Stagnant Healthcare Reform and Tragedies Continue.

Japanese

Recent tragedies in ER and Obstatric cares further raised a greater public attention and after so many years, the government of Japan finally proposes to increase the quota of medical students to fill the need.  But this increase requires many years to deliver medical doctors, thus addresses only one aspect of the problem.

The system of medical care is another critical issue which demands a major reform, and such policies have been introduced a few years ago.  But actual implementation has been very, very slow and has been seen only in a very limited number of municipalities.  Many tragedies continue to occur and we have little time to spare.

A recent report in the Japan Times, quoting my thoughts, addresses this issue as in my recent Op-Ed in Asahi News in Japanese.

The public needs to get more involved in the policy-making and decision-making processes in a transparent and democratic manner, and this is what our Heath Policy Institute tries to promote.

From Dubai-Part 2: Summit on the Global Agenda

→Japanese

From early in the morning on Nov. 9 participants from Japan held a breakfast meeting on the conference hall terrace (Photo 1-4). Almost everyone at the conference from Japan was there. Can you tell who’s who?

Photo 1-4: A meeting with participants from Japan

Dsc00302 Dsc00301Dsc00300 Dsc00303

After breakfast more brainstorming, and then the closing session. Each of the 8 clusters of large themes gave final presentations in about six minutes. Please watch the webcast of the closing session which was moderated by BBC’s Nick Gowing. I was quite impressed with the polished skills of the speakers, wrapping up their presentations within the given time frame.

After the summit I rested a bit at the hotel before I made a trip to the new Dubai Mall. It recently opened right near the construction site of what will become the tallest building in the world, Burj Dubai. Amid Japanese flagship brands like SONY, Canon, and Panasonic, the Japanese bookstore, Books Kinokuniya, is also in the mall. There is a huge aquarium with a 75-centimeter thick acrylic viewing panel. Who else could it be that manufactured something like this? Of course, the Japanese company Nippura.

Photo 5-10: Dubai Mall 

Dsc00308 Dsc00311 Dsc00314 Dsc00317 Dsc00326 Dsc00331

I think a total of about 400 people were at the conference. There were more Japanese participants than usual. I think Japan’s increased presence at the conference, which comes at a time when there are signs of a global paradigm shift occurring because of the financial crisis, is a good thing. Overall, however, many working-level people, both in politics and business, seemed to have been absent because of the uncertainties in the financial sector and economy. I felt like participants, both from Japan and elsewhere, were mostly academics or “independents”. Attendance of people in finance was of course low.

In the evening I went to dinner with Ambassador to the UAE Takuma Hatano and others to the restaurant, Zheng He’s. (FYI: Some say that Zheng He discovered America over 50 years before Christopher Columbus.)

Photos from the dinner at Zheng He’s.

Dsc00348 Dsc00350 Dsc00352

I left Dubai airport at 2:45am on 10th and returned to Tokyo via Kansai airport in the evening of 10th.

From Dubai-Part 1: Summit on the Global Agenda

→Japanese

After a six-and-a-half hour flight from London, I arrived at Dubai Airport on the morning of Nov. 8 without enough sleep. I checked into my hotel Jumeirah Al Qasr and went to the conference venue early. I was in Dubai for the first “Summit on the Global Agenda” convened by the World Economic Forum. It’s a huge brainstorming meeting on the global agenda. If you check out the conference website you can see that 8 large themes are broken down into 68 global challenges. A working council for each issue held a series of discussions, each lasting for about three hours. I am a member of the councils for “Innovation” and for “Global Health.” I mainly focused on attending sessions at the “Innovation” council. I reunited with many friends. Mr. John Gage who was also at the STS Forum in Kyoto in October and Davos conference in January was on the same council. I also ran into Mr. Tim Brown of the IEDO, whom I recently introduced in this blog, for the fifth time this year. He was participating in discussions at the council for “Design.” The sessions can be quite draining as they require debating skills and concentration. If you read the columns on the blog of Dr. Yoko Ishikura who was also at the conference you can probably see what I mean by “draining.”

In the evening, a 40-minute bus ride took us to a reception in the desert. Here are some images from it.

Dsc00288Photo1: The University of Tokyo President Hiroshi Komiyama(on a day trip to Dubai), Prof. Akihiko Tanaka, Prof. Motoshige Ito, Prof. Hiroko Akiyama

Dsc00290Photo2: With JICA President Sadako Ogata and Ambassador of Japan to the US Ichiro Fujisaki and Mrs. Fujisaki.

