USAID-Japan Partnership for Global Health

June 11, 2002

For more than a decade Japan and the U.S. have been working closely together to improve global health. Since the early 1990s, the U.S. and Japan worked closely to harmonize policies in the sector and develop complementary programs and projects in more than thirty countries. A good example of our global leadership in this area is the strong support from President Bush and Prime Minister Koizumi for the Global Fund for AIDS, TB and Malaria: a global coalition designed to address key health concerns in a meaningful way. Building upon these successes and our growing partnership, and following the 2000 G8 Kyushu Okinawa Summit, Japan and the U.S. began looking at ways to strengthen this important collaboration. Still further, from autumn of 2001, we began a comprehensive review of our work together in an effort to improve the efficiencies in our collaboration and reinforce our collective impact. This partnership set out below highlights the importance of collaboration, reaffirms our desire to work together, and proposes steps designed to raise the collaborative impact of our development assistance policies and programs.

Vision

The goal of our work together is to improve the Population, Health and Nutrition (PHN) status of people in developing countries, based on the understanding that through synergy we can have the greatest beneficial impact. We will accomplish this through our joint promotion and support of appropriate PHN policies, services and practices in host countries. In this regard, we recognize that host country ownership is critical, and host country goals and interests - both public and private - serve as the foundation of our collaboration. We will work to maximize the impact of our work in the PHN sector by increasing the level of consultation and collaboration in the planning, implementation and evaluation of programs and projects at the global, regional and country levels.

Both sides strongly support global health activities through a variety of programs in many countries. USAID's strategy, for example, seeks to stabilize world population and to protect human health through programs in maternal and child health, HIV/AIDS, family planning and reproductive health, infectious diseases, environmental health, nutrition and other life-saving areas. The Government of Japan has focused on population/reproductive health, primary health care and community health development. Additionally, the Okinawa Infectious Disease Initiative of 2000 has proven Japan's even stronger commitment to fighting HIV/AIDS, tuberculosis, malaria and other parasitic diseases, and other infectious diseases.

Increasingly, global health challenges are too large for any single government, agency, or organization to confront alone. Our mutual successes have been achieved through close collaboration and partnership with the people and governments of assisted countries, other donors, private voluntary organizations, universities, and private sectors. We will continue to forge such alliances and support key international efforts. Our renewed cooperation under the overall U.S.-Japan partnership for development aims at better meeting today's health challenges in a measurable manner. Key elements of this vision of collaboration include:

Strategic Approach

Based on an ever-growing intersection between our programs and policies in this sector, the following outlines some of the key approaches both sides will adopt to improve our collective performance:

Field-driven Collaboration - With host country ownership a key to our successful partnership, a field-centered approach will enable close cooperation and strategic input among those with the greatest knowledge and understanding of host country needs and interests. Thus, both sides will work to respond favorably and quickly where possible and within existing budgets to collaborative proposals from the field. In order to streamline the collaboration process in the field and improve the impact of collaboration, both sides will: 1) assure an adequate number of PHN staff in the field to assist collaboration; 2) name one or more persons to be point(s) of contact in key field offices (embassies, JICA, JBIC and USAID) for collaboration; and 3) encourage field offices to jointly develop an action plan and matrix with a timeline for interventions, duly respecting ownership of the host government, other partners and communities.

Strategic Planning - Both sides will: 1) encourage strategic communication and collaboration in the field through early joint planning and programming, especially through Japan's integrated annual Needs Assessments; 2) promote short-term staff exchanges among field offices and headquarters; and 3) continue to carry out joint Project Formulation Missions as well as encourage participation on each other's more focused missions. Both sides will share schedules of missions and work to synchronize field visits from headquarters where appropriate. In addition, both sides will actively encourage the identification of opportunities for more focused collaboration in key areas of interest (see below), particularly involving personnel exchange and other technical staff as collaboration advisors.

Management Support - Recognizing the importance of follow-up and to ensure close communication, both sides will name one or more persons in headquarters to be point(s) of contact for tracking the progress of the collaboration identified in this Partnership. In addition, the USAID-JICA personnel exchange will continue to be a focal point for information sharing and support for collaboration, especially for the field. Both sides will endeavor to reduce the management burden of cooperation by focusing on larger scale activities reaching a wider population and replicating and/or scaling up successful projects wherever possible. Both sides will facilitate timely decision-making by headquarters (where necessary) for projects/programs developed at the field level and proposed by local partners and ensure the implementation of confirmed field-developed matrices.

Communication, Information Sharing and Knowledge Management - Both sides will work to strengthen communication at both central and field levels. Each side will encourage site visits and meetings in the field and in headquarters as well as regular consultations between health experts in key areas. Both sides will work to deepen the understanding on the aid programs and schemes of the other side, to develop a platform to save and share success stories and lessons learned, and to widely disseminate this information among field offices and headquarters and where appropriate to publicize the results of our collaboration. The use of IT will be explored where appropriate.

Monitoring & Evaluation - Both sides will work to monitor progress and impact of our collaboration and to help measure progress towards achieving the International Development Goals and other global development targets. In PHN, these include: 1) reducing child mortality; 2) improving maternal health; and 3) combating HIV/AIDS, malaria and other diseases. In that regard, both sides will collaborate on monitoring and evaluation issues (including data gathering through Demographic and Health Surveys and other surveillance tools) and address quality assurance in our programs and projects.

Multisectoral/Integrated Approach - Both sides will work to adopt multisectoral and comprehensive approaches to achieve greater impact on global health. Examples could include linking Population and Environment activities or Infectious Diseases and Information Technology.

International Fora and Global Alliances - Both sides will work to actively collaborate, participate and contribute to relevant international and in-country policy and technical meetings and coalitions based on our shared goals and priorities. Both sides will work to support and utilize global partnerships and mechanisms to reduce the administrative burden on developing countries.

Areas of Interest

Global Health Issues - Recognizing the diverse possibilities of collaboration in the PHN sector, the following are provided as examples of areas of strong interest on both sides. Again, priority will be given to jointly developed field driven proposals and need not fall under this illustrative list. Field missions are encouraged to discuss collaborative possibilities with each other, host country and other development partners and submit proposals to headquarters. Key areas of joint interest include:

HIV/AIDS Tuberculosis Malaria and other parasitic diseases Other Infectious Diseases

Polio/EPI Micronutrients/Nutrition Reproductive Health/Family Planning Maternal and Child Health

Next Steps

Recognizing the vast needs in the developing world, changing circumstances and evolving programs, Japan and USAID will work to expedite action based on the above aspects of this partnership. Both sides will work to develop a comprehensive action plan from which we will work and review this partnership on a regular basis and update it as needed.

/s/ Tsuneo Nishida Director GeneralEconomic Cooperation Bureau Economic Cooperation Bureau Ministry of Foreign Affairs Japan

/s/ For the United States Agency for International Development E. Anne Peterson, MD, MPH Assistant Administrator Bureau for Global Health

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