Health Summit -2

Japanese

We held Health Summit (in Japanese) on Saturday February 26th、the day after Global Health Forum 2011. It was an event that was also held in the years 2008 and 2010.

The program for this year was slightly different from the past because it also introduced a collaborative work with the Center for Strategic and International Studies (CSIS).

Unfortunately we had less participation of the members of the Diet than last year because many of the legislators of the Democratic Party of Japan (DJP, the ruling party) and other parties were back at their home constituencies for the nationwide local election.

Please refer to the HGPI website (in Japanese) for program and main speakers of this Summit.

A full report is in preparation, so I will let you know once it is available.

Now is the time to change the naming of ‘Medical Policy’ to ‘Health Policy’.

Health Summit: The Annual Event of the HGPI

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Following the Congressional Briefing with the members of the Diet of Japan which took place on February 25nd, we opened the Global Health Forum 2011on 26th.

We focused on Global Health, in collaboration with  UNITAID and Department of Global Health Policy of The University of Tokyo.

As you can see from the program, the host of this forum was Ms. Doden of NHK, an expert in this field, and the key note was delivered by Mr. Douste-Blazy, Board of UNITAID, UN Special Advisor on Innovative Financing for Development, and former Minister of Foreign Affairs of France.  The panelists were; Professor Shibuya, University of Tokyo, Mr. Tistdall, GAVI (Japan is one of the major nations supporting the bond issuance for immunization), Mr. Eun Joo Lee, the Minister of Foreign Affairs of Korea, Ms. Cristina Parsons Perez, American Cancer Society,  Mr. Mugitani, Senior Vice Minister of Ministry of Health of Japan, Dr. Stephen Morrison, Senior Vice President of CSIS and Director of Global Health Policy Center, and Dr. Yonekura, Chairman of the Sumitomo Chemical and Japan Business Federation (Keidanren).  I am grateful for their participation, knowing their tight schedule.

The forum succeeded in coordinating a good, meaningful discussion thanks to the participation of many key persons in the field of Global Health.  I would also like to note here that Mr. David Bowen of the Gates Foundation kindly joined our Forum.

The discussion started by searching for the possible area and means where Japan could contribute.  We focused on the achievement of the MDG, discussing possible support by the developed countries, and the process to follow, taking into account the current financial difficulties which those developed countries have.  Although Japan is currently making contributions through immunization bond issuances in addition to ODA by the government, we tried to figure out new types of support that is independent from the tax money allocated from the government of Japan.

I hope that the Japanese economy as well as the mood in its society will improve soon.

 

Collaboration with CSIS and Congressional Briefing: A New Process

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Our HGPI (Health and Global Policy Institute) have been hosting Health Summit every February and for this year it was held on February 26th.

We launched this year a collaboration project on Health Policy with CSIS (Center for Strategic and International Studies), a well known Think Tank based in Washington DC.  This collaboration has been our hope and issue since last year.

The background of this collaboration is that Dr Brian Biles of CSIS participated in our Health Summit last year, and HGPI co-hosted an international conference last June in London under the title of ‘Transition from G8 to G20: Health and Development’ with CSIS and Chatham House (an established British Think Tank).

We had a preliminary meeting at the Congressman Hall room on February 25th with influential Japanese legislators and the CSIS team Stephen Morrison , Brian Biles.  Also participating in the meeting were the specialists of the project – Professor Gerard Anderson of Johns Hopkins University and Professor Ikegami of Keio University for ‘hospital payments’, Professor John Hamelka of Harvard (he has a wonderful blog site) and Professor Akiyama (in Japanese) of the University of Tokyo for IT and health record and patient safety.

A number of legislators with good knowledge of healthcare policy shared their valuable time with us; Mr. Otsuji (in Japanese)(LDP, former Minister of Health and Welfare), Dr. Sakaguchi (in Japanese)(New Komeito, former Minister of Health, Labour and Welfare), Mr. Seko (in Japanese) (LDP), Mr. Kan Suzuki (in Japanese)(DPJ, Senior Vice Minister of Ministry of Education, Culture, Sports, Science, and Technology, Japan), Dr. Adachi (in Japanese)(DPJ, former Parliamentary Secretary for Health, Labour and Welfare), Dr. Umemura (in japanese)(DPJ), and Mr. Konishi (in Japanese)(DPJ).  I thank them all for their participation and good, productive discussion.

