Human Security Challenges of HIV/AIDS and Other Communicable Diseases

Former Japan Prime Minister Yoshiro Mori.
Former Japan Prime Minister Yoshiro Mori.

by Yoshiro Mori

There is an old saying in Japan, “The people are the foundation stones, the people are the castle.” To me, this means that the people, each and every individual, are the foundation for building a nation. It seems to me, in other words, that the two things that support each of us in living out our lives, the two essential pillars of human strength, are none other than education and health.

Sadako Ogata, former United Nations High Commissioner for Refugees, together with Professor Amartya Sen of Cambridge University and some of the wisest minds from five continents, recently proposed that in this era of rapidly advancing globalization, we need a new way to look at human security. Their thinking stems from the idea that in combating the many and various crises being faced today—from wars and conflict to disease—people need to engage in comprehensive, solid, community-building. That becomes the base to empower people as individuals, enabling them to live life without losing their human dignity. In this vision of human security, good health is an absolutely essential factor.

Today, Japan has the highest average life expectancy of any country in the world, and our country has had a long and varied experience in getting to this point. This experience has been valuable in our efforts to help improve health in developing nations. For example, Japan played a big part in eradicating polio from certain areas in the western Pacific, a successful project that is especially gratifying.

Against this backdrop, I proposed the Okinawa Infectious Diseases Initiative in 2000 at the Kyushu-Okinawa G8 Summit. The proposal provided for more aggressive moves by Japan toward the eradication of communicable diseases worldwide, and, to that end, our nation pledged US$3 billion in aid to be used over the next five years in the field of health in developing nations. Later, I proposed the launch of the Human Security Commission before the international community at the 2000 Millennium Summit and then, in 2001, had the privilege of attending the UN AIDS summit as the representative of the Japanese government. The way was well paved, therefore, when the United States and Japan took a leading role in creating a Global Fund in 2002 to fight the world’s three major killer diseases: AIDS, tuberculosis, and malaria.

Japan pledged US$265 million to the newly established Global Fund, more than half of which has already been disbursed. To hear how the Global Fund has already made such concrete progress gives me great pleasure. Before this meeting, Secretary Thompson and I were able to speak, and he asked that Japan continue to support the Global Fund. I feel strongly about this as well, and I told him I would make certain to relay this to Prime Minister Koizumi.

Still, the road ahead in the fight against communicable diseases will be long and hard. For one thing, many of the most prevalent communicable diseases are becoming more and more difficult to deal with. The frightening resurgence of tuberculosis, for example, is due to the proliferation of multi-drug-resistant bacteria, and the same is true of malaria. As for AIDS, many people believe that AIDS is not a major problem in Asia, but according to the latest report of the Joint United Nations Programme on HIV/AIDS (February 2004), there is no more time to spare in some of the more heavily populated Asian countries, like India, China, and Indonesia. It is not too late, the report says, but if we do not act now, we face the possibility of a catastrophic AIDS outbreak in those nations. Recently, avian influenza and mad cow disease have become major problems in Japan. The fact that animal-borne diseases are not spread by the movement of people, but can be carried by birds which fly freely all around the world, is illustrative of how disease is not limited to one region or area.

With this in mind, today I would like to stress four points.

First, the crucial importance of prevention. This is especially vital in the fight against diseases like HIV/AIDS, for which there is still not yet any cure, and diseases for which drugs developed so far have lost their effectiveness. It is especially important that children and young people be taught about diseases and disease prevention, and that we take measures to prevent the transmission of HIV from mothers to infants.

the necessity of providing adequate treatment to those who have a communicable disease. This is essential if we are to prevent the further spread of multi-drug-resistant bacteria. Last year the WTO came to an agreement about patents for drugs. It was a welcome development, for it opened the way to supplying drugs at a reasonable cost under certain conditions.

My third point concerns care for people who are afflicted with a communicable disease and their families. For me, the very thought of the 11 million AIDS orphans reported in sub-Saharan Africa is heart-wrenching. This is a complex problem that requires a multi-facet approach, but one thing that should and can be done fairly quickly is to make sure that these children are given regular lunches at school.

