Global Health and Human Security

Universal Health Coverage in the New Development Era:
Toward Building Resilient and Sustainable Health Systems

December 16, 2015


On December 16, 2015, approximately 300 leaders from around the globe—political leaders, heads of international organizations, NGO leaders, scholars, and other experts in the fields of global health and development—converged in Tokyo for a major conference on the topic of universal health coverage (UHC). The meeting, which was co-organized by JCIE and the government of Japan, came at a key moment in history: It represented the first major international meeting on global health following the adoption of the 2030 Agenda for Sustainable Development at the UN General Assembly in September of this year, marking a shift in the world’s development agenda from the Millennium Development Goals (MDGs) to the Sustainable Development Goals (SDGs). The timing of the conference was also important in that Japan will assume the presidency of the G7 next year, with the G7 Ise-Shima Summit and the G7 Kobe Health Ministers’ Meeting scheduled to take place in Japan in May and September respectively. In addition, the 6th Tokyo International Conference on African Development (TICAD VI) will be held in Africa for the first time in 2016.

Japan has been at the forefront of the political momentum on UHC. It achieved UHC domestically more than 50 years ago and has promoted UHC globally as a concrete tool for advancing human security, a central pillar of its foreign policy. Prime Minister Shinzo Abe opened the conference by sharing his vision for the role that global health plays as part of his commitment to enhancing Japan’s “Proactive Contribution to Peace,” and he reaffirmed his intent to take up health as a priority agenda item at the G7 Ise-Shima Summit. World Health Organization (WHO) Director-General Margaret Chan also expressed her support for UHC in her global leadership address, stating that it is “one of the most powerful social equalizers of all policy options.” The sentiment was echoed by World Bank Group President Jim Yong Kim followed with a compelling call to action, urging world leaders to make good on the Alma Ata commitment to health for all and quoting Dr. Martin Luther King Jr., who once said, “We are confronted with the fierce urgency of now . . . This is no time for apathy or complacency.”

Bill Gates, co-chair of the Bill & Melinda Gates Foundation, set an encouraging tone for the rest of the conference in his keynote speech, as he expressed his optimism about the potential at this moment in history to save and improve lives due in part to what we know about primary healthcare’s ability to not only save lives but lift the burden of poverty.

Tedros Adhanom Ghebreyesus, Ethiopian minister of foreign affairs, shared his country’s experience in implementing UHC (at right: Christopher Murray, director of the Institute for Health Metrics and Evaluation)
Lucica Ditiu, Executive Secretary of the Stop TB Partnership, on the need to start with the most vulnerable in implementing UHC. (at right: Mushtaque Chowdhury, Vice Chairperson of BRAC)

Sessions 1 and 2 dealt with challenges and experiences on the ground in implementing UHC, and in adjusting how we approach health and development in light of two major changes in the development landscape: (1) the shift from the MDG era, which was defined by interventions that targeted specific diseases, to the broader SDG framework, and (2) the global repercussions of weak health systems, as exposed by the recent Ebola epidemic. A lunch session began with keynote addresses by Japan’s Minister of Health Yasuhisa Shiozaki and Thailand’s Minister of Public Health Piyasakol Sakolsatayadorn, who shared their countries’ experiences in implementing and sustaining UHC. This was followed by a panel discussion organized by the Global Health Innovative Technology Fund that examined the critical role that innovation—both innovative social policy and R&D—plays in advancing health outcomes.

Session 3 delved into the types of reforms to the global governance architecture that are needed to properly mitigate future health crises from the perspectives of the major multilateral organizations involved in the response—Médecins Sans Frontières, the WHO, and the World Bank—as well as on the basis of findings from the upcoming report due out in January from an independent National Academy of Medicine commission tasked with assessing the global health risk framework in light of recent failures in the Ebola outbreak response.

Mustapha Sidiki Kaloko, African Union (AU) commissioner for social affairs, gives his feedback to the Global Health Working Group (GHWG) based on the AU’s responses to the Ebola crisis (at left: Simon Wright of Save the Children UK)
Bart Janssens of Médecins Sans Frontierès (MSF) gives a realistic account of the challenges countries face based on his experiences responding to the Ebola outbreak

The final session focused on Japan’s role in the upcoming Ise-Shima G7 Summit. JCIE’s Global Health Working Group for the 2016 G7 Summit, a Track 2 interdisciplinary working group, has been compiling recommendations that will feed into the global health portions of the upcoming G7 Summit agenda, and its findings were presented in order to receive feedback from those in attendance.

The conference closed with a rousing speech by Richard Horton, editor-in-chief of the Lancet, who put the discussions of the day into the broader context of the unique drivers of global instability that define the current age we live in and the ways in which we seek safety and peace.


