1993-1996: 1996-1999: Som-Arch Wongkhomthong : 1999-2006 3: : NGO

1. ????????:????? ????????? ????

2. ?????????: ?? 1993-1996:????? ??????? 1996-1999: Som-Arch Wongkhomthong?? ???????? ?????:???????????? ??????????? 1999-2006�3?:????? ????:?????? NGO????? ????????(??????) ???????????????(???????????)

3. ???????? ???????????????? ?????????????????? (??????? ?2?:2005)

5. WHO??????????(1994-6?)

6. De-development vs ??? ???(under-development) ???????????????????. De-development: ???????????(???)?????????????????(?????????????)

7. ?????????:????? Difficulties of doing research during the armed conflicts. (Lancet, 2003) Conflict and home birth increase in the West Bank. (Trop Doct, 2004) The influence of economic factors on the location of birth among Palestinian women in Bethlehem during the second Palestinian uprising. (Trop Doct, 2007)

8. ?????????(????�????) ?????????????????????????????? 2???3???????????????????? ??????????????????????????????????????????? ????????????????????????????????????(????�?????,P149) ???????

9. ????????????:??????? development??envelope?????? ?????????????????? ??????????????????=?? ???????????!

10. ????????????��� ????? ??????????

11. ?????????:???? Is Gandhi's philosophy of non-violence dead in Nepal? (Lancet, 2001) Difficulties of doing peace-building efforts in Nepal. (CMAJ, 2005)

13. ??????:?????????? ?????????????????????????????????(WHO) Health education x environment (USA) Health education x policy (UK)

14. ????:???? ?? ?? ??

15. ??????????:???? ????+???? ???? ??/QOL ????

16. ????????????????��� ?????�???????????�???????????????? ??:????????????????????? ?????????? ??????????????????????? ?????????????! ??????? ????????????

17. ???????:2002? ?????�????? ???????????????????????? ???????????? ??????????????????!

18. ??????????:??? ?????????????????????�???????(?2???4?) ?????????Precede-Proceed?????? ????�?????????????????????????? ??????????????????????? ????????21???????????????????????

19. ??????????:??? ????: ??�??????????(1996-2001:JICA???) ????????(2001-4;JICA???) ???: ??????�??????????? (2002-5:JICA???) ????????????(2002-2006:JICA???) ????? ?????????(2003-:JICA???) ????????????(2005-:????) ???:??????????????���

20. ??????????????????: ???? ?????????? ???????(????) ???????(???????????????) ???????????? ?????????(????????????) ????????? ???????????????

23. ??????????????

24. ?????????? Beyond deworming. (Lancet, 2005) School health research in low-income countries in East Asia and the Pacific. (Japan Med Assoc J, 2005) School health for parasite control in Thailand: a review and current model activities. (Southeast Asian J Trop Med Public Health, 2006 in press) Keys to success for a school-based malaria control program in primary schools in Thailand. (Parasitol Int, 2006 in press).

29. ??????????????????

30. ?????????????????�???????? (2007 Sep~) ? ? ?? ?? ?? ?? ???????????? ?? ?? ??????????????(????) ?? ?? ?????????? ?? ?? ???????????? ?? ? ?????? ?? ?? ???????????? ?? ?? (?)???????? ?? ?? ??????????? ?? ?? (?)?????????�???? ?? ?? ????????? ?? ? (?)?????????????� ?? ?? ?????? ?? ? ???????????????????? ?? ?? ???????????????? ?? ?? ????????????????

31. 31 ??????(2000)?????????? ???????????? �?????� ?? HIV/AIDS, ??????? ??????????????????????? 2008?(???)????????? Okinawa Summit in 2000, in which Japanese Government announced Okinawa Infectious Disease Initiative, created a momentum for world leaders to focus on infectious diseases of public health importance. The most outstanding response from the global community is the creation of the Global Fund, which so far saved 1.5 million lives. However, we continue to face challenges. Okinawa Summit in 2000, in which Japanese Government announced Okinawa Infectious Disease Initiative, created a momentum for world leaders to focus on infectious diseases of public health importance. The most outstanding response from the global community is the creation of the Global Fund, which so far saved 1.5 million lives. However, we continue to face challenges.