As I mentioned to Secretary Thompson this morning, I was in second grade in elementary school when the war in Japan came to an end. I was told by other children, and even by teachers, that we would be killed or imprisoned by the American army. However, the first thing the American soldiers did when they came to Japan was to give canned milk and beef to starving Japanese children. This was a shock for us children. We would never have even dreamed that the Americans who had defeated Japan would bring us food. I think that all of us around the world can live together in this spirit. It is the responsibility of many people, of all of the politicians from countries blessed with good health, to ensure that the children of Africa are saved.

And, thus, it should be possible to guarantee that if a child goes to school, she or he will get a meal and this will encourage them to stay in school. This may seem to be a small thing, but it could contribute greatly to enabling them to continue their education and prepare for a constructive life later on.

Fourth is the critical importance of building up human resources in these areas that I have mentioned in the developing nations, and it is crucial that a wide variety of people from all over the world work together closely in this regard.

I was a rugby buddy of Ambassador Oku Katsuhiko, who was killed while serving in Iraq. Many people have already heard about how he sent 71 emails to the headquarters of the Ministry of Foreign Affairs from his post in Iraq. However, it is not widely known that he was also exchanging messages with some of the players on his old rugby team. Ambassador Oku told these university students, “ Right now I am doing something that is extremely risky. I may never return to Japan. But when I look into the bright eyes of the Iraqi children, I want to try to somehow give them a better life. For this reason, I am willing to sacrifice myself for them. The rugby spirit is ‘One for all, all for one.’ If we can bring this spirit to the whole international community, there is so much we can accomplish.”

I first visited Africa as the prime minister of Japan. Sadako Ogata, the former UN High Commissioner for Refugees, took me to visit a refugee camp in Kakuma, Kenya. Tens of thousands of children were living inside tents. I saw a mother who would not let go of her dead child. The doctors told me that the child had been dead for several hours, but she kept stroking its back. I wanted to do something to save those children. There was a mother who had traveled 200 or 300 kilometers to get to the camp, all the while clutching four infants. Their arms and legs were so covered in dust and sweat that they resembled the shell of a tortoise. Without thinking, I took the hand of one of the children and began wiping off the sand, but the women glared at me and snatched back the child. She probably thought I was going to steal her baby.

Yet, with all of this going on around us, when we visited the camp school, I saw that all of the children were sitting on the ground listening attentively to their teacher. When I joined them, they sang a wonderful song for me. Then, I asked them what they wanted most and they told me pencils and notepads. When I returned to Japan, I called together the vice-ministers and ministry officials and told them to gather up pencils and notepads, and we sent three truckloads to Kakuma. This sort of thing does not solve the larger problem, but I was just overtaken by the impulse to do something.

Now, if you look at Japan, there is a great deal of unease with the weak economy. But young people can all buy expensive goods, go to concerts, and follow their favorite singers around Japan or even around the world. That is all Japanese youth are using their money to do. Sometimes they use their money to support themselves, but most are supported by their parents. I wish they would want to give one-tenth or one-twentieth of this money to help the world’s children. This is something that we politicians have to call upon the people to do. I hope that everyone gathered here today will call for this to be done all around the world. This is an important role we can all take upon ourselves.

One of the advantages of the Global Fund is that it is not merely a traditional international cooperation scheme driven by governments, but rather one that forges new partnerships combining the strengths of many diverse players. As Ambassador Oku would say, “one for all, all for one.” I am delighted by the report of the launching of the Friends of the Global Fund Japan at the initiative of Tadashi Yamamoto, which will give form to this spirit in Japan, and I wish to assure my wholehearted support for this effort to draw upon the participation of many in the private sector in encouraging nongovernmental and governmental support to advance the work of the Global Fund. I look forward with great anticipation to working together with everyone gathered today in the global fight against communicable disease in order that every single human being can live a life of dignity.