Kidney Center in Hanoi, 10th Anniversary

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In the morning of 9th, after the dialogue session with Mr. Toyama, I left for Hanoi.  This travel is to join the 10th anniversary of the Kidney Center which I helped its foundation with Dr Tang and Dr Ann  whom I have introduced to you last year. This plan is also an outcome of the effort by the International Society of Nephrology (ISN) for these 20 years of focusing its activities to the programs for developing countries

In 1990 the ISN meeting was held in Tokyo.  I have been leading the ISN activities as a committee and executive member and later as the President (1997-99) of the ISN, so I was naturally involved in COMGAN  program in reaching developing countries since its very beginning, and have traveled to Asia and many other parts of the world.  Through various activities such as COMGAN, ISN has succeeded in constructing the networks of people throughout the world for 15 years including kidney specialists in many developing countries of the world.  We celebrated the 50th anniversary of ISN last month although I had to be excused because of other responsibilities elsewhere.

Through more than 20 years of work at Asian Pacific Congress of Nephrology (Ref.1) and other activities, I have expanded my networks with many kidney specialists, medical leaders and scientists in Asia Pacific including Dr Tang and his colleagues,  visited Hanoi and Ho Chi Ming City (former Saigon) a few times, and about 15 years ago we started to make plans for Kidney Center.  The hospitals and clinics then were in terrible conditions that one may hardly imagine.

The Kidney Center is located within the hospital of Ministry of Transportation.  It is an outcome of what we would call today the ‘Public Private Partnership’ between the government of Vietnam and a few corporations of Japan.  Japanese companies did not necessarily pursue　profits, but brought about a big success in creating jobs and enhancing the growth of local businesses.   I attended their 5th anniversary, and now we are celebrating the 10th.  We had a great exciting ceremony with large number of participants.

The accommodation at Hanoi was Intercontinental Hotel. I highly recommend to try this nice elegant hotel which stands by the lake if you have a chance to visit here.

On 11th, I moved to Ho Chi Ming City. Here, everything is much more ‘developed’ compared to Hanoi and was filled with completely different energy.  I enjoyed dinner with my friends here at Cham Charm.  I do not hesitate to recommend this restaurant to you also.

At any rate, every city is filled with motorbikes.  I even saw a whole family riding on one bike. So energetic!

The return flight from Ho Chi Ming City was in the midnight of 11th, so I was able to hear the news of the overall result of the election of the Upper of Japan.  I regret having had to miss watching the World Cup final game…. I congratulate Spain for the victory.

A Very Provocative Dialogue with Mr. Kazuhiko Toyama

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Among the books that I recommend to young people are the books by Mr. Kazuhiko Toyama (Ref.1) (links are in Japanese), ‘Yubi ippon no syunen ga shyobu wo kimeru (A finger-tip of obsession decides the winner)’ and  ‘Kaishya wa atama kara kusaru (A company will rot from the head)’.  If you have not read these books yet, I can assure you that they are worth reading.  Mr. Toyama has done a great job at Sangyo Saisei Kiko (Industrial Revitalization Corporation of Japan) and more recently was involved actively in the effort of revitalizing JAL (Japan Air Line)

Three years ago, Mr. Toyama and his colleagues established International Growth Platform and I was invited to its 3rd Anniversary on July 8th.  At preliminary discussions we decided that we should make very provocative comments.

The program opened by a dialogue between Mr. Toyama and Professor Kunio Ito of Hitotsubashi University (in Japanese), followed by a keynote speech by Mr. Hasegawa (Ref.1,2) (links are in Japanese), President and CEO of Takeda Pharmaceutical Company Ltd., and the last was a dialogue between Mr. Toyama and myself.  Audience was about 200 people.  I arrived at the venue late so I missed the dialogue session of Mr. Toyama and Professor Ito.