We also invited several people from business and mass media.  Dr. David Bowen of the Gates Foundation happened to be in Tokyo, so we asked him to come as well.  Dr. Bowen worked for many years as the policy staff for Senator Edward Kennedy so he has a good knowledge of how healthcare policies work or how legislators develop and manage the process of legislation.

I think that this is the very first case that policymaking process like this took place in Japan.  It is the first time that an independent think tank of Japan and the United States collaborated in policymaking, and in its process, set up a Congressional Briefing session with nonpartisan legislators at the Japanese congress auditorium.  Next meeting of this CSIS-HGPI project will be held in Washington DC on July 14th, at the timing where a large framework is worked out.

I hope that this event will eventually become one of the new steps of legislation process in Japan

The World Think Tank Ranking: HGPI Ranks in the Top 10 for the 2 Consecutive Years

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The world ranking is a topic in many areas as the world goes global.  There are the top 500 rakings of companies, rankings on DGP and competency of the nations, rankings of the universities, billionaires, so on and so forth.

It was just last year that I noticed that there was such thing as the ranking of think tanks.  The list I found was based on the study by the University of Pennsylvania.

It came as a big surprise to us when we discovered in 2009 that our Health and Global Policy Institute (HGPI)  (founded in 2004, originally named as Health Policy Institute but changed to current name in 2011) was ranked in the Top 10 (Ref.1 P.42) in the field of Health Policy.  The list included Harvard University, Johns Hopkins University, RAND, and other institutions known to the world as the first class policy institutes.

I wondered what this year’s ranking would be since I have thought that the result of 2009 might have been some sort of a mistake.  So, as we were preparing for the annual Health Summit to be held in February, I had some concern about the evaluation for 2010.  However, it turned out that our institution was again among the Top 10 (Ref.1 p.34&35). I don’t want to boast, but this is truly a great achievement.
 
The number of think tanks completely independent from government organizations is still small outside the United States or Great Britain.  I would like to express my deep appreciation and thanks to all the people who supported our activities and the staffs who did a great job at our institution.

From San Diego ? Delivering a Keynote Lecture at the First ‘Cell Society Clinical Annual Meeting’

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On February 17th, I left Narita for San Diego via San Francisco.  I was to give a keynote lecture at the Cell Society Clinical Annual Meeting.  I checked in at the Estancia Hotel at La Jolla where the meeting was to take place.  It actually was quite a comfortable Hotel.

The weather, however, was not at all like South California; cold, dim, and we even had a rainfall.  This is a rare situation, but it’s no use complaining.  The weather recovered, however, during the afternoon of the second day. 

The objective of this gathering was quite clear; to discuss exclusively on the current status of adult Stem Cell usage in clinical settings.  We didn’t focus much on basic research; rather, on what was happening in each field ? including correspondences with the investigation authorities.  I enjoyed the presentations: many of the presenters are people with whom I rarely have opportunites to see in my regular academic activities. I felt as if I was being introduced to a new frontier

As we learned about various knowledge gained in various fields, we gradually came to see all kinds of possibilities that adult ‘Stem Cells’ have for clinical fields.  I think there is a great potential especially in the field related to orthopedics or cosmetic surgery.  Considering that we are in the aging society, there would be need other than authentic healthcare.

From such broader perspectives, I felt that my keynote lecture was adequate for the occasion.  I said a few words on Watson (Ref.1, 2), too.   (I noticed that Dr. Yoko Ishikura also commented on Watson in her blog).  Many of the participants congratulated me for the speech.  I was very happy to know that they liked it.

Moreover, I strongly felt that in the context of the progress of 20th Century medicine, this meeting, by itself, established a very unique standpoint.  It suggested us the possibility of a totally different perspective and framework of science.  I would like to talk more on this issue at some other occasion.