32. 32 Such challenges include, delay in health MDGs achievement. The situation is most difficult in Sub-Sahara Africa. But we need not to forget to pay attention also to the rapid progress of epidemiologic transition in many developing countries. There is an increasing consensus that health systems strengthening is necessary in order to scale-up and speed-up for MDGs. Health human resource crisis is recognized as one of the most critical bottlenecks. Many governments and organizations have recently announced different initiatives. Even though we are delighted to see more commitment and resources for health coming from the global community, the picture is becoming a little complex and over rapped. Therefore we need to create a political momentum for health systems strengthening through human security approach and for better coordination of global health initiatives to make difference for the people. Such challenges include, delay in health MDGs achievement. The situation is most difficult in Sub-Sahara Africa. But we need not to forget to pay attention also to the rapid progress of epidemiologic transition in many developing countries. There is an increasing consensus that health systems strengthening is necessary in order to scale-up and speed-up for MDGs. Health human resource crisis is recognized as one of the most critical bottlenecks. Many governments and organizations have recently announced different initiatives. Even though we are delighted to see more commitment and resources for health coming from the global community, the picture is becoming a little complex and over rapped. Therefore we need to create a political momentum for health systems strengthening through human security approach and for better coordination of global health initiatives to make difference for the people.

33. MDG4-U5MR:1990 vs 2005 ????? No progress? (The Lancet� 2008;� 371:1247-1258)

34. MDG5-?????? ????13??????????????? (The Lancet� 2008; �371:1247-1258)

45. ???????

46. Stakeholders

47. 47 ???????????????? (Koumura M: Lancet. 2007 ;370:1983-5.) ??????? : human security(???????) ???????????????: ??????????????? ???????????????? ???? ??????????? In November, Foreign Minister Komura delivered a speech on Japan�s policy on global health. Global health will be one of the important topics in coming Toyako Summit. We are expecting to develop international framework for action which seeks good balance between disease-specific approach and comprehensive, system-wide approach. The process needs to be participatory involving many stakeholders. That is a challenge for Japan as a host to TICAD and G8. In November, Foreign Minister Komura delivered a speech on Japan�s policy on global health. Global health will be one of the important topics in coming Toyako Summit. We are expecting to develop international framework for action which seeks good balance between disease-specific approach and comprehensive, system-wide approach. The process needs to be participatory involving many stakeholders. That is a challenge for Japan as a host to TICAD and G8.

48. ??????? ???????????�????????????(????????????????????????????) ????(1994)????????? ???????????????(1997) SARS(2003) ??�?????????�???????????????? ????????????????

49. ??????????????(May 2003, by ??????�???????) ?????????? ???????????????????????????????????????????? ????????????????(???????????????????????? )(1994, UNDP) ????????????????????? ????????????????

50. ??????????:??? 1998?12?1? (?)??????????????????????????1????????????????????????????????????????????????????????????????????????????????????????????????21????????????????????????? 1998?12?16? ?????????????????????????????????????????????21????????????????????????????????????????????????????????????????????????????????????????????????????????????5??(?420???)???????????

51. ??????????:??? 2000?9?7? ???????�????????????????????????????????????21????????????????????????????????????????????????????????????? 2001?1? ????????????�?????????????????????????? 2003?4??? ?????????????�???????????????150???????????? 2003?5?1? ???????????????????�???????????????? 2003?8?29? ????????????????????????????????????????????? 2005?2?4? ?????????????????????????????????????????????????????

52. ??????????:??? 2005?10?24? ?60???????????????�????????????????????????????????????????????????????????????????????????????????????????????? 2006?5? ?8?????????????????????????????????????????????????? 2006?10? ?1???????????????? 2007?? ?4?????????(TICAD IV)?????1????????????????????????????