President Hasegawa is a very sharp and able business executive, always speaks up his real views without hesitation and ‘no no-sense’, demonstrates strong leadership in carrying out what he believes is right.  He also earns high reputation at the Davos meeting as a top business leader.  Mr. Toyama and I, standing on the stage throughout the session, exchanged challenging and very provocative views to endorse and enhance the messages delivered by Mr. Hasegawa – his (as always) sharp analysis and drastic points of view reflecting his deep concerns about the future of Japan.  

I said, for example, that weeks before the World Cup games in South Africa I foresaw that the ‘key’ to Japan was to let Honda play as freely as he believes; that in the audience of that day, only several women (below 10) were present; that in Mr. Toyama’s company 80% of the 100 employees are ‘career’ and among them, ‘None’ employed as fresh university graduates or ‘zero’ (and this actually is pretty normal outside of Japan….); that components made in Japan were drastically less in iPad than in iPod.  I also pointed out how Japanese lack ability to recognize the ‘strength’ or ‘weakness’ unique to them, how in general, poor in building global networks of connections on individual basis, or how I hate being told of ‘reasons for why something can not be done'. Our dialogue also included many specific examples as well as specific recommendations.

Frankly, I enjoy this kind of ‘events’.  The reception that followed was filled with excitements, too (as I was told later).  But actually, to be honest, the most important key is how each one of us can take actions from here…..  I sincerely urge each one of you to start actions whatever you can in whatever position you may be.

Dr. Jonathan Dorfan to Assume the Presidency of Okinawa Institute of Science and Technology

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As you know, a plan to build a new graduate university in Okinawa had been in progress for quite a while.

Almost 10 years have passed since the inception of this idea, and ever since the Okinawa Institute of Science and Technology Promotion Corporation (OIST P.C.)  was launched as an Independent Administrative Agency with Dr. Sydney Brenner as the first President, we have been working hard for many years.  This institution’s concept is revolutionary in every aspect; the Cabinet Office of Japan is responsible in taking charge of this project, it is a scientific institution totally open to the world for the new global age.  Also, I would like to especially point out the fact that Dr. Brenner is extraordinary by his broad views and rich connections and greatly helped build OIST PC..

Since this was a very new concept, we did have some difficulties along the way such as in trying to gain understandings of the stakeholders including Japanese science community.  However, now we have paved the path enough to set up a graduate school, and finally are proud to announce that Dr. Jonathan Dorfan of Stanford University will assume his office in July as the first President elect of OIST (Ref.1).  This is truly an epoch making event.  That Japan will at last have a scientific institute with longer perspectives open to the world is something we all should celebrate.  Again, this is a revolutionary achievement.

As I have written in my past postings, conventional Japanese universities were unable to materialize such concept, although they were willing to discuss it (Ref.1, 2).  

I am determined to support President Dorfan and continue working with everyone to make this institution a success.  The credibility of science research in Japan is being evaluated and watched even through such a seemingly ‘small’ event like this in Okinawa.  I think the world might have started seeing some hopeful signs of change in Japan after a long time.

For up until now, even in the ‘academic arena’ the situation in Japan is yet closed and quite insular minded (Ref.1).

At Chatham House: From G8 to G20, Issues on Health and Development

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Photos by the courtesy of NHK Asian Voice and HPI-Japan

Chatham House in London is more formally known as The Royal Institute of International Affairs, one of the world’s top Think Tanks on international issues, a place for debates, famous also for the rule often referred to as the ‘Chatham House Rule’

This Chatham House, CSIS, an American Think Tank in Washington DC (Ref.1), and  our Health Policy Institute Japan have spent about a year preparing for this meeting at the Chatham House which was held on June 30.  The meeting was scheduled at the timing of the G8 Summit in Canada that took place a few days earlier, and the theme of the meeting was ‘Global Health: What’s next for the G20? Investing in health and development’.

Its agenda, panel speakers, and sponsors were all superb.  I understand that the total number of participants was around 200.  Dr. Shigeru Omi (in Japanese), former regional director of WHO Western Pacific Regional Office, represented the government of Japan.  Also, some Japanese officials in London were present including Minister Oka of Japan Embassy, from JETRO, and NHK crew came to report this meeting.  I would like to extend my sincere thanks to them all.