Dsc00295Photo3: Horse riding demonstration

Having been engaging in intense debates at conferences one after another, in Tokyo, London and then Dubai, I felt a bit tired.

But then I learned that JICA President Sadako Ogata had left Dubai on Nov. 6 to attend the opening event of a new terminal at Afghanistan’s Kabul International Airport on behalf of the Japanese prime minister, and then made a quick return to Dubai for this conference. I’ve got to tip my hat to her. She even attended the evening reception in the desert with us.

Wherever Ms. Ogata goes people always gather around her. You can tell that they sincerely admire and respect her.

Back to London, Part 2

→Japanese

The final conference for the WHO Commission on the Social Determinants of Health was filled with wonderful sessions and panel discussions. It was the last formal gathering with the other Commissioners whom I’ve worked with for 3 years. The Commission’s final report is very unique. The WHO set up the special Commission to collect evidence of social determinants of health and recommend action, which is normally done by existing top-down orders of societies. So, the report’s recommendations will of course take time to put in place. Some of the recommended actions may simply be impossible. The greatest challenge is to implement what the Commission has identified. This is just a starting point.

In this "Hot, Flat, and Crowded" world, as Thomas Friedman puts in his new book, an unprecedented change is happening on a global scale. If humans cannot adapt, it will be too late. Different regions and countries are already being affected in ways that threaten to make the world unstable. Many people have been driven from their homes due to riots, strife and war. This is happening not only in Africa, but in areas of Pakistan, Palestine, Iraq and Kashmir. I fear that the situation may worsen over time. Poverty, lack of water, food and energy, and the movement of people will most certainly create further instability.

One piece of good news is that the United States seems to be on its way to regain trust and confidence of the international community by electing Senator Barack Obama as its next president. No one had imagined his victory even a year ago. However, Mr. Obama probably cannot afford to just focus on the rest of the world as he needs to fulfill his campaign promise to revive employment in the US.

In this global world, companies and non-government organizations will increasingly move beyond existing national frameworks and become more international. But politicians of democratic nations will basically remain local as they get their jobs by being elected in their countries.

I am posting some images from the conference. I hope you will enjoy the webcast and the website. You can listen to some amazing speeches by Hilary Benn (Photo 1&2) who I met at the May G8 Environment Ministers’ Meeting, Prof. Paul Hunt and former president of Ireland, Ms. Mary Robinson (Photo 3&4). I’m also in the Cafe Conversation on the afternoon of Day 2.

Dsc00241Photo1  UK Environment Secretary Hilary Benn

Dsc00275Photo2  With Secretary Benn (The red flower on his lapel is for Poppy Day to commemorate the war dead. I was wearing one too. )

Dsc00276Photo3  Ms. Mary Robinson

Dsc00280Photo4  Ms. Mary Robinson and Conference MC, Mr. John Humphrys of BBC

On Friday, the second day of the conference, I skipped the final session and left for Heathrow Airport at 4:30 pm to fly to Dubai.

To London once again.

→Japanese

After a meeting in Tokyo, I left Narita on November 4th, to London via Paris.  The travel was to attend the final meeting of Commission on Social Determinants of Health CSDH, WHO, where I served as one of the commissioners.  A report was neatly prepared by then.

Obama was elected for the next president at just about 5 am of November 5th local time, and I listened to his live speech on television at the lounge of Charles de Gaulle International Airport.  Wasn’t it a wonderful message?  Obviously the speech was a declaration of a strong will as the leader of America, perfectly aware of the attention that he attracted from the whole world.  "Google" the related sites, English sites, of course.

The fantastic thing about this meeting is that it is hosted by the Department of Health of Great Britain.  Approximately 500 people will gather from all over the world and not only the details will be broadcasted, but also the speeches and videos will be open to the public on internet.  Visit the web site in to get the idea of what has been discussed and feel the atmosphere.  My interview is uploaded, also.  I was a bit nervous, because it was <one to one> interview and I had no clue to what the overall program was like, or who came before and after me, or what the topics were, and also there was no rehearsal or editing, and lasted for 5-6 minutes.  It makes me sweat.