53. 53 ??????????:??????? ???????: ?2??????????(??????????) ????????????????? ????????????????????????? ????????????????????????????????????? (?????????????????????????? ) (??????????????) There are political reasons why Japan is focusing on human security. There is an urgent need to revitalize pacifism in Japan which is being lost. Foreign policy based on robust pacifism will strengthen the Japan�s position in global politics. Health is a good subject to consider how Japan can actually contribute to international community through policy based on pacifism and human security. There are political reasons why Japan is focusing on human security. There is an urgent need to revitalize pacifism in Japan which is being lost. Foreign policy based on robust pacifism will strengthen the Japan�s position in global politics. Health is a good subject to consider how Japan can actually contribute to international community through policy based on pacifism and human security.

54. ??????????????????????:???G8????????(Lancet 2008;371:865-9) 1 ???????? ??????????? ??????????? 2 ????????????????????????????? ???????????????? 3 ?????????????????????????

55. 55 ??????????????? ???????? ??????? ????????????? ???????(??????) ???????????????????????? Japan itself used to be a developing country. Japan faced high prevalence of several kinds of infectious diseases. Also, Infant Mortality Rate was high. Japan itself used to be a developing country. Japan faced high prevalence of several kinds of infectious diseases. Also, Infant Mortality Rate was high.

56. 56 ?????????????? This is one of the positive outcome of our strategy. IMR decreased rapidly. We have several examples besides IMR.This is one of the positive outcome of our strategy. IMR decreased rapidly. We have several examples besides IMR.

57. 57 ?????????? ???????????????????? ???????:????????? ????????-??????? ??????????????? ????????????????? ?????????????????????????????????? In summary, Japan�s experience is quite relevant to global health today. It shows the effectiveness of human security approach, which combines top-down and bottom-up approaches. We started out with clear targeting on tuberculosis and MCH. Global Fund applyies similar approach today. However, Japan�s experience suggests that system strengthening through service integration needs to be promoted at the same time. The use of MCH handbook as a tool for service integration and spreading of health workers even to the remote communities are good examples. Such combination brought about sustainable improvement of people�s health. In summary, Japan�s experience is quite relevant to global health today. It shows the effectiveness of human security approach, which combines top-down and bottom-up approaches. We started out with clear targeting on tuberculosis and MCH. Global Fund applyies similar approach today. However, Japan�s experience suggests that system strengthening through service integration needs to be promoted at the same time. The use of MCH handbook as a tool for service integration and spreading of health workers even to the remote communities are good examples. Such combination brought about sustainable improvement of people�s health.

58. 58 JICA???????? ??????? Decentralized staffing and operation Needs-based and pragmatic solutions ??????? ????? Protection and empowerment of individuals and communities Proactive involvement of government and other stakeholder ????? Timely assistance (esp. after natural/man-made disaster) Better coordination with other stakeholders Results oriented, without sacrificing steady capacity development ??????? JICA and JBIC* will be merged in 2008 Innovative mix of technical experts, volunteers, grant aid and loan System-wide support may be possible JICA is now under the transformation and the case of Zambia provides good example in that aspect also. More field orientation, more attention to human security and more aid efficiency and effectiveness are three pillars of JICA transformation under the leadership of Mrs. Ogata. More integration of aid modalities, realized through the integration of JICA and JBIC in next year will provide good opportunity, at the same time with some challenge, for Japan�s to scale up its contribution to global health. JICA is now under the transformation and the case of Zambia provides good example in that aspect also. More field orientation, more attention to human security and more aid efficiency and effectiveness are three pillars of JICA transformation under the leadership of Mrs. Ogata. More integration of aid modalities, realized through the integration of JICA and JBIC in next year will provide good opportunity, at the same time with some challenge, for Japan�s to scale up its contribution to global health.

59. 59 ????????????????? ????????????????????????? ?????????????????? ?????????????? ??????????? ????????????????????????? ??????????? ?????????? I would like to present some preliminary ideas on Japan�s emerging role in global health policy. I would like to present some preliminary ideas on Japan�s emerging role in global health policy.