Japan’s Global Health Diplomacy in the Post-COVID Era—The Paradigm Shift Needed on ODA and Related Policies

Special Commission on Japan’s Strategy on Development Assistance for Health
November 2020

Overview & Recommendations (総論) – (English |日本語)

Full Text (全文) – (日本語)

A report from a high-level commission organized by JCIE, the Special Commission on Japan’s Strategy on Development Assistance for Health (DAH), calls for the Japanese government to better coordinate and strategize its health ODA by creating a centralized “control tower” and to double funding for global health. It also makes a host of other recommendations to better align different ODA streams, engage more with NGOs, strengthen human resource development for global health, and make ODA more effective.

JCIE launched the Special Commission in November 2019. Under the chairmanship of Rep. Yasuhisa Shiozaki (former Minister of Health, Labour and Welfare), the 23-member commission assessed how to utilize Japan’s ODA in a more strategic manner to advance global health, adapt to structural shifts in the development field, and increase the efficacy and impact of its funding in order to help achieve Goal 3 of the SDGs, “Ensure healthy lives and promote well-being for all at all ages.”

The Japanese-language Overview and Recommendations and a more in-depth Supplementary Report were released as part of the commission’s full report on November 30, 2020, to inform government deliberations. 

The Overview and Recommendations is now available in English, and a translation of the Supplementary Report will be available in February 2021.

Summary of Recommendations

The following offers excerpts from the Overview and Recommendations, and summarizes action items that are listed in the Japanese-language Supplementary Report as possible steps to be taken to implement the commission’s recommendations. (Please note that the action items are intended to be representative of the range of measures that can be taken rather than to be taken as consensus recommendations from the commission.)

In order to facilitate more flexible and effective responses to developments worldwide, a restructuring should be undertaken to clearly delineate and strengthen the capabilities of a “control tower” at the Cabinet level, directly under the prime minister, that is responsible for decision-making on overall ODA policies. As part of this effort, a “control tower” for global health, including health-related ODA, should be clearly delineated and strengthened…. (read more)

POTENTIAL ACTION ITEMS

Short-term

  • Revise the Basic Design for Peace and Health and clarify the institutional framework for designing and implementing Japan’s domestic and global health strategies
  • Establish a “Council on Global Health Strategy” (tentative name)
  • Create a public-private platform to inform the Council on Global Health Strategy
  • Establish a strong secretariat structure for the “control tower” with the ability to provide technical advice and draw upon outside expertise
  • Strengthen the “right person in the right place” system for assigning specialists to government posts in Japan and overseas dealing with global health

Japan should aim to double the funding directed to global health activities from both the public and private sectors in the next five years. First, the public sector (i.e., ODA) should lead the way and double its contributions. Then, efforts should be made to ascertain the private-sector trends in the global health field and, based on a clearer understanding of the characteristics of private-sector funding, Japan’s contributions in global health should be increased through public-private cooperation…. (read more)

POTENTIAL ACTION ITEMS

Short-term

  • Establish a 5-year global health strategy
  • Provide support for health financing and the achievement of UHC in developing countries impacted by COVID-19
  • Manage country-specific rolling plans from a sector-based perspective
  • Create a strong base for mobilizing private-sector resources for global health
 

Medium-term

  • Strengthen health financing systems by helping partner countries promote collaboration between finance and health authorities
  • Establish a system for continuous monitoring and evaluation of global health ODA
  • Measure the return on investment for global health ODA and publicly disclose it

Japan should aim to contribute in the following areas, taking into account bilateral priorities, national security and economic implications, and the potential for Japanese industry to contribute, including through Japanese R&D and digital innovation or medical/biotech venture businesses…. (read more)

POTENTIAL ACTION ITEMS

Short-term

  • Strengthen analysis of ODA for global health
  • Restructure the evaluation of international health organizations to promote evidence-based, strategic contributions to their work
  • Promote international policy research and dialogue on global health
  • Strengthen systems for mutual learning in which Japanese knowledge can be shared as an international public good

Proposed direction for ODA projects

Short-term

  • Lead international cooperation on the COVID-19 pandemic
  • Enhance low- to middle-income countries’ efforts to build up sustainable capacity to respond to emerging infectious diseases
  • Use yen loans to expand “health policy funding” support for global health
  • Provide assistance to prevent a secondary health crisis
  • Strengthen Japan’s capacity to support pandemic responses in low- and middle- income countries

Medium-term

  • Strengthen assistance for health policymaking, including for health financing reform
  • Support initiatives on reducing health risk factors
  • Strengthen efforts to address social, economic, and environmental determinants of health
  • Expand support for community health system strengthening
  • Expand investment in health infrastructure that contributes to strengthening primary health care (PHC) systems

In terms of bilateral assistance, we should strengthen the institutional arrangements (including human resources) for engaging in policy consultations and dialogues with development partners—including recipient government and international organizations—prior to project formation as a step toward developing strategic consistency in Japan’s bilateral and multilateral assistance and improving development outcomes in a cost-effective manner. For multilateral assistance…. (read more)

POTENTIAL ACTION ITEMS

Short-term

  • Create a Global Health Ambassador position
  • Initiate policy consultations among relevant Japanese ministerial officials and senior officials from international health organizations
  • Appoint a Health Multilateral-Bilateral Partnership Advisor (tentative)
  • Expand the input from experts through advisory committees, etc., to support Japan’s engagement in international health organizations
  • Create a model for coordination with multilateral assistance at the country-level

Medium-term

  • Formulate investment strategies for each international health organization
  • Strengthen capacity to offer effective policy input for international health organizations
  • Promote coordination by the Multilateral-Bilateral Partnership Advisor

Consultations and dialogues with NGOs and CSOs should be promoted, paying respect to the diverse roles they play and their autonomy, and partnerships should be strengthened with domestic and foreign NGOs and other organizations in the development of global health strategies and related policies as well as in the planning and implementation of ODA projects. Moreover, full support should be provided to realize the rapid development of the human resources and capabilities of Japanese NGOs so that they can play a leading role in international cooperation…. (read more)

POTENTIAL ACTION ITEMS

Short-term

  • Effectively incorporate the knowledge and expertise of NGOs in the policymaking process
  • Organize a task force to support greater involvement of NGOs in ODA projects
  • Expand support for local NGOs
  • Reflect the perspectives of NGOs and others starting in the project research and formation stages

Medium-term

  • Expand schemes that support social development activities

In order to increase the numbers of Japanese personnel in international organizations, a medium-term plan should be formulated for the training and strengthening of human resources, and the functions of the existing HRC-GH and the Recruitment Center for International Organizations should be enhanced with a particular focus on the discovery and successful placement of executive-level personnel. The medium-term plan may include the following measures…. (read more)

POTENTIAL ACTION ITEMS

Short-term

  • Conduct an evaluation of the Human Resource Strategy Center for Global Health (HRC-GH)
  • Identify posts and human resource needs that should be prioritized for global health ODA
  • Expand the role of the HRC-GH under the control tower
  • Create a five-year plan for global health human resource development
  • Establish mechanisms for cultivating technical expertise (expert meetings, expert committees, etc.)
  • Expand opportunities for nongovernmental actors to be engaged in policy discussions of international health organizations

Medium-term

  • Increase the number of Japanese nationals in executive posts at major international health organizations
  • Expand support for people starting careers in global health
  • Strengthen systems for identifying and supporting promising candidates without medical backgrounds who can make mid-careers shifts to the global health field
  • Establish a system to support more flexible “revolving door” career paths
  • Provide opportunities for training and education for global health specialists to respond to increasingly diverse needs
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