From 9:30pm.  I had some wine with a few Japanese students studying at UCSD and other universities, and also people from CONNECT, at the hotel until very late at night.  Photos are here.  I always enjoy exchanging views with young people from Japan. They are always full of energy.  I want them to become globally active, and am looking forward to seeing that happen.

So, again, I was exposed to more things to think about.

A Table for Two’s Holiday Season Charity

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Have you ever heard of Table for Two (TFT) ?

It originated in Japan.  This idea was developed to make this world a better place.  It links the hunger people in the poor developing parts of the world with the overweight people of developed countries.  TFT is now spreading through the world and the name is gradually gaining recognition.

I have been supporting this project as one of its advisers since its inception.

TFT threw a Charity Party in Aoyama, Tokyo the evening of December 25th.  For many years, I was unable to attend this party but this year I did.  I thought it also a good opportunity to have a reunion with Dr. Kogure, the director.

Dr. Kogure seemed to be in good shape, but he of course has his shares of worries.  The party was packed with lively youth, a very different generation from mine.  Presentations, quiz game that competed between groups (I was in the Rwanda group), and other activities followed one after another to keep the guests entertained.

The party closed with the song ‘We are the World’ (Ref.1) First, a professional singer started, and then we all followed. 

The power of this song is truly amazing.

 

Young Scientists Take Action for the Insular-Minded Young Researchers of Japan

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On many recent occasions, the issue of the declining numbers of Japanese students who seek international study is being pointed out.  This trend seems to apply to the field of science, also.  In this global age, many Asian young scientists go abroad to study at western universities in the hope to structure better careers.  They know that this will give them better chances to access opportunities that lead to popular international careers sought by future leaders of the world.

Typically in Japan scientists work for 2-3 years as Post-Docs at western universities and then go back to their home institution or lab for permanent jobs.  Going abroad to earn PhD degrees and remaining there to build a career will present unexpected challenges in Japan.  However, this is also definitely a way that will enable one to professionally work anywhere in the world. 

Recently, though, the number of Japanese Post-Docs going abroad for research is declining. There is also a decline in the number of Japanese students who earn PhD degrees overseas , which is low to begin with.  This difference is the most conspicuous difference between Japan and other Asian countries.  In other Asian countries the number of youths going to western countries for higher educations is rapidly increasing.  I truly am bothered by our young Japanese researcher’s inward-guided mindsets..
 
Unlike the so-called ‘great’ professors in Japanese Universities, there are very few scientists actively working in the U.S. (such as Professor Kobayashi of Princeton University) (Ref.1, 2,3 4) who share the same concern as me. 

The problem is that distinguished professors have certain privileges and have ulterior motives. .  Though agreeing to the overall idea of international education, they will never actually let go of their young scientists for study abroad. This is because they are the ‘useful instruments’ or ‘hands and feet’ of the professors.  I think it is quite obvious that most of the university faculties have insular mindsets  (Ref.1).

The foundation for this mindset is clear when you look at what the profession provides: a professorial position ensures comfort in many ways in Japan. The Japanese society is a hierarchical society that looks up to national institutions and looks down on private institutions.  Increasing the number of academic achievements is top priority for professors, rather than nurturing the students. Therefore, no matter how the university faculties pretend to support international experience, they are actually enjoying their high position within conventional Japanese society. As such, they resist innovation and educational reform just as much as other components of the Japanese social structure. Merely looking at their professional position makes it clear enough where they stand.  I cannot help but believe university faculty care most about their interest.

Do you remember a Post Doc whom I touched upon in my posting a year ago in the context of an occasion where I spoke with Japanese youths working in Boston? I was strongly impacted when a Post Doc said: “What I regret most in my short life so far is that I earned my PhD degree in Japan” (by the way, he earned his PhD degree at a prestigious national university in Japan.  When he sought for advice from his professor, this professor strongly recommended that he studying in a Japanese graduate school…)   I think that his regret was stronger because he was trying to seek an independent career as an individual.

I noticed recently how people are taking action  (Ref.1, 2)  (all links are in Japanese) to address this issue.  They are the few young Japanese who earned their PhD degrees in US, UK, or other western countries, currently working hard outside Japan.  They share the concerns which I have described above.

