For the first time in 15 years, The Lancet has published a special issue on Japan, with two policy papers analyzing Japan’s healthcare system and international health strategy featured in The Lancet Regional Health—Western Pacific. These papers, co-authored by a working group of 25 researchers and policy practitioners from Japan and the Asia-Pacific region, offer policy recommendations for redesigning Japan’s health care and foreign policy toward 2040. This special feature is chaired by Prof. Shuhei Nomura of Tohoku University’s Global Health Policy Lab at the International Research Institute of Disaster Science (IRIDeS), with JCIE serving as the secretariat.

In 2011, a special Japan feature in The Lancet showcased the achievements and challenges of 50 years of Japan’s universal health coverage (UHC) system (see link below). Fifteen years later, aging populations, labor shortages, and fiscal constraints are forcing a review of domestic systems, while international health funding is shrinking and geopolitical fragmentation is progressing, making it difficult for a single country to handle infectious diseases, unstable drug supply, drug resistance, disasters, and climate change preparedness alone. The working group reviewed the evidence and discussed what must change to meet current and upcoming challenges. Based on those discussions, these articles examine the domestic reforms needed to support UHC and health diplomacy in the Asia-Pacific region.

Key Points

With an eye to 2040, the researchers suggest three main changes: (1) a shift from hospital-centered care to community-centered support; (2) a shift from aid to human security diplomacy; and (3) a shift from one-way knowledge transfer to mutual learning.

The papers give particular weight to that third shift: alongside sharing its own experience, Japan has much to gain by learning from its neighbors. Japan can share experience in areas such as universal health coverage, long-term care, and disaster response, and can, in turn, learn from Asian partners in areas such as efficient payment systems, digital health tools, and community-based care developed under tight resource constraints.