WHO South-East Asia Regional Office Conference: “Partners for Health In Southeast Asia”
Honorable guests, ladies and gentlemen, I would like to express my sincere apologies for not being able to participate in this important Conference as I must remain in Japan to confront the aftermath of the devastating earthquake and tsunami.
The Nippon Foundation is involved in a wide range of activities for the public good at home and abroad. These include health, welfare, education, disaster relief and many other fields. In all these activities, we place great importance on building partnerships. These range from collaboration with governments and international organizations to joint efforts with NGOs and the individuals we are assisting. We work with lawmakers, media and service providers. We form partnerships at every level and with all stakeholders.
As some of you know, The Nippon Foundation has been involved for many years in the effort to free the world from leprosy. Leprosy is a disease of low infectivity. Yet if there is a delay in diagnosis and treatment, it can lead to impairment and result in disability.
Making the world free from leprosy initially seemed as a goal impossible to achieve. However, the development of multidrug therapy, or MDT, in the 1980s, was a beacon of hope for everyone with leprosy. In order to deliver treatments to every patient, The Nippon Foundation underwrote the free distribution of MDT around the world through the WHO between 1995 and 1999. From 2000, this role has been performed by the Novartis Foundation for Sustainable Development. As a result, over 16 million people worldwide have been cured since 1985. Leprosy will soon be eliminated as a public health problem in every country in the world.
This is due to the committed efforts of all partners — namely, the WHO, governments, pharmaceutical companies, and the staff of both health ministries and NGOs working in the field. They have ensured that the drugs reach those who need them. The people affected by leprosy are also rising as crucial partners to take roles in the control program. My role has been to encourage the formation of partnerships to this end.
I believe that problems as well as solutions are to be found in the field. I spend a third of each year overseas, visiting remote areas where efforts are being made to control leprosy. When I travel to these remote areas, one thing has come to my notice. I find the drugs for treating leprosy in all health posts in all countries, but drugs for such common complaints such as fevers, colds and diarrhea are often lacking.
What is needed is a system that gives people living in isolated areas access to inexpensive medicines when they need them. As I thought about this problem, a simple solution occurred to me: home medicine kits based on traditional remedies.
In Japan, the medicine kit system has a three hundred-year tradition. Medicine vendors go directly to people’s homes and leave behind a supply of medicines. The next time they visit, they collect money only for the medicines that have been used, and they replenish the kit as necessary. Under this arrangement, people always have medicines on hand when they fall ill.
In Mongolia, many people live a nomadic life, traveling great distances every year. Because of the difficulties nomads have in accessing doctors and medicines, relatively minor complaints often develop into serious illnesses. Seeing the potential of the medicine box system as a way to improve primary health care, The Nippon Foundation launched a model project in Mongolia in 2004. To reduce the cost of each kit, we combined Mongolia’s traditional medicines with the medicine kit distribution system. Traditional medicines are much less expensive than modern medicines, usually only between a tenth and a twentieth of the cost.
The total cost of the medicines contained in one medicine kit comes to around ten US dollars. The kit consists of nine basic medicines for things such stomach ache, diarrhea and fever. In addition, it contains a handbook on how to use the drugs and what they do, and also a statement of accounts to be filled in when a doctor makes a house call.
As a result, in one region, the number of visits required by physicians fell by forty five percent. At present, around sixteen thousand households use the system, or about one-tenth the total number of nomadic families. Recently, the Mongolian government is planning to incorporate this project into the nation’s health policy.
In order to share the results with other countries, in 2007 the WHO and The Nippon Foundation co-organized a conference on Mongolian traditional medicine. After seeing how the use of traditional medicine in Mongolia helped to resolve the problems of high medical costs and access to medical care, other countries started to adopt their own version of the system.
In Myanmar, instead of placing a medicine kit in each home, it was thought more effective to have kits kept by community leaders in each village. In Cambodia, the country’s first national institution dedicated to Khmer traditional medicine has been set up in order to help systematize knowledge and skills in this field. In Thailand, where all medical costs are borne by the government, a feasibility study is under way to see whether the medicine kit system can help reduce the country’s health care outlays. It may pave the way to reducing national healthcare costs – an issue many countries are trying to deal with.
This is one approach to ensure sustainable primary health care to people in remote areas in partnership with governments, schools of traditional medicines and local health workers.
Collaborative efforts are vital at the time of natural disasters. The aftermath of the earthquake and tsunami that hit Japan on March 11th is far beyond what anyone could have predicted. The recovery from this devastation will require much time and resources.
As the largest private foundation in Japan, The Nippon Foundation is committed to take a role as a catalyst to facilitate cooperation from various sectors to confront this state of emergency. This includes organizing an emergency relief team consisting of people with different areas of expertise, such as paramedicine, nursing, and psychiatry, to be sent to the affected areas, as well as coordination between private corporations and hard-hit municipalities over delivery of relief supplies. In addition, a special tsunami relief fund has been set up to accept donations from people in Japan and overseas, aimed at supporting both the relief organizations currently working in the affected areas and the extensive reconstruction work that will follow. In times of turmoil, proper coordination is crucial to make the most use of limited resources, and this is where NGOs with experience and expertise can contribute.
From elimination of an endemic disease, ensuring primary health care for undeveloped remote areas to recovery from a devastating natural disaster, the challenges the world faces today are too arduous to tackle by one organization. That is why we need to form strong partnerships among stakeholders internationally in order to make full use of resources including human capital, money and know-how. New ideas will emerge and the outcome will be doubly enhanced when people from different cultural, economic and national backgrounds share information.
Speaking from experience, I am confident that it is possible to overcome these challenges through the collaborative efforts of all possible stakeholders.