Now and in the future, such process of independent Think Tanks or other non-governmental institutions hosting and organizing conferences to set global agendas to lead discussions that in the end can come up with some overall understandings or agreements is and will be extremely important.  Organizing and participating in such conferences have been a very good experience to us, too.  I myself was honored to have a role of listening to the discussions of the day and wrapping them up in the closing.  We also tried to make clear what we could do with the outcomes of this meeting, or what our next steps could be.

These things are easy to say, but actually to reach to this point was truly a tough task. I did write several postings on this process in this site (Ref.1, 2, 3) in addition to the reports which are posted on the web site of the Health Policy Institute, Japan.  Most importantly, we must understand that in the global world, building ‘personal’ credibility/trusts’ amongst ‘colleagues of the world’ is the basis of everything. 

It seems to me that one of the fundamental problems of Japan lies in the conventional attitude of the majority of the Japanese people who think that those global issues must be handled by ministries in charge, i.e. government offices or bureaucrats, or big companies if talking about industry.  In other words, our society is not yet mature enough as the ‘Civil Society’ – at least in my view.

So, let us all together nurture as many human resources and capitals as possible who are capable of taking actions based on the deep understanding of the importance of actions by independent individuals who do not necessarily rely on ‘governmental authorities’, as well as the importance of development of mutual trusts in individual levels, particularly in this ‘global’ and ‘flat’ world.

Commentary and Other Publication Relating to Harvard University

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This year, I was invited twice ? in January  and May (Ref.1) – to participate in the activities of Harvard University.

No publication was issued of the meeting of January, but for the meeting in May  a report for the participants only was prepared under the Chatham House Rule.  One of the participants, Mr. Kurihara wrote in his Gazette (in Japanese) that he ‘laughed many times during Professor Kurokawa’s talk’ (p.3 left column) which I take as ‘honor and pleasure’.

Since the report includes a short description of that part, I will quote it below.

Session 2: Biotech Models for Development
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‘Panelist Kiyoshi Kurokawa, Graduate Institute for Policy Studies, Japan, addressed the issue of biotechnology by first delineating some key issues related to its development ? globalization, food and water, environment, and biodiversity ? and then discussing some of the challenges facing countries interested in advancing biotech. Citing Ghana and Botswana as examples, Kurokawa argued that developing countries have little need for the newest and most scientifically intricate technologies, like genetic recombination. Rather, they need simple technologies that can be used to improve the quality of life for local people.

Kurokawa advocated the deployment of existing technology to address the most severe of world crises, like food and water shortage. Such use of technology could also result in bottom-up growth and benefit social entrepreneurs. Again emphasizing the local, Kurokawa further argued that biotech enterprises should also consider how “indigenous knowledge” might propel new developments in biotechnology. Local remedies, like the use of bark to treat malaria in China or of aspirin, have the potential to help biotechnology better address the “big needs” of the world today.’
、、、、、、
‘In the discussion that followed, Kurokawa re-emphasized his position that while frontier science contributes important discoveries, these discoveries should be shared and there should be a collective effort to apply new advancements to the betterment of the human condition.’

Another publication is a Commentary which I co-authored with my colleague Dr. William Saito for ‘Harvard Asia Quarterly’  published by Harvard Asia Center.  Its title and summary are as below.

Global Climate Change:
The Interconnection with Medical Technology and Health Care
Medicine, along with culture and technology, can both cause and resolve the problem of climate change. Medicine has helped reduce infant mortality and increase longevity, thus contributing to overpopulation which results in excessive pollution and resource consumption. But it can also help solve these problems by providing better forms of contraception and education.

The full text  is about 7,000 words which is a bit long, but if you could spare time to read it, I would be very grateful for comments and suggestions.