Dsc00207

Photo1:  Prime Minister Brown

Dsc00210

Photo2:  Minister Johnson

Dsc00215

Photo3:  Chairman Sir Marmot

The opening speech of 6th was delivered first by Prime Minister Gordon Brown and next was Minister of Department of Health, Alan Johnson.  Both speeches were impressive, as political leaders of Great Britain always are.  Responding to the report of this conference, the British government expressed their decision to develop specific policies and requested Professor Marmot, the Chair of WHO CSDH to organize a special committee for this objective.  They are very serious about what they are doing.  This is truly what I would call a government initiative.  Isn’t it admirable?   I envy it.

Japanese do not see the difference of the roles of bureaucrats, public officials, and politicians (I don’t know why but many of them are Niseis and Sanseis, i.e. successor of their fathers or grandfathers.  Even their electoral district is descendent, which is obviously not normal.  It might be that the candidates are unknown "outside their home district").  And also, English people perceive government as "Civil servants" while Japanese people see it as "Okami (people who reign)".  This difference is huge.  I feel embarrassed that without perceiving this basic difference in the societies of Britain and Japan, Japanese politicians, public officials, and specialists only quickly mock the system of Great Britain superficially, when problem arises and talk about "agency-nization," "privatization," "two major opposing political parties," "Thatcherism," and so on as if they are experts.  Actually, they don’t really know what they are talking about.

Dsc00218

Photo4:  Chair of the conference, BBC presenter and writer John Humphyrs, and Chair of CSDH

Dsc00220

Photo5:  A panel. On the left is chair, Editor of Lancet, Dr. Richard Horton

Dsc00187
Photo6:  At the reception. Asian network, mainly organized by Dr. Hashimoto of University of Tokyo. The 3rd person from the left is Dr. Kumaresan, president of WHO Kobe Center

By the way, the venue of the meeting was Queen Elizabeth II Conference Center, and the accommodation was Royal Horsegurads.  They are located only a few minutes away from each other by foot.  In between stands Prime Minister’s official residence Downing 10, Westminster Abbey, The houses of Parliament and Big Ben, and so on.  I have been to this place early in September, too.  This time, I had an opportunity to stop by at the residence of minister Nishigahiro.

G8 Summit Global Health Follow up Tokyo meeting

→Japanese

2008 Toyako Summit had on its table agendas on energy, climate change, surging food prices, financial crisis, etc., all of which are major global problems that seemed to appear so suddenly.  However, I would like to point out that Japan played a significant role here even in this difficult time, especially in the area of global health where Japan followed up the promises between health care providing systems and G8, producing outcomes that were very highly evaluated by the world.

A follow up meeting was held on November 3 th and 4th in Tokyo under the auspice of JICE with the cooperation of Ministry of Foreign Affairs of Japan.  Participants were the world’s top members in this field, Dr. Margaret Chan, Director General of WHO (photo1, the last time I saw her was at Seattle in June), Dr. Tachi Yamada, president of the Global Health Program at the Bill & Melinda Gates Foundation (we were together at Fusionopolis 3 weeks ago), Dr. Julio Frenk, former Minister of Health of Mexico and Dean elect of the Harvard University School of Public Health (can you imagine such selection in Japanese university?), Dr. Richard Horton, Editor in Chief of The Lancet.

In addition, Dr. Miriam Were, the recipient of the "Hideyo Noguchi Africa Prize" announced at TICAD4 this May was present, also a happy reunion for both of us.  Large number of specialists gathered, not just from Japan but from all over the world.  Here, I would like to acknowledge their effort.

Rimg00192whodg2008113photo 1  From the left end, Ms. Ikegami of UNFPA Tokyo Office, Dr. Mari Simonen(deputy executive director of UNFPA), me, Dr. Margaret Chan(Director General of WHO), Dr. M Prakasamma(director of Academy for Nursing Studies and Women’s empowement Research Studies).

Dsc00181
photo 2, 3  Panel title. Myself as the chair, to left, Mr. Yamamoto, Ministry of foreign affairs and two officers of Ministry of Foreign Affairs who were assigned to the G8 of next fiscal year.

Dsc00182

In this meeting, Japanese government intends to summarize and stabilize plans that will be handed to Italy, the next host of the G8 Summit.  Former vice minister of the Ministry of Health, Labour and Welfare, currently Senior Fellow at Harvard University School of Public Health, Dr. Keizo Takemi is working to make this happen, which is truly wonderful.  Political activities carried out not only by government offices but also by many global NPOs and social movement groups, in which many of us participate, are part of the great social changes occurring in Japan as well as all parts of the world in this global era (refer to my speech at the G8 meeting of the ministers of environment).  Thanks to all who participated.  I was in the panel, too (photos 2, 3).  At the reception, Minister of Foreign Affairs, Mr. Nakasone delivered a welcome speech.