    Opening Session

Opening Remarks
    Prime Minister Shinzo Abe

Overview of the Conference
    Keizo Takemi, Member, House of Councillors, Japan; Senior Fellow, JCIE; Chair, Global Health Working Group for the 2016 G7 Summit

Global Leadership Address
    Margaret Chan, Director-General, World Health Organization (WHO)

Global Leadership Address
    Jim Yong Kim, President, World Bank Group

Keynote Speech
    Bill Gates, Co-chair, Bill & Melinda Gates Foundation, USA

    Shinichi Kitaoka, President, Japan International Cooperation Agency (JICA)
    Akio Okawara, President and CEO, Japan Center for International Exchange (JCIE)

Session 1: Defining Opportunities and Health Challenges in the Changing Development Landscape

  • Peter Piot, Director and Professor of Global Health, London School of Hygiene and Tropical Medicine, UK

    Session Keynote
  • Babatunde Osotimehin, Executive Director, United Nations Population Fund (UNFPA)

  • Christopher J. L. Murray, Professor of Global Health and Director of the Institute for Health Metrics and Evaluation (IHME), University of Washington, USA
  • K. Srinath Reddy, President, Public Health Foundation of India; Member, Commission on Global Health 2035
  • David L. Heymann, Head and Senior Fellow, Royal Institute of International Affairs (Chatham House); Chairman, Public Health England, UK
  • Tedros Adhanom Ghebreyesus, Minister for Foreign Affairs, Ethiopia
  • Mark Dybul, Executive Director, The Global Fund to Fight AIDS, Tuberculosis and Malaria

Session 2: National Strategies to Achieve Resilient and Equitable UHC

  • Anne Mills, Deputy Director and Provost and Professor of Health Economics and Policy, London School of Hygiene & Tropical Medicine, UK

  • James Wainaina Macharia, Cabinet Secretary for Ministry of Health, Kenya
  • Hideki Hashimoto, Deputy Director, Global Health Working Group for the 2016 G7 Summit; Professor, Department of Health and Social Behavior, School of Public Health, University of Tokyo, Japan
  • Lucica Ditiu, Executive Secretary, Stop TB Partnership
  • Seth Berkley, CEO, Gavi, the Vaccine Alliance
  • Takao Toda, Director General, Human Development Department, JICA

Lunch Session

  • Peter Piot, Director of the School and Professor of Global Health, London School of Hygiene and Tropical Medicine

    Health Policy Challenges toward Achieving UHC
  • Keynote Address:
  • Yasuhisa Shiozaki, Minister of Health, Labour and Welfare, Japan
  • Piyasakol Sakolsatayadorn, Minister of Public Health, Thailand

    Innovations as Catalysts for Better Access to Health—GHIT Fund as Japan’s Flagship R&D Initiative
  • Opening Remarks:
  • BT Slingsby, Executive Director and CEO, Global Health Innovative Technology Fund (GHIT)
  • Panel:
  • Tachi Yamada, Venture Partner, Frazier Healthcare Partners, USA
  • Peter Piot, Director of the School and Professor of Global Health, London School of Hygiene and Tropical Medicine
  • Closing Remarks:
  • Kiyoshi Kurokawa, Representative Director and Chair, Global Health Innovative Technology Fund (GHIT); Adjunct Professor, National Graduate Institute for Policy Studies; Chairman, Health and Global Policy Institute

Session 3: Whither Governance for Global Health—Ensuring a Seamless Approach to Health Security and Resilient Health Systems

  • Michael Reich, Taro Takemi Professor of International Health Policy, Harvard T. H. Chan School of Public Health, USA

  • Ilona Kickbusch, Director, Global Health Programme, Graduate Institute of International and Development Studies, Switzerland
  • Victor Dzau, President, National Academy of Medicine, USA
  • Bart Janssens, Director of Operations, Operation Centre Brussels, Medicins Sans Frontieres (MSF)
  • Marie-Paule Kieny, Assistant Director-General for Health Systems and Innovation, WHO
  • Timothy G. Evans, Senior Director of the Health, Nutrition and Population Global Practice, World Bank Group

Session 4: Role of G7 in Promoting Effective and Innovative Responses to Global Health Challenges

  • Lincoln Chen, President, China Medical Board, USA

  • Mustapha Sidiki Kaloko, African Union Commissioner for Social Affairs
  • Kenji Shibuya, Director, Global Health Working Group for the 2016 G7 Summit; Professor and Chair, Department of Global Health Policy, Graduate School of Medicine, University of Tokyo, Japan (presentation of the draft proposals to the 2016 G7 Summit)
  • Simon Wright, Head of Child Survival, Save the Children
  • Mark Pearson, Deputy Director, Employment, Labour and Social Affairs, Organisation for Economic Co-operation and Development (OECD)
  • Hans-Peter Baur, Deputy Director General, Federal Ministry for Economic Cooperation and Development, Germany

Closing Session

    Richard Horton, Editor-in-Chief, The Lancet, UK
    Yasumasa Nagamine, Deputy Minister for Foreign Affairs, Japan

Joint Reception with the Global Fund 5th Replenishment Preparatory Meeting