Contributed Article by Prime Minister KISHIDA Fumio to The Lancet

January 21, 2023
“Human security and universal health coverage: Japan’s vision for the G7 Hiroshima Summit”
The COVID-19 pandemic has made an unprecedented impact on the international community and exposed the vulnerabilities of the present global health architecture. Better governance and finance measures are urgently needed to strengthen pandemic prevention, preparedness, and response (PPR) for global health threats and to create more resilient and sustainable health systems that lead to universal health coverage (UHC).
The international community, including Japan, is now discussing the way forward for global health architecture to ensure better health and living standards for all people—with a sense of urgency. I firmly believe that global health should be based on a human-centred approach in line with human security. The concept of human security in the Anthropocene, which focuses on the importance of global solidarity, can help guide efforts to address this planetary challenge.1
I believe that human security remains critical to strengthen the global capacity to prevent, prepare for, and respond to public health emergencies and contribute to achieving UHC. Realising and sustaining UHC is crucial to improve people’s health and provide the safety net that contributes to inclusive growth and the creation of peaceful and stable societies. This commitment to UHC is how Japan has achieved one of the healthiest societies in the world.2 Embracing these ideas, the Japanese Government launched its Global Health Strategy in May, 2022.3 The strategy reflects the concept of human security as a core principle of Japan’s diplomacy and reiterates the Japanese Government’s commitment to global health.
In May, 2023, Japan will host the G7 Summit Meeting in Hiroshima and the G7 Health Ministers’ Meeting in Nagasaki—in the Cities of Peace. At these meetings, building on the discussions and outcomes of previous G7 meetings, I intend to highlight the strategic importance of undertaking efforts on human security and UHC as central to the Japanese Government’s vision for the Summit. To this end, I emphasise three important areas in support of this vision.
First is the need to strengthen the global health architecture to prepare for public health emergencies. Based on the lessons learned from gaps and vulnerabilities exposed by the COVID-19 pandemic,4 the international community needs to further work on policies, governance, and financing to enhance the global health framework with a focus on PPR for health emergencies.
More specifically, an integrated and holistic approach is needed to improve international governance and ensure sustainable financing to rebuild PPR within the global health architecture. This approach requires coordinated actions and effective financial mobilisation. Enhanced collaboration between finance and health policy makers is crucial for these efforts and was an underlying rationale of hosting the first G20 Joint Finance and Health Ministers’ Meeting in 2019 under the Japanese Presidency. As the international community looks towards the post-COVID-19 era, we need to build up this political momentum to strengthen and institutionalise finance and health collaboration, as well as operationalise the Pandemic Fund,5 which Japan has supported since its creation. These actions should also foster whole-of-government and multisectoral approaches based on the coordinated engagement of heads of state and government.
It is also vital to reinforce international norms and regulations in tackling pandemics. For this reason, the Japanese Government attaches importance to the development of a WHO convention, agreement, or other international instrument on PPR (WHO CA+), together with amendments to the International Health Regulations.6 I trust that the discussions among G7 members will help us identify a direction on important elements regarding these international norms and regulations.
The second important issue is the advancement of UHC towards the post-COVID-19 era. Japan is a long-standing and dedicated promoter of global advancement of UHC.2,4 Health systems must be able to effectively respond to and overcome health challenges to meet the Sustainable Development Goals.7 These challenges include infectious diseases, such as HIV/AIDS, tuberculosis, malaria, and neglected tropical diseases. Non-communicable diseases, including mental health conditions, a life-course approach that encompasses reproductive, maternal, newborn, child, and adolescent health, and healthy and active ageing are also important challenges. Japan bears a special responsibility to shed light on the demographic challenges as one of the world’s superaged societies.
G7 contributions to enhanced PPR for global health threats should also be combined with strengthening of primary health care to move countries towards achieving UHC. The renewed momentum and concept of UHC should work as the foundation for the upcoming UN General Assembly High-Level Meetings on UHC, PPR, and tuberculosis to be held in 2023. In this context, Japan will further work on a global hub to promote UHC in the new era to guide global efforts in this field.
The third key area is the promotion of health technology innovation, including in the digital domain. Innovation is needed to facilitate a more enabling global ecosystem to make rapid research and development of medical countermeasures possible, as proposed in the 100 Days Mission.7 The global response to COVID-19 shows that remarkable progress in research and development can be achieved to address global public health threats. However, the international community needs to face the fact that striking inequities in access to COVID-19 tools persisted despite major global efforts. Building on the 100 Days Mission and beyond, Japan supports achieving the goal of accelerating development of research and development for PPR and reiterates the importance of assuring equitable access to vaccines, diagnostics, and therapeutics under the overall goal of UHC. Creating an effective global system to ensure equitable access should expand manufacturing capacities in low-income and middle-income countries. On the basis of an assessment of global experiences during the COVID-19 pandemic,8,9 the G7 should explore ways to assure equitable access to new technologies for future threats. In this regard, a focus on human security can help guide G7 efforts to better address needs on the ground so that all people can have equitable access to new technologies, with the aim of leaving no one behind.
All stakeholders need to support and build up the infrastructure and capacities required for research and development before future health crises emerge. The international community also needs enhanced research and development to address ongoing health challenges, such as antimicrobial resistance and neglected tropical diseases, among many others. Additionally, the global surveillance network should be transformed into an effective early warning system for health threats. Developing this system will require strengthening the health emergency workforce, and digital transformation should be promoted for the next-generation health emergency management. National capacity is the foundation of PPR; enhancing regional and global institutions in a coherent way to support national efforts and collective actions is a key priority for effective PPR. In this regard, Japan will continue its full support to the ASEAN Centre for Public Health Emergencies and Emerging Diseases (ACPHEED).
I am confident that the G7 members and other colleagues around the world will embrace human security and UHC as a core principle of advancing global health and addressing crucial global challenges as we move towards the post-COVID-19 era. I believe that this principle will assist all of us in building a healthier, more equitable, peaceful, and prosperous global society.
1 United Nations Development Programme. Special report on human security: new threats to human security in the Anthropocene demanding greater solidarity. New York, NY: United Nations Development Programme, 2022.
2 Abe S. Japan’s vision for a peaceful and healthier world. Lancet 2015; 386: 2367–69.
3 Prime Minister’s Office of Japan. Global Health Strategy outline. 2022.ファイル」 (PDF/1,115KB)(accessed Dec 26, 2022).
4 Sachs JD, Karim SSA, Aknin L, et al. The Lancet Commission on lessons for the future from the COVID-19 pandemic. Lancet 2022; 400: 1224–80.
5 The World Bank. G20 hosts official launch of The Pandemic Fund. Nov 13, 2022. (accessed Jan 4, 2023).
6 WHO. Intergovernmental Negotiating Body to draft and negotiate a convention, agreement or other international instrument. 2022. (accessed Dec 26, 2022).
7 Pandemic Preparedness Partnership. 100 Days Mission to respond to future pandemic threats. Reducing the impact of future pandemics by making diagnostics, therapeutics and vaccines available within 100 days. A report to the G7 by the Pandemic Preparedness Partnership. 2021.ファイル」(PDF/168KB) (accessed Dec 26, 2022).
8 WHO. ACT-Accelerator. (accessed Dec 26, 2022).
9 WHO. External Evaluation of the Access To COVID-19 Tools Accelerator (ACT-A). Oct 10, 2022. (accessed Jan 10, 2023).

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