In the evening, besides other appointments, I had an opportunity to meet with Dean Olian of UCLA Management School (whom I saw last year, too), the Vice President, and Mr. Shibusawa (reference 1 ), a graduate of UCLA Management School and my friend (photo 4).

Dsc00186
photo 4  Dean Olian of UCLA Management School, Mr. Shibusawa, in the back row, Assistant Dean, Dr. Schakelford.

It was a busy day.

Speeches, “strength” and ideas of leaders

→Japanese

At last, Obama is elected the next President of America. Great!

A person with such background becoming president indicates the inner strength of American society – its power and commitment to take up the responsibility to react to the changing global world and expectations of the world. Didn’t this moment create a sense of envy in us? In every corner of the world, people are talking about it with excitement and emotion. I am also one of those who felt that this election was a great historic event which proved the inner strength of America. Japan, on the other hand, though economically ranking 2nd in the world, can not “change” in the least. Comparison is easy, isn’t it?

Even in U.S., he is called an “orator” (great public speaker). Some people say that he is such a presidential candidate ever since JFK. Of course, great speech is not all. He is also surrounded by brilliant people and supporters, started with the civil activities and overcame many adverse circumstances. This indicates inner strength. He is not a common person. I think people who have never experienced “adversity” in their life can not cope with any “disastrous situation” that might happen in the future. It is as mentioned in the book ‘Yubi ippon no shunen ga syoubu wo kimeru (Obsession of one finger decides the game)’ written by Mr.Tayama Kazuhiko. There is hardly any exception if you examine history.

For the process and significance of messages of leaders, collection of speeches of “JFK” and “Winston Churchill” are good references.

Ted Sorenson, author of the former book ‘Let the Word Go Forth,’ (Whom I unexpectedly met last year) was a speech writer of JFK at the age of 31. His “Foreword” of the book is excellent. We can learn much from it about the ideas, significance, and background of speeches by JFK, the incomparable politician. I recommend this book to you as a good reference.

The latter is “Never Give In” authored by a grandchild of Churchill, whose name is same i.e. Winston Churchill (just the middlename is different). This book is also helpful to understand the speeches of politicians, their thoughts, drafts, and style of communication to people.

After reading these books, one will think that top politicians are too much “at ease” in a closed country like Japan. Like it or not Japan cannot survive in the world all by itself. I must say that Japan has no such competent, substantial speeches of a “Leader” with the strength to inspire citizens so far. At any rate, it is hardly possible to win confidence as a politician if a speech means merely reading a draft given from government officers. Today in this Global era, even if you speak in Japanese, what you have said will be known throughout the world in no time. And as those spoken words spread, they will eventually create trust on politicians and ultimately trust upon a nation. Nevertheless, same can be said for the business leaders, scholars and government officials as well. And all of them put together will sum up to what you would call “Dignity” or “the Style” of the nation.

Mr. Miki Watanabe, Education and Special zone for Agriculture

→Japanese

Mr. Miki Watanabe, President of Watami Co. Ltd., is a very enthusiastic and a dashing entrepreneur and chief executive, who is turning excellent passions and dreams into a reality.  He authored many books as well.  Search at "amazon" for these books.  Caring about the education, he is rapidly expanding activities such as education assistance to many children not only in Japan but as well as in Cambodia (recently in Nepal too).  It is really admirable.

As the price of crude oil is increasing (at present the price is temporarily stabilized but, eventually to what extent will it rise?), there is already shortage of food worldwide (moreover, there is a sign of condition to be worse due to changing climate, scarcity of water etc.) and so the present condition where millions of people are starving to death (also called as "2C+3F" -Climate Change and Fuel, Food, Feed-) is hardly expected to improve.  I would say that agriculture must be promoted as a growing Industry from a long term point of view since agriculture technology of Japan is excellent.  Many worldwide brands will emerge from this sector not to mention the obvious improvement of  the food self sufficiency ratio.  Moreover, since non-edible parts of agricultural products may be widely used as reclyclable energy, research and development in this field is already becoming competitive worldwide.

