Department of Global Health Policy, Graduate School of Medicine, University of Tokyo, Japan.
Lancet. 2011 Oct 1;378(9798):1255-64. doi: 10.1016/S0140-6736(11)61048-9. Epub 2011 Aug 30.
Over the past 50 years, Japan has successfully developed and maintained an increasingly equitable system of universal health coverage in addition to achieving the world's highest life expectancy and one of the lowest infant mortality rates. Against this backdrop, Japan is potentially in a position to become a leading advocate for and supporter of global health. Nevertheless, Japan's engagement with global health has not been outstanding relative to its substantial potential, in part because of government fragmentation, a weak civil society, and lack of transparency and assessment. Japan's development assistance for health, from both governmental and non-governmental sectors, has remained low and Japanese global health leadership has been weak. New challenges arising from changes in governance and global and domestic health needs, including the recent Great East Japan Earthquake, now provide Japan with an opportunity to review past approaches to health policy and develop a new strategy for addressing global and national health. The fragmented functioning of the government with regards to global health policy needs to be reconfigured and should be accompanied by further financial commitment to global health priorities, innovative non-governmental sector initiatives, increased research capacity, and investments in good leadership development as witnessed at the G8 Hokkaido Toyako Summit. Should this strategy development and commitment be achieved, Japan has the potential to make substantial contributions to the health of the world as many countries move toward universal coverage and as Japan itself faces the challenge of maintaining its own health system.
在过去的 50 年里，日本在实现世界上最高的预期寿命和最低的婴儿死亡率的同时，成功地开发和维持了一个日益公平的全民医保体系。在此背景下，日本有可能成为全球卫生的主要倡导者和支持者。然而，相对于其巨大的潜力，日本在全球卫生方面的参与程度并不突出，部分原因是政府碎片化、公民社会薄弱以及缺乏透明度和评估。日本政府和非政府部门的卫生发展援助一直很低，日本的全球卫生领导力也很薄弱。治理和全球及国内卫生需求的变化带来了新的挑战，包括最近的东日本大地震，现在为日本提供了一个机会，重新审视过去的卫生政策方法，并制定新的战略来应对全球和国家卫生问题。政府在全球卫生政策方面的职能碎片化需要重新配置，并应伴随着对全球卫生重点的进一步财政承诺、创新的非政府部门举措、提高研究能力以及投资于良好的领导力发展，正如在八国集团洞爷湖峰会所见证的那样。如果实现了这一战略制定和承诺，日本有可能为世界卫生做出重大贡献，因为许多国家正在朝着全民医保覆盖迈进，而日本本身也面临着维持其自身卫生系统的挑战。
