A. Importance of addressing global health
Communicable diseases, such as tuberculosis, malaria, HIV/AIDs (‘Big Three’) and the coronavirus pandemic, have vividly demonstrated the cross-boundary impact on the health, society, policy and economy of multiple nations. Similarly, noncommunicable diseases (NCDs) such as cancer and dementia, which still lack blockbuster treatments for eradication, remain a great threat to both Global North and Global South nations, as economic impacts, such as the reduction in work capacity of an individual after the onset/treatment of NCDs, may be observed. Additionally, both disease types (communicable and NCDs) will continue to threaten the population's health, as well as the overall society, due to the progression in borderless society with active migration, and changes in lifestyle in accordance with acceleration in urbanisation.
In order to resolve the threats outlined above, simply finding the applicable medical treatment for both communicable and NCDs is essential yet insufficient. As observed with the case of the coronavirus vaccine distribution, ensuring that the treatment reaches the right people at the right time is crucial. The health issue would never be resolved even if effective treatment is developed. Importantly, the willingness of each nation to help one another to address concepts such as market access strategies, supply chains and facilities development, is critical to truly resolve the health issues we face today. As the world is becoming more borderless and urbanised, successful practice of global health through strong collaboration among nations is inevitable to ensure the health of the overall population. This in fact is the ethos of global health.
As we prepare for tracking the next big threat in a successful manner, it is essential for each individual to first recognise and understand the concept of global health. In this series, we will explore the concept of global health, by first covering what the concept is, its history and the role Japan plays based on past G7 activities.
In the upcoming series to follow, different topics that constitute global health, such as Universal Health Coverage (UHC), climate change and migration, communicable diseases and NCDs will be explained to further deepen the readers’ understanding on the complexity of global health. Additionally, this should lead to opportunities for various stakeholders to proactively consider methodologies for innovative cross-border collaboration strategies, with the hope of achieving the health of all populations.
B. History of global health
In order to understand the concept and the importance of global health, we must first recognise the history of how it has evolved over the past decade.
The term originated from international health, which was first introduced as colonial medicine in the 19th Century, when the eradication of diseases such as the yellow fever progressed through colonising power. That transitioned into tropical medicine in the 20th century, when ‘preserving the health of European colonial rulers and protecting them from the health hazards of tropical diseases’ (Jolst, 2020)*1 became the focal point.
In 1948, the World Health Organization (WHO) introduced international health, a concept designed to help reduce the burden of diseases beyond tropical diseases that were widespread in the Global South, such as malaria and HIV/AIDs, through the support of high-income countries for their health security interests.
Importantly, the introduction of Millennium Development Goals (MDGs) further supported the criticality of practising international health. MDGs encouraged the importance of nations helping to support the developing countries through applicable funding schemes and education, which helped improve not only the overall health, but also associated social issues and poverty rates faced in the Global South by 2015*2.
As 2015 approached, the United Nations (UN) agreed on evolving the MDGs into Sustainable Development Goal (SDGs), which focus on the economic, social, environmental and health issues. SDGs are not restricted to the Global South, but also include issues that are faced in the Global North*3. Accordingly, health topics like practising Universal Health Coverage (UHC) and tackling NCDs were introduced, stressing health as the basis for accomplishing economic, social and environmental goals.
With this movement, the concept of international health gradually evolved into global health (Diagram 1), which is recognised as a multidisciplinary field that promotes health of the overall population at a global scale. In recent years, global health has opened new fields such as planetary health and One Health, which will be explored in-depth in the upcoming series.
Diagram 1. Comparison between international health and global health
C. Leaders of global health
As outlined in the introduction, the recent outbreaks such as Ebola and COVID-19 have demonstrated the catastrophic impacts across borders. They also have ‘brought the urgency to efforts to strengthen the way countries and the world prepare for, prevent, detect and respond to health urgencies’ (WHO, 2023)*4. This raises the question, who is to lead all of this? Generally, the applicable leader to be appointed would be the WHO, but several issues observed within WHO (Diagram 2) prevent the organisation from leading critical global health agendas.
Diagram 2. Issues within WHO
The issues within WHO point to the strong responsibilities and ownerships of each nation to make the ultimate decision in supporting one another and to exit from any catastrophic situations. Importantly, each nation must determine whether global health can be realised, which is why it is critical for each nation to recognise its role in the global health agenda.
D. Expected Japan’s leadership
Japan, a key member of the G7 and Asia’s leading nation in global health, has put the spotlight on the critical global health issues during the G7 summit it has hosted in recent years. Such actions led to significant milestones, such as the establishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria (Diagram 3).
Diagram 3. Key events where Japan have led the health agenda
| Year | Events | Health agenda |
| 2000 | G8 Kyushu- Okinawa Summit |
Japanese Prime Minister Yoshiro Mori invited members from Africa and discussed actions on infectious diseases, which resulted in the creation of the Global Fund to Fight AIDS, Tuberculosis and Malaria. |
| 2008 | G8 Hokkaido Toyako Summit | Prior to the summit, international conferences such as the Global Health Summit brought together participants from both public and private sectors, in preparation for the intensive discussions to be held at the summit. |
| 2013 | Established the Global Health Technology (GHIT) Fund — through a public-private partnership between the Japanese government, Japanese pharmaceutical companies and the Bill & Melinda Gates Foundation — to support research and development on neglected tropical diseases (NTDs)*6. | |
| 2015 | Organised the International Conference on UHC in the New Development Era in Tokyo, discussing ‘emergency preparedness, global governance, and the 2017 G7 Summit’s role in global health’ (JHPN, 2016)*7. | |
| 2016 | G7 Ise-Shima Summit | Presented the ‘Ise-Shima Vision for Global Health’ specifying a detailed action plan for infectious disease control, promotion of UHC and women’s and children’s health. Japan became the first nation in G7 to promote UHC as a major topic in the summit*8. |
| 2023 | G7 Hiroshima Summit | Formulated the Global Health Strategy in response to the coronavirus and led efforts to address global health challenges in preparation for the next pandemic through acceleration of UHC. |
As mentioned above, Japan has been putting a tremendous amount of effort into resolving health issues, and prioritising health-first for its citizens. In particular, as appointed by the World Bank*9 and the Ministry of Foreign Affairs*10, Japan excels in practising UHC and is expected to lead other nations in achieving it. It is important for countries like Japan to show leadership in mitigating health issues by supporting Global South nations. In the next series, we will dive deeply into the world of UHC.
Reference
*1: Jens Holst, 2020, BMC, Global Health - emergence, hegemonic trends and biomedical reductionism, https://globalizationandhealth.biomedcentral.com/articles/10.1186/s12992-020-00573-4
*2: https://www.jica.go.jp/about/organization/sdgs/SDGs_MDGs.html
*3: https://www.jstage.jst.go.jp/article/jniph/68/5/68_372/_pdf/-char/ja
*4: Director General, 2023, WHO, Strengthening WHO preparedness for and response to health emergencies, https://apps.who.int/gb/ebwha/pdf_files/WHA76/A76_10-en.pdf
*5: Srikanth K. Reddy, Sumaira Mazhar & Raphael Lencucha, 2018, BMC, The financial sustainability of the World Health Organization and the political economy of global health governance: a review of funding proposals, https://globalizationandhealth.biomedcentral.com/articles/10.1186/s12992-018-0436-8
*6: https://5th.ghitfund.org/history/en
*7: https://japanhpn.org/en/global-health-japan/
*8: https://www.gov-online.go.jp/eng/publicity/book/hlj/html/202301/202301_09_en.html