Dr. Shigeki Sugii 
(Ref.1, 2)(all links are in Japanese)is one example.  Dr. Sugii is trying to reach Japanese youths who might be interested so he may give practical advices on how to earn PhD degree in the US.

Activities to encourage overseas studies include the publication of ‘Studying Science and Technologies at Overseas Graduate Schools (Rikei Daigakuin Ryugaku)’  (in Japanese) and creation of ‘Networks of Scientists (Kagakusha Netto)’  (in Japanese) both in which I was partly involved.  There are also other promotional activities happening in Japan. Still,  it seems to me that these efforts are, first of all, the responsibility of the university faculty: they should encourage youth, advise them to go overseas to learn, offer them more possibilities to choose from, and always be supportive.   The adults should always bear in mind that youth are our hope of making our future better.  The youth are our most precious assets and resource.

Dr. Sugii and his friends organized a symposium last week under the title: ‘The First Symposium on the Careers of Doctors: How to Make the Best Use of Doctoral Degree ? Grab Chances Because Now is the Difficult Time for Job Hunters!’ (Ref.1) (in Japanese). Dr. Kitazawa, President of JST , and I were invited to deliver keynote lectures. (However, to my regret, I had to leave the site right after my speech because I had an appointment with Mr. Saisho.)

Dr. Sugii is currently working for UCSD but is planning to move to A*STAR in Singapore  (Ref.1) next year.  I like it.  I hope and expect to see more and more young Japanese scientists go overseas to work in international settings.

I ask all adults to help youth see the whole world, create more opportunities for first hand experience, encourage them to participate in such opportunities, and give great support so that they may grow into good leaders of the global world.

This world is huge and it is there for the youth who earnestly pursue their career.  As the proverbs says ‘‘If you love your child, let him/her travel (kawaii ko ni wa tabi wo sasero)’

 

My Views of the ‘Medical Care System’ Reform Issues. Recent Article in JBPress

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I am originally a medical doctor and have spent more than 10 years both in Japan and the United States practicing medicine. So naturally I am quite familiar with the health care system, think much about it, and am very concerned about the issue in Japan.

I am confident that I have been faithfully doing my job pointing out where the problems exist on this web site as well as in other forums, despite various complaints and criticisms thrown at me from authorities in Japan.  The effects of these discussions may not be easy to see, but I think they are starting to show.  A system reform is above all the development of human asset capable of adapting to a global era.

If you just search my web site by related key words, you will find many postings, and I have also published many books for common readers such as ‘University Hospital Reform (Daigaku Byoin Kakumei)’, ‘A Challenge to Japanese Healthcare Culture (Nihon no Iryo Fudo e no Chosen’, ‘Lessons for Medical Students (Igakusei no Obenkyo)’  (all books are in Japanese), to  name just a few, and I have introduced some more in my web site  (in Japanese).

The world has gone through a drastic change since the beginning of the 21st century.  Major issues of healthcare system today are: an aging society; increased chronic diseases, especially those related to lifestyle or adult diseases; expansion of the inequality of wealth particularly in the past 20 years due to the globalization of market and economy; and the rapid increase of country debt after the Lehman Shock.

What about Japan?  As the most rapidly aging society amongst the developed nations, we have many problems.

Although I intend to continue my effort to help promote the reforms of healthcare systems through activities and recommendations of our Health Policy Institute  or WHO there are lots of power politics occurring at the same time.  The many stakeholders (i.e. opposition powers) involved make reform a major political issue and this complicates how we address reform in developed countries.
 
Besides  reports and comments on my web site, my recent views are also presented in a book ‘E-Health Reform: IT to Change the Future of Japan’s Health and Healthcare (e-Health Kakumei:IT de Kawaru Nihon no Kenko to Iryo no Mirai)’ (in Japanese), an interview, and on-line publications such as JBPress.

Please take a look when you have time.

In this context, I think the Twelve Ideas developed at the Symposium by Swedish Medical Center (SMC) in Seattle in October are worth noting.

How do we implement these political process is the next question. The book I introduced to you before would be a good guide.

