The Department of Global Health Policy of the University of Tokyo (GHP) and the Institute for Global Health Policy Research (iGHP) of the National Center for Global Health and Medicine, in cooperation with Japan International Cooperation Agency (JICA), had the pleasure of co-organizing an event titled “Ensuring access to health for all: locally, regionally and across borders.” This event was supported by the Ministry of Health, Labor and Welfare of Japan and was held as an official part of Universal Health Coverage (UHC) Day 2018.
The aim of this event was to consolidate ideas and viewpoints on how we can ensure equitable access to health for all people locally and globally. By inviting experts on health systems from Japan, China and Thailand, we examined the future directions of health systems for these three rapidly aging societies and to find the key for “leaving no one behind.”
For the event, we were honored to have two distinguished guests, Dr. Chieko Ikeda, Senior Assistant Minister for Global Health under the Minister's Secretariat in the Japanese Ministry of Health, Labor and Welfare and Dr. Suwit Wibulpolprasert, Vice Chair of International Health Policy Program Foundation. In her opening remark, Dr. Ikeda emphasized the fact that the highest standard of health is a basic human right. While Japan has been taking the leadership to ensure countries across the globe attain UHC by 2030, Dr. Ikeda noted on Japan’s own challenges to maintain the quality and coverage of healthcare as a rapidly aging society. With the occasion of UHC Day, she expressed her sincere wishes for all of us to think of how we can ensure health for those in Japan and for the world.
Following Dr. Ikeda’s opening remark, Dr. Suwit Wibulpolprasert touched upon Thailand’s unique experience over the past half a century in achieving the country’s UHC in 2002 to “leave no one behind.” Some instrumental factors were) 1) strong political commitment, 2) transparency and ownership through a participatory governance system, 3) promotion of Primary Health Care (PHC) services, 4) a mix of payment and innovative financing schemes, 5) institutional capacity building and policy research. Dr. Suwit finished off his presentation noting that health is about the wellbeing of all people and that UHC needs to be inclusive of everyone.
Following the keynote address, two speakers each gave a presentation on their country’s progress on UHC; Dr. Kun Tang of Peking University’s Department of Global Health on how health agenda is driven in a socialist country like China, and Dr. Yoshihiro Takayama of Okinawa Chubu Hospital on how Japan is shifting to a localized care for chronic illnesses based on PHC.
Dr. Tang illustrated the progress of on health measures in China in the recent years, which has benefitted much from the country’s promotion of UHC. In 2015, China reached 97.8% population coverage using a mix of insurance schemes for civil servants, urban employees, rural and urban residents. Despite such achievements, financial protection coverage remains to be an issue , which is being addressed through China’s next set of actions, which include a PHC focused reform to promote UHC.
Dr. Tang also touched upon how China is in the position to drive global UHC promotion with the Silk Road and Belt Initiative, which promotes trade and provides infrastructure in over 80 countries and 70% of world population. Together with its ODA for health, which invests heavily on health system strengthening, China will ensure strengthening of health service delivery and their systems in all these countries.
Following Dr. Tang’s talk, Dr. Takayama spoke from the caregiver’s perfective on whether we are really able to provide an inclusive care even in a country where UHC has supposedly been achieved. Japan currently faces an era where medicine has shifted from acute care to chronic care where localized care system has been the core health policy. He illustrated how individual’s needs are cared for and taken into consideration at the medical care provision level, but that we should be careful about systemizing all good practices and rather should pay careful attention to providing the flexibility to meet the localized and individualized needs.
In the panel discussion, the panelists discussed on further challenges that each country or the global community faces, and the key to achieving medical care where no one is left behind.
The first issue discussed was on migrants. Dr. Supatik Sirilak of Thailand introduced various coverage schemes that Thailand offers to its migrants, while Dr. Tang mentioned that internal migration poses to be an issue in China and can also be seen as a window of opportunity for the private sector to step in. Dr. Takayama, on the other hand, discussed about the need for the younger generation to be involved in community building and to promote diversity and inclusiveness in welcoming in migrants.
Dr. Makoto Tobe of JICA went on to discuss how we can address global issues, to which he stressed the importance of raising the awareness and involvement of decision makers. In particular, Dr. Tobe touched upon how the involvement of those from the finance ministry is a key in order to secure the necessary budget. In addition, he mentioned about the importance of PHC and highlighted Thailand as a prime example of how they drove a hospital based to a PHC-based health care system to achieve UHC.
Ms. Mihoko Kashiwakura of the Bill and Melinda Gates Foundation highlighted that Sustainable Develop Goals are goals for every citizen of the globe, and in order for us to change the world and achieve these goals, each one of us needs to be involved in the process.
This event was well-received by more than one hundred participants that consisted of government officials, developing partners, academia, medical professionals, private sector, and civil societies from various countries.
- Dr. Chieko Ikeda, Senior Assistant Minister for Global Health, Minister's Secretariat, Ministry of Health, Labor and Welfare, Japan
- Dr. Suwit Wibulpolprasert, Vice Chair, International Health Policy Program Foundation; Vice Chair, Health Intervention and Technology Assessment Foundation, Thailand
- Dr. Kun Tang, Assistant Professor, Department of Global Health, Peking University School of Public Health, China
- Dr. Yoshihiro Takayama, Chief Physician, Regional healthcare Department, Okinawa Chubu Hospital, Japan
- Dr. Supakit Sirilak, Deputy Permanent Secretary, Ministry of Public Health, Thailand
- Dr. Kun Tang, Assistant Professor, Department of Global Health, Peking University School of Public Health
- Dr. Yoshihiro Takayama, Chief physician, Regional Healthcare Department, Okinawa Chubu Hospital
- Dr. Makoto Tobe, Senior Advisor, Human Development Department, Japan International Cooperation Agency (JICA)
- Ms. Mihoko Kashiwakura, Head of Japan, Bill & Melinda Gates Foundation