Michael Jackson and My Family: A Life in Encino

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One year has passed since the sudden death of Michael Jackson (MJ).  It was truly a tragedy.  Michael made his first appearance to show business as the lead vocal of the ‘Jackson Five’ in late 60s of the 20th century.  The group’s first singles, (I Want You Back, ABC, The Love You Save, I’ll Be There) became #1 hits in a row in a hit chart (Billboard Hot 100).

In the early 80s he released one after another a new style of entertainment putting together vocals, dances, and visuals; such as ‘Billie Jean’, ‘Beat It’, or ‘Thriller’, which brought about drastic changes to the Pop Music.  He was truly an extraordinary genius.  No wonder people call him the ‘King of Pop’.  Michael created ‘new art of the age’ which is a combination of vocal, dance, and visual that is very popular today.  Yet his works are still shining like a star after all these years.

His sudden and unexpected death came precisely when the whole world was waiting with great expectation his last series of live performance ‘This Is It’.  When you look at the movie ‘This Is It’  which was made from rehearsal clips, you can see and feel his talents, personality, the greatness of true professional performance, hard and uncompromising work he went through and demand to his entire team.  You never get tired of seeing no matter how many times you play it.  His performance is just extraordinary and wonderful.  Since this video is a work edited from rehearsal clips unfortunately he was often not singing in his fullest in the video, so it makes you feel sad when you imagine how the live show would have been or how this whole piece of work would have turned out to be when completed.  I myself am also a great fan of MJ.  I own several DVDs, too.

After a year from his death, ‘This Is It’ continues to move people’s hearts with his personality and I hear that his popularity has become higher then ever since his death.  The total sales of DVDs etc. are said to be over 30 million albums, which is worth nearly one billion dollars.  This is so extraordinary.

In the summer of 1977, I returned to UCLA and bought a house in Encino, a town located 15 min. by car going North on Freeway 405 that runs beside UCLA, over the Santa Monica Mountains across Mulholland Drive （a street also well known in films )(Ref.1) and down the mountain slope facing San Fernando Valley.  16465 Refugio Road, Cul de Sac, was the place.  The view, environment, neighbors…..everything was very nice.

Then only after a short while, surprisingly, Michael Jackson (MJ) came to live in our neighborhood. 4641 Havenhurst Avenue.  He was famous already, but speaking in the context of his career as a whole, I think it was the time when he was searching for the next step.  He then moved in 1988 to Neverland, about 200km west of Encino: when he died last year, the house in Encino was the residence of his parents.

It was during that time when we (my family and I) used to see Michael Jackson every once in a while, at a nearby supermarket – Gelson  (a premier supermarket at the intersection of Havenhurst Avenue and Venture Blvd）.  He was shopping all by himself, and we used to exchange few words for a few minutes. He was a very shy and charming young man.  MJ was 19 years old then.

Then, I returned to Japan in October, 1983.  MJ was already a big idol, having released ‘Thriller’  in 1982.  In this album, ‘Beat It’, ‘Billie Jean’ were also included.  It was and is a great album!  I recall ‘Thriller’ being played on TV repeatedly in these days.

In 1969, the year we went to US, MJ has been a new idol kid, and in 1983 when I returned to Japan, MJ began his career as King of Pop.  He was without doubt the greatest entertainer connecting the 20th century to the 21st century.

By the way, Google Maps (maps, street views) is an amazingly great tool.  You can find Gelson by tracking about 100m North from MJ’s house along Havenhurst Avenue.  Going south for 400m and you will reach Lanai Road, then go 400m, turn East at Havenhurst Drive, go 300m and enter Balliana Drive, then another 300m to Ballina Canyon Road, go on and on up to the mountains.   After about 200m, turn right to Refugio Road and 5 houses ahead will be the dead end of the street.  Our house was on the right side of Cul de Sac.  You can see the area both by Street Views and Air Views, but see here for a description of my house (in Japanese).  It was during these days when late Mr. Saburo Shiroyama, a great Japanese non-finction writer, visited us and wrote a short article about me  (in Japanese) with some description of the house.

