Japan: Universal Health Care at 50 years 5 Re-invigorating Japan's commitment to global health: challenges and opportunities
Japan: Universal Health Care at 50 years 5 Re-invigorating Japan's commitment to global health: challenges and opportunities
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DOI：
10.1016/s0140-6736(11)61048-9
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发表时间：
2011-10-01
期刊：
影响因子：
168.9
通讯作者：
Shibuya, Kenji
中科院分区：
文献类型：
--
作者：
Llano, Rayden;Kanamori, Sayako;Shibuya, Kenji
在过去50年里，日本除了实现世界上最高的预期寿命和最低的婴儿死亡率之外，还成功地发展并维持了一个日益公平的全民医疗保险制度。在这种背景下，日本有可能成为全球卫生的主要倡导者和支持者。然而，相对于其巨大潜力，日本在全球卫生领域的参与并不突出，部分原因是政府分裂、民间社会薄弱以及缺乏透明度和评估。日本从政府和非政府部门提供的保健发展援助仍然很低，日本在全球保健方面的领导作用也很弱。治理变化以及全球和国内卫生需求所带来的新挑战，包括最近的东日本大地震，现在为日本提供了一个机会，审查过去的卫生政策做法，并制定解决全球和国家卫生问题的新战略。需要重新调整政府在全球卫生政策方面的分散职能，同时应进一步对全球卫生优先事项作出财政承诺，采取创新的非政府部门举措，提高研究能力，并投资于八国集团北海道洞爷湖首脑会议所见证的良好领导力发展。如果这一战略的制定和承诺得以实现，随着许多国家朝着全民覆盖的方向迈进，日本本身也面临着维持本国卫生系统的挑战，日本有可能为世界卫生做出重大贡献。
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.