence of avian influenza has been recognized among domestic poultry, primarily in Asia, since the end of 2003. It is a highly pathogenic strain (virus subtype H5N1) which has been gradually spreading geographically, resulting in a series of human infections and deaths. As the number of infection cases from birds to human increases, so does the danger of emergence of a new influenza strain. The international community has been activity discussing the promotion of countermeasures.
To deal with the threat of these infectious diseases, it is extremely important to prevent a world pandemic by taking early containment measures, including monitoring occurrence of outbreaks, quarantining patients, and placing restrictions on movements of people. It is necessary for the international community to work on the issue in partnership with each other. The Government of Japan hosted the Japan-WHO Joint Meeting on Early Response to Potential Influenza Pandemic in Tokyo in January 2006. The meeting focused on early responses to the spread of infection and contributed to consensus building in the international community. The assistance for controlling avian influenza pledged by Japan in January 2006 comes to a total of approximately US$155 million. Japan commenced its assistance aimed at communication campaigns, enhancement of monitoring, prevention of epidemics, and improvement of early response capacity, primarily in the Asian region but also in some countries in Africa. The Government has been providing this assistance in cooperation with WHO, FAO, OIE, UNICEF, and other international organizations. Also, Japan has been carrying out capacity development in developing countries in which risk of occurrence of the infection is high, by developing facilities and fostering human resources.