I have written this posting to commemorate the １ｓｔ anniversary of the death of Michael Jackson.

New York City; Wonderful Season, Great Discussions, Reunions With Young Physicians

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After 14 hours’ flight from Seoul, I arrived at JFK Airport.  The weather looked great from above few clouds but it was also a delight to feel the refreshing dry air as I stepped down the steps from the aircraft.  This is clearly the best season of the year in New York.

I headed to Le Meridian located in the Mid-Town Manhattan , the venue of the President’s Council (Ref.1 ) of the University of Tokyo.  You may remember some of my previous postings on this Council.  It was originally founded by former President Dr. Komiyama, is now succeeded by President Hamada.  Last meeting  was held at the Komaba Campus of Todai, which included an initiatives, two separate seminars by two Council members, Bill Emmott-san and by Victor KK Fung-san.

After checking in to the hotel and taking a short rest, I spent a wonderful afternoon in the fresh leaves and soft breeze walking for about an hour in the Central Park 　(Ref.1,2) to MOMA  (it was a pity that the museum was closed because it was Monday), and through the Madison Avenue.

In the evening, a reception was held with the local Todai alumni association joining in (article on this is uploaded in the University archive of June 8th ), and the number of people turned out to be quite large.  I was happy to see several old friends whom I had not seen for a long time and of course was glad to be introduced to many new friends.

On the next day, the President’s Council meeting opened welcoming the members including professors Princess Chulabhorn Mahidol of Thailand, Vartan Gregorian, Rita Colwell, Kari O Raivio, Michael Y Yoshino of Harvard, P Laudichina-san of AT Kearney, Yoshi Yokoyama-san, the former director of McKinsay & Company Inc of Tokyo.

Special guest of this meeting was Dr Rebecca Chopp (Ref.1,2) the President of Swarthmore College.  Main theme was ‘Liberal Arts’ education.  I will write on this further in a separate posting.

In the evening I enjoyed having dinner with young Japanese physicians, some in  medical residency at a medical center in NYC, and their OBs/OGs.  We had nice heated discussions on a variety of topics.  It is my firm belief that to nurture as much as possible those kinds of talents, to encourage more young people to work in broader fields outside of Japan, is so crucially important not only for Japan’s tomorrow but also for Japan to be trusted by other nations of the more and more interconnected world.  To let young people in Japan know about those young (Japanese) people studying and working at overseas, to show them good role models that they can look up to as their short-term future choices, is a very important element in the education of and nurturing young Japanese potentials that are well capable of working in dynamic global world.

Asian Pacific Congress of Nephrology in Seoul

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Just recently I have reported to you about having participated briefly in the meeting of the International Society of Nephrology (ISN) after a long interval.

I returned from Doha to Japan in the evening of June 1st.  Next day, I headed to the Yagami Campus of Keio University to give a lecture as part of the SONY lecture series on Innovation  organized by Professor Mario Tokoro, President of SONY CSL.  The day after, June 3rd, after taking care of several things I flew to Seoul to join the Asian Pacific Congress of Nephrology (Ref.1) held at COEX.  My first program was to appear in the Opening Plenary as co-chair with Professor Ho Yung LEE, the President of APCN.

I truly enjoyed reunions with lots of colleagues who came to participate from Asia-Pacific and countries like US and EU.  During my appointment as Counselor and later as the President of ISN I used to catch every opportunity to travel abroad, so to see many of the young people; many of them whom I met in those days have been turning into leaders in their country and the world, was a tremendous joy for me.  Speaking of myself, I had the honor of receiving the first ‘Priscila Kincaid-Smith Award’  founded at the last meeting two years ago.  Dr. Kincaid-Smith is a renowned Australia based physician and researcher, especially known for her world class contribution in the advancement of nephrology and was elected the first President of ISN from Asian Pacific (she was also the first female ISN President).  I have had the honor of being in touch with her in many occasions.

