Japan's Official Development Assistance White Paper 2007
Next PageMain 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
<Record for FY2006>
For record for FY2006, see record for the health and welfare sectors.
<Current Status>
Infectious diseases, including the three major communicable diseases: HIV/AID, tuberculosis and malaria, 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. Concerning HIV/AIDS, it is estimated that approximately 40 million people are living with HIV worldwide. The Millennium Development Goals Report issued in July 2007 states that in 2006, the number of people who have died from AIDS increased to approximately 2.9 million worldwide, and that in 2005 over 15 million children lost one or both parents because of AIDS. For tuberculosis, 1.9 billion people are infected every year, of which approximately 8.8 million people show symptoms and 1.6 million people die. Over 95% of the cases of health hazard by tuberculosis are concentrated in developing countries. In addition, in 107 countries around the world approximately 3.2 billion people live in a region at high risk of malaria. It is believed that the number of people showing symptoms of malaria ranges from 350 to 500 million annually, and the number of deaths each year exceed one million people.48 Because the acceleration of globalization has facilitated the movement of people and goods, infectious diseases are more likely to spread to other countries across borders. Infectious diseases have thus become a global issue that must be tackled through international cooperation.
Chart II-19. Assistance Disbursement in Health and Medical Sectors by Region
<Japan's Efforts>
In June 2005 after the completion of the Okinawa Infectious Diseases Initiative (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. Under this initiative, the Government is to provide comprehensive assistance amounting to approximately US$5.0 billion over five years from 2005 to 2009 for health issues, including measures against infectious diseases. Furthermore, in order to crystallize HDI in Africa, Japan drew up the African Infectious Diseases Action Plan in May 2006. Japan also announced the plan to promote the Asia-Africa Cooperation (South-South Cooperation): one of its features is boosting the fight against the three major communicable diseases and parasitic diseases in Africa.
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) following the G8 Kyushu-Okinawa Summit held in July 2000. The Global Fund realizes a wide-ranging public-private partnership that transcends the traditional framework of inter-governmental cooperation. To date Japan has contributed a total of US$662.68 million to the Fund. Moreover, as a member of the Executive Board since the Global Fund was first established, Japan has been contributing to its effective and efficient management.
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 FY2006 for each major infectious disease are as follows.
See Section 2 for details on health-related measures other than those against infectious diseases
The Global Fund to Fight AIDS, Tuberculosis and Malaria
1. Projects assisted by the Global Fund (as of October 12, 2007)
Financial assistance totaling US$8.6 billion has been approved for over 451 projects to fight against infectious diseases in 136 countries. Of the assistance approved, 58% is accounted for by HIV/AIDS, with 24% for malaria, and 17% for tuberculosis. Disbursements from the Global Fund accounts for 21% of international financial contribution for HIV/AIDS, 67% for TB, and 64% for malaria.
2. Results (as of December 2006, unless otherwise specified; figures in parentheses show estimates upon completion)
(1) HIV/AIDS
>Anti-retrovirus therapy (ARV therapy) for 1.1 million people (1.8 million people) (July 2007)
>Voluntary Counseling and Tests (VCT) service for 9.4 million people (62 million people) aimed at HIV prevention
(2) Tuberculosis
>DOTS treatment for 2.8 million people (5 million people) (May 2007)
>MDR-TB control for 8,600 people
(3) Malaria
>Distribution of 30 million insecticide-treated mosquito nets (190 million nets) (May 2007)
>Artemisinin-based combination therapy for 23 million people (264 million people) against multidrug-resistant malaria
1. Projects assisted by the Global Fund (as of October 12, 2007)
Financial assistance totaling US$8.6 billion has been approved for over 451 projects to fight against infectious diseases in 136 countries. Of the assistance approved, 58% is accounted for by HIV/AIDS, with 24% for malaria, and 17% for tuberculosis. Disbursements from the Global Fund accounts for 21% of international financial contribution for HIV/AIDS, 67% for TB, and 64% for malaria.