I speak whenever there is an apportunity, as does Mr. Watanabe.  In May this year, for example, I had an opportunity to speak about agricultural policies at a committee meeting of Liberal Democratic Party that was attended by Mr. Koichi Kato as the chairman, Mr. Motegi, Secretary General, and Mr. Yatsu, Member of the House and former Minister of Agriculture, Forestry and Fisheries.

Mr. Watanabe uses Special zones for Agriculture also (it is difficult to use in reality, why is it so?), and as I was hoping to talk with him about this, he kindly set up an opportunity for me.  A one page summary of this dialogue is scheduled to be released soon.  Some parts of the talk is posted in his blog (in Japanese).

From Singapore, The opening ceremony of Fusionopolis

→Japanese

After my visit at Seoul, I came to Singapore to participate in the opening ceremony of Fusionopolis.  Attended by many scientists in Singapore and around the world, Director Lim of A*STAR made a welcome speech.  Then, a powerful message from the Prime Minister Lee Hsien Loong, followed by fascinating high tech holographic demonstration, musical performance by researcher group, and a reception.  I had the honor of being introduced to the Prime Minister Lee at the reception hall and talking with him.  He explained how his government is committed to making Fusionopolis a center full of energy that attracts scientists and youth around the world.  By the way, the architecture of Fusionopolis was designed by Dr. Kisho Kurokawa, a well known Japanese architect.

Dsc00165_3

photo  Prime Minister Lee at the Opening.

On the next day, I attended the board meeting of A*STAR.  Then, in the evening of the day after, had dinner with Professor Ito (ref. 1 ), a very active scientist at A*STAR as well as former director of Institute for Virus Research, Kyoto University, and Mr. Kakihara, the manager of Riken Singapore office.

Anyway, I would like all of you to know how sad I am not to see Japanese researchers, especially young generations, participating in such places to mix with other researchers for training and competition as Samurais did for fencing in their era.  Shouldn’t Riken stop making excuses and send more scientists to Fusionopolis?  I dare say that Riken is just wasting their money if they don’t.  As I always say, I do not want to hear excuses for not doing.  Remember the Japanese old sayings such as "Young ones head to wilderness (Wakamono wa koya wo mezasu)" or "If you love your child, let him/her travel (Kawaii ko niwa tabio saseyo)."  They have universality and implications.

I expect everyone to do better.

“Galapagosnization (Galapagos-ka)” of Japanese manufacturers

→Japanese

The word "Galapagos ka (Galapagosnization)" (if you "Google" the word in Japanese, it will hit nearly 360 thousand sites) is now widely spreading.  I trust that you are aware of this word.

At last a book titled extactly it, "The Galapagosnizing Japanese manufacturers" (original title is "Galapagos-ka suru Nihon no Seizogyou") appeard from Toyo Keizai Shinpo-sya.

I urge you to read this book.  It is a helpful reference especially for the people in business.

It is often said that "Manufacturing items (Monotsukuri)" is the strength of Japan, but that only is not enough.  As I have mentioned many times in my blog.

"Story telling (Monogatari)" is very important to catch hold of people’s heart.  "Monotsukuri" is just a part of "Monogatari."  So set the goals, develop strategies and move on rapidly.  Do we find people like Morita of Sony or Soichiro Honda of Honda of the ’60s, today?  They did the "business."  Today, in this global era, speedy action is important.  Those with "domestic only" attitude had better get out of the business.  Young generation does not grow with such thinking.

People always say that "Japan is the number one country in technology" but, how much has it advanced so far in the world?  Next month the King of Spain is going to visit Japan with the rising solar panel industries of Spain.

This book has various hints as the author Dr. Tomohiko Miyazaki, Doctor of Theoretical Physics, Department of Science at Tokyo University, has provided the data based on the results of the research for Nomura Securities Co., Ltd.  After reading this book one should firmly think about ‘what he has to do’ without telling ‘excuses for not doing’ and go on carrying things out one by one.  Especially, I expect that the "leaders" and people holding responsible positions in the business enterprises take actions.  Please behave in such a way that you will be a role model for the youth.  Everyone in Japan and the world is looking at you.

This year is the 150th year of the publication of "On the Origin of Species" by Darwin.  It’s core message is "Not those who are the strongest or the wisest, but those who adapt to the environmental changes will survive." (Please refer to my speech on this site).  Speed to adapt will determine the winner.

Is Japan adapting enough to the changes of environment in today’s "globalization and flat world?"  This is a topic that also repeatedly appears in Dr. Yoko Ishikura’s blog.