Unless we rename “Medical care system” (Japanese word for “Healthcare system”) by adopting something that more accurately describes the problem like, “Health and Healthcare policy” (Ref.1), I think executing good reform that addresses the actual needs of our society will be really difficult.

The naming of policies is important.

A Meeting With Dr. Margaret Chan, Director General of the World Health Organization (WHO)

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Dr. Margaret Chan (Ref.1) visited Tokyo after attending a meeting at the WHO Kobe Center.

For about thirty minutes 4 staff members of our Health Policy Institute who specialize in Global Health  joined me in exchanging opinions about Global Health with Dr. Chan. I’ve had many chances to see her in the past (Ref.1,2), but I was particularly thrilled to see her this time because it had been such a long while since the last time we had met. Dr. Nakatani, one of the Assistant Directors of WHO, accompanied by an official from the Ministry of Health, also joined us.

The topics of our discussion covered issues such as Global Health, the meeting at the Chatham House, the number of increasing patients suffering from chronic diseases, social determinants of health, the Davos Meeting that will be held next January, and so on.

I think this meeting with Dr. Chan, the top female leader of WHO, was an exciting experience for our young staff.
 
Providing opportunities for young professionals to interface with the leaders of the world in person is very important and meaningful.  It is a very stimulating experience, one that will encourage our young generation to set higher goals for themselves.
Asking questions such as ‘What’s the point in trying to become the best?’ is irrelevant here.  People work harder when they see higher goals.

These important interactions serve as the seeds of ASPIRATION within the hearts of youth. 

Welcoming Mr. Ryoji Noritake to My Keio SFC Class

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My Keio SFC class.:  On October 27th we welcomed Mr. Ryoji Noritake, a wonderful individual doing a great job at the Health Policy Institute, an NPO in which I serve as Chairman.
 
Mr. Noritake is an alumni of SFC, class of 2007.  After graduating, he joined our Health Policy Institute Think Tank and has since been working actively in fields like, measures for cancer, cancer and brain stroke patient support ,  programs to nurture leaders of patients, and so on.  These programs have produced many results that will positively affect the health care industry.  As he persists in leading these diverse activities, he is gaining invaluable experience as a great leader.  He has become one of the most indispensable members of our institute.

Because he is an SFC alumi, I think Mr. Noritake was able to connect with the students even better. The students related with him more because he was their senior and because of his sharing of many moving stories.  

Among those stories, I was impressed especially by the one regarding the World Trade Center terrorist attack on September 11, 2001.  He was studying at Oklahoma University at the time.  He spoke about the reactions he observed of the people around him, and how he was moved to witness for the first time the power of words beyond his imagination.

In this course I aim to have students understand the importance of moving towards the global age, and to provide them opportunities to listen to the real world stories of people who are qualified enough to be their role models.  Such inspirational narratives, because they are true experiences, have power to move youth, to make them want to emulate or pursue similar careers .

Jiro Shirasu (in Japanese), is one of my favorite historical characters. He was a politician, whose career covered the early Showa era.  I wrote several articles (Ref.1,2,3,4 in Japanese) (Ref.5,6 in English) on him on this web site.   

Mr. Shirasu’s post-World War II work in Japan is just remarkable.  He studied at Cambridge University, and became a true ‘English Gentlemen’.  There are several books about Mr. Shirasu published, but he is more generally known for his philosophy of Principle (the fundamentals, essence, of things…) as well as for his countless piquant episodes.  I haven’t seen many true gentlemen like him around recently …
 
There is one collection of the essays by Jiro Shirasu titled,  ‘Japan: A Nation Without Principle’.  I purchased it at ‘Buaiso’ (in Japanese), his former residence.  In this book, there is a line that says something like ‘Education is about whether the teachers are practicing in real life what they teach…’  This is, in my view, an important ‘Principle’, especially in higher educations.  I remember nodding here and there as I went on reading.

Similarly, the stories that Mr. Noritake told in class clearly illustrated the importance of experiencing the world at an early stage in one’s life.

Thank you, Mr. Noritake, for giving us such an inspirational lecture.  I am confident that many of your juniors learned and sensed something important from your stories.