The reception hosted by President Lee was held at the annex of Walkerhill Hilton  (the garden of Aston House  (the photos are seen in this web site) which is known to many through a popular Korean TV series ‘Hotelier’ .  I hear that this place was built for the meeting of Heads of North and South Koreas.  At the reception I had a great time talking with many old and new friends.

On 7th, left Seoul from Incheon International Airport  to New York JFK, a 14 hours’ flight.

Japan, UK, US, Korea Cancer Clinical Trials International Symposium ? A Report

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In my May 29th posting I have reported that we hosted Japan, UK, US, Korea cancer clinical trials international symposium.

A report on this meeting is now uploaded on the web site of Health Policy Institute 

Every session was excellent, but from Japan’s standpoint, the rapid internationalization and growth of Korean clinical trials in the last few years was impressive and very much worth focusing.  Details are illustrated in the slides (especially the latter half, #7 and after) of Professor Yung-Jue Bang of Seoul University, the 3rd presentation in the plenary session (first presentation was by Dr. Miyata of Ministry of Health, second was Dr. Kondo, Chief Executive of PMDA).  Please note that cancer or oncology is now the largest stream of clinical trials in Korea.　

I think that these rapid changes were possible through the excellent co-operations and leadership among government agencies, universities, health care stakeholders, indurstry etc., strong initiatives in prioritization, good decisions and quick actions for internationalization (introduction of international standard systems).

For Japan, the fastest way would be to participate aggressively in multiple international clinical trials right from the early phases, simultaneously.  Understanding, co-operations, and pressure of patients advocacy and their family would be crucially necessary to make it possible.

The so-called ‘Drug Lag’ is not just a problem of regulatory agency, but equally important factors are the speed of decisions of companies and clinical trials process

Doha, Qatar-3: Education in the Global Age, Concerns About Japan

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In this Global age, of fast growing Asia, with expectation of great change ahead, education in Japan has ‘more than enough’ of problems. 

Since the major work force in academic, political, and industrial arena of Japan today are comprised of those who went through the conventional school system, having  spent the 20 years of Japan ‘bashing→passing →nothing→missing’ time period with people who experienced the golden age of high economic growth of 60s to 90s, I can not but help suspecting they hardly recognize the fundamentals of education reform towards the global age.

In comparison to the population, number of Japanese people having been educated in overseas universities (undergraduate) is too small.  I presume also that there are only but few who got into (overseas) graduate schools through official entrance exams, finished full courses and graduated.  This goes particularly for male students most of whom are likely to have earned MBA under the support of ‘dispatch’ program of ‘institutions’ such as companies or government offices.

True that there were some historical backgrounds uniqe to Japan of education system , but still, Japan among growing Asian countries has exceptionally smaller number of people in comparison to its population who have gone through overseas (US and UK) higher education or who have been at ‘Boarding Schools’ (in US and UK) where ‘elites’ are nurtured.  And yet, the so called ‘leaders’ of Japan preach us ‘the vision for education’ in high pitch.

Of course, top universities of Japan are quite good.  However, even today, the ‘elites’ in Japan (in politics, enterprises, governments ? and I wonder how things are at universities…) do not have good command of spoken English, and to be honest with you, generally speaking their ‘passion’ is weaker than the elites from China or Korea not to speak of their ability to appeal themselves and sending out messages at international arenas.

At Doha we had sessions on ‘Education’, and it was quite clear that every country was very serious about nurturing/educating next generation, thus prepared for the global age.  All were fully aware that the issues they face were different from those in the conventional education of the past.

In this sense, the message on education by Queen Rania of Jordan was wonderfully focused on its essence.  I urge you to listen to her on web (資料１).  She was without doubt one of the most wonderfully influential and committed person in this forum.

May 30 – June 2 columns in the blog of Dr. Yoko Ishikura are also a very good source of additional information to what I have reported in this ‘Doha, Qatar　series’ postings.  By all means, I recommend that you visit her site.