2. Results (as of December 2006, unless otherwise specified; figures in parentheses show estimates upon completion)
(1) HIV/AIDS
>Anti-retrovirus therapy (ARV therapy) for 1.1 million people (1.8 million people) (July 2007)
>Voluntary Counseling and Tests (VCT) service for 9.4 million people (62 million people) aimed at HIV prevention
(2) Tuberculosis
>DOTS treatment for 2.8 million people (5 million people) (May 2007)
>MDR-TB control for 8,600 people
(3) Malaria
>Distribution of 30 million insecticide-treated mosquito nets (190 million nets) (May 2007)
>Artemisinin-based combination therapy for 23 million people (264 million people) against multidrug-resistant malaria
● Emerging Infectious Diseases
Avian influenza, one of the emerging infectious diseases that has become one of the global issues in recent years, is of a serious concern in the Asian region. Japan has actively supported measures against Avian and pandemic influenza, emphasizing the importance of international cooperation under the three pillars of early response, communication, and transparency. In December 2006, Japan announced an additional grant assistance totaling US$67 million at the Ministerial-level Donors Meeting on Avian and pandemic Influenza. Through international organizations such as WHO and UNICEF, Japan has been contributing to public awareness raising, capacity building for vaccine production in developing countries, and development of early warning systems and rapid containment capacities. Since 2006, Japan has disbursed a total of US$222 million for this purpose.
Chart II-20. Key Workings Related to the Avian and Pandemic Influenza
● HIV/AIDS
Japan has been contributing to HIV/AIDS prevention activities for youths and high risk groups, Voluntary Counseling and Training (VCT), and management of the HIV/AIDS survey and diagnosis system. Moreover, the international community has agreed to provide assistance for the prevention, treatment and care as much as possible by 2010.
In Tanzania, Japan has been implementing technical cooperation projects since March 2006, aimed at strengthening the organization of the National Anti-Aids Measures Program at the Department of Health and Human Services that manages the Treatment for Sexually Transmitted Diseases/VCT Program. Through national guidelines for the treatment of sexually transmitted diseases and VCT services, and by upgrading the training manuals and strengthening the monitoring system, Japan has contributed to the standardization and qualitative improvement of government anti- HIV/AIDS measures.
In addition, Japan works on anti-AIDs measures in tandem with the loan aid projects for large-scale infrastructure development, taking into account the possibility of the increased risk of HIV infection due to the employment of migrant workers for those projects.
See Japan's ODA White Paper 2006 Column II-6 for further detail on anti-HIV/AIDS measures in infrastructure projects
In November 2006, Japan invited health administrators involved in HIV/AIDS control, as well as health professionals involved in the prevention, treatment, and care for HIV/AIDS, from the Association of Southeast Asian Nations (ASEAN) countries to hold the Japan-ASEAN HIV/AIDS Workshop in Chiang Rai, Thailand. In the Workshop, the participants confirmed the region-wide support systems49 through the on-site inspections of medical facilities and health care centers, and held active discussions following the visits and presentations by each country.
Sharing Experiences for Better HIV/AIDS Control
Although the HIV/AIDS situations differ by country, neighboring countries may have some common tasks. Sharing one country's previous experiences with others can lead to better counter-measures.
For example, the HIV/AIDS Regional Cooperation Center Project in Thailand conducts two kinds of training in Cambodia, Laos, Viet Nam, and Myanmar: one being country-specific training adapted to the needs of each country; another being multi-country training for common challenges. The training not only aims to acquire knowledge, but also includes workshops, observations of Thailand's projects to combat HIV/AIDS and exchanges of opinions with staff were conducted, focusing on applying Thailand's experiences in each country.
Furthermore, staff from Ghana and Zambia engaged with HIV/AIDS control participated in the joint training provided in Thailand on care and treatment for AIDS patients. Although Thailand's experiences cannot immediately be African countries, due to the difference in their backgrounds such as the health systems and HIV infection routes, there is much for them to learn from the learning process Thailand has undergone in tackling HIV/AIDS. In this respect, the interaction between Asia and Africa proves to be a great stimulant for both.
Although the HIV/AIDS situations differ by country, neighboring countries may have some common tasks. Sharing one country's previous experiences with others can lead to better counter-measures.
For example, the HIV/AIDS Regional Cooperation Center Project in Thailand conducts two kinds of training in Cambodia, Laos, Viet Nam, and Myanmar: one being country-specific training adapted to the needs of each country; another being multi-country training for common challenges. The training not only aims to acquire knowledge, but also includes workshops, observations of Thailand's projects to combat HIV/AIDS and exchanges of opinions with staff were conducted, focusing on applying Thailand's experiences in each country.
Furthermore, staff from Ghana and Zambia engaged with HIV/AIDS control participated in the joint training provided in Thailand on care and treatment for AIDS patients. Although Thailand's experiences cannot immediately be African countries, due to the difference in their backgrounds such as the health systems and HIV infection routes, there is much for them to learn from the learning process Thailand has undergone in tackling HIV/AIDS. In this respect, the interaction between Asia and Africa proves to be a great stimulant for both.
● Malaria
For Africa, where approximately 80% of malaria-related deaths are concentrated and where the situation is most dire, Japan announced its plan to provide 10 million long-lasting insecticide-treated nets (LLITNs) by 2007. Through partnerships with UNICEF and other international organizations, Japan distributed approximately 9.49 million nets as of the end of August 2007. According to UNICEF estimates these nets can prevent the deaths of 110,000 to 160,000 children in Africa; it is expected that up to 620,000 infant mortalities can be prevented.
See Part I, Chapter 1, Section 2 for details on mosquito nets
Chart II-21. Mosquito Nets Provided to Counter Malaria (as of November 2007)
● Tuberculosis
In the past, tuberculosis was the major focus of Japan's own efforts to combat against infectious diseases. Therefore, Japan has a high standard of research, survey and treatment techniques in the field of tuberculosis, and has provided support to developing countries using its extensive experience. Currently, Japan seeks cooperation focusing mainly on the promotion of Directly Observed Treatments, Short-course (DOTS),50 in accordance with the Global Plan to Stop TB 2006-2015 formulated on the basis of international collaboration in the field of tuberculosis. Japan has provided tuberculosis medication and clinical equipment, prioritizing countries facing serious tuberculosis problem, including those amongst WHO's High Burden Countries for tuberculosis. Japan also dispatches TB experts to countries such as Afghanistan, Pakistan, Myanmar, the Philippines, Bangladesh, and Zambia, to strengthen management structures of local anti-tuberculosis programs, as well as to provide training, supervision and guideline support for improving testing capacities. Through these efforts, Japan has contributed to the expansion and promotion of DOTS.
In Cambodia, where the percentage of tuberculosis patients rose to the highest in the world after the end of civil war, Japan has supported treatment of more than 20,000 tuberculosis patients per year, compared to before the project was launched. Japan has provided grant assistance not only to renovating the tuberculosis center, providing tuberculosis medicines, and strengthening DOTS management through technical cooperation for human resources development, but also to implementing community DOTS in order to make treatment available in communities across the regions.
Japan's cooperation has also steadily shown results in other countries. Out of the 22 High Burden Countries for tuberculosis, in which 80% of the world's tuberculosis patients are concentrated, the three countries of China, Viet Nam, and Philippines have achieved international goals. For these countries, Japan has provided integral assistance through technical cooperation and grant assistance.
Recently, due to incomplete medication and other factors, Multidrug-resistant Tuberculosis (MDR-TB) and Extensively Drug-resistant Tuberculosis (XDR-TB), which are more difficult to treat, have emerged as new problems in tandem with the spread of superinfections among HIV/AIDS patients.
Chart II-22. Japan's Major Assistance on Tuberculosis (1963-May 2007)
● Polio
In 2000, WHO issued a complete polio eradication manifesto for the Western Pacific Region. As the number of polio epidemic countries was reduced to four (Nigeria, India, Afghanistan, Pakistan) by 2006, the world is facing the last stage in the efforts towards polio eradication. Given these circumstances, in February 2007, WHO announced a new strategy featuring concentrated cooperation in the four polio epidemic countries in the two years from 2007 to 2008.
Japan, adhering to WHO's Global Polio Eradication Initiative (GPEI), has provided polio vaccines in cooperation with organizations such as UNICEF. As Japan also seeks to eradicate polio through concentrated support for target countries, in 2007 it decided to strengthen assistance for Nigeria. Out of the abovementioned four countries, the situation is most dire in Nigeria, which is also the only epidemic country in Africa.
● Parasitic Diseases
To combat parasitic diseases, Japan has provided assistance for sanitary measures in schools and local communities, encompassing prevention and treatment, educational campaigns, and the installation of latrines. Japan also helped to train more than 220 people in its efforts for human resources development in relevant fields. Training was provided through the International Anti-Parasitic Measures Centers established in Thailand, Kenya and Ghana.
Recently, "neglected tropical diseases" have been drawing attention, such as Chagas' disease, Guinea Worm disease, filariasis, and schistosomiasis. Japan has been making serious efforts to combat Chagas' disease in Central American countries and its support to develop the structure for preventing vehicular transmission has led to a significant reduction of infectious diseases risk.
Regarding filariasis, which brings long-term harm to people health and social life as parasites remain in the human body, Japan has been cooperating with WHO in the efforts toward eradicating filariasis in the Oceania region by 2010 and in Bangladesh by 2015. Through the distribution of anti-parasitic agents and education materials, as well as prevention education provided by JOCV, Japan has contributed to a significant reduction in the number of patients newly infected and has helped to maintain the disease retains non-epidemic status.
Column 9 A Battle against Chagas disease — The Silent Infection