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Feature The Fight Against Infectious Diseases
The Fight Against
Infectious Diseases
A child with HIV/AIDS symptoms receiving a nutritional supplement (Zambia).
The Current Status of Infectious Disease
and Control Measures
Around 1970, momentum was gained that may
have led to infectious diseases being brought under
control. This was due to the development and spread of
antibiotics and vaccines, improvements in sanitation,
and better nutrition, and it was exemplified by the
declaration of smallpox eradication in 1980. Since that
time, however, human beings have come under assault
from previously unknown infectious diseases.
The typical example of this is acquired immune
Figure 1-1
The Mechanism of Infectious Diseases
Elimination of vector
Creation of an environment
where it is difficult for vector to breed
Reduction of contact with pathogens (hygiene)
Routes of infection
Existence of host and vector
(intermediate host) + breeding
conditions
Air, water, blood and feces of
infected person, etc.
Invasion of human body
(via skin, mouth, etc.)
Detection, testing and
diagnosis of patients
Human
being
Treatment (deworming
through medication*,
surgery, etc.)
Release into the environment,
invasion of vector/carrier
Creation of an environment where
it is difficult for pathogens to survive
The specific infection routes vary according to
the type of infectious disease
Increased resistance (nutrition,
immunity, vaccination*)
Infected person
Reduction of release of pathogens into
the environment (quarantine)
Elimination of pathogens
(disinfection)
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deficiency syndrome (AIDS), which was first reported
in 1981 and is now a socio-economic problem for
developing countries. In addition, newly emerging
infectious diseases*1 such as Creuzfeld-Jakob disease*2,
Ebola hemorrhagic fever, Legionnaires’ disease, and O157 have emerged. Furthermore, drug resistant strains
of re-emerging infectious diseases*3 such as tuberculosis and malaria have spread widely, rendering
previous treatments ineffective. Diseases such as
whooping cough, salmonella, rabies and dengue fever
also continue to be prevalent.
Behind the question of why attention was once again
*Note:
There are no vaccines or
treatments for some infectious
diseases
Shows the movement of pathogens (microorganisms)
Shows main countermeasures
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JICA’s work against the problem of infectious
diseases dates back to the early days of Japan’s ODA
after World War II when its predecessor, the Overseas
Figure 1-2
HIV/AIDS
Currently over 36 million people around the world
are infected with the human immunodeficiency virus*4
(HIV), and 21.8 million have already died from AIDS
as of December 2000. In addition, at present approximately 16,000 people are infected every day, and it is
estimated that 95% of those infections take place in
developing countries (refer to Figure 1-2).
AIDS was first reported in 1981, and JICA
became involved in control measures against AIDS a
few years later.
The AIDS serological diagnosis and seroepidemiological research, which was conducted as part of the
Noguchi Memorial Institute for Medical Research
project (October 1986 to September 1991) in Ghana,
Feature/The Fight Against Infectious Diseases
Outline of JICA’s Activities to Combat
Infectious Disease
Technical Cooperation Agency (OTCA), began control
projects against tuberculosis. Cooperation projects
were later conducted over a wide range of fields,
including malaria and childhood infectious diseases.
Below is an outline of JICA’s cooperation activities against major infectious diseases such as AIDS,
tuberculosis, parasitic diseases and vector-borne
diseases, malaria and polio. These are the priorities in
the infectious disease control strategy based on the
Okinawa Infectious Diseases Initiative and other policies described previously.
Chapter 1
focused on these kinds of infectious diseases in the 1990s
is the impact of globalization. The frequent international
movement of people and goods meant that infectious
diseases that had previously been considered local
became worldwide problems. In addition, as a result of
the population explosion and environmental destruction,
human areas of habitation have encroached on animal
habitats that had previously been separate. This has led to
an increase in zoonosis. There is also the impact of
unsanitary environments involving drinking water,
sewage systems, and so forth. (refer to Figure 1-1).
With the global spread of infectious diseases,
control measures have been on the agenda at forums for
international discussion. At the 1998 G8 Birmingham
Summit, Japan proposed the “Hashimoto Initiative for
Global Parasitic Disease Control.” Further, at the 2000
Kyushu-Okinawa Summit, Japan was instrumental in
initiating the “Okinawa Infectious Diseases Initiative,”
in which developed nations announced a strengthening
of measures against infectious disease.
Trend in the Number of People Infected with HIV
(People)
30 million
Latin America, Caribbean
Highly industrialized countries
Eastern Europe and Central Asia
North Africa and Middle East
25 million
20 million
Sub-Saharan Africa
15 million
10 million
Southern and Eastern Asia
5 million
0
80
82
84
86
88
90
92
94
96
98
2000
(Year)
(UNAIDS data)
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Feature The Fight Against Infectious Diseases
was JICA’s first effort to tackle AIDS. Since then,
JICA has implemented Technical Cooperation projects
across a wide range of fields, including prevention,
education, human resources development for basic
research, and measures to prevent transmission from
mother to infant. These projects have mainly taken
place in Asia and Africa, including Thailand, the
Philippines, Kenya, Ghana and Zambia.
In addition, JICA has also provided equipment
for AIDS diagnosis, blood testing and educational activities for anti-AIDS campaigns through its Anti-AIDS
Equipment Donation programs. The Japanese Government
decided to provide equipment for blood screening and
educational activities against AIDS through Grant Aid
programs for the first time in Viet Nam.
In Thailand, where the number of people infected
with HIV has risen sharply since the end of the 1980s,
JICA has implemented AIDS cooperation projects that
are based at the National Institute of Health, which was
constructed by Japanese Grant Aid. By strengthening
the research and analytical capacities and improving
education materials, JICA has supported the basic
infrastructure* for anti-AIDS activities in Thailand.
There are still many hurdles which we have to
overcome for the control of AIDs—no vaccine or
Main Cooperation over the Last Ten Years
AIDS
● Project-type Technical Cooperation
Philippines: Project for Prevention and Control of AIDS (July 1996–June 2001)
Thailand:
Project for Prevention and Control of AIDS in the Kingdom of
Thailand (July 1993–June 1996)
Thailand:
Project for Model Development of Comprehensive HIV/AIDS
Prevention and Care (February 1998–January 2003)
Thailand:
Project for Strengthening of National Institute of Health Capabilities
for Research and Development on AIDS and Emerging Infectious
Diseases (March 1999–February 2004)
Ghana:
The Noguchi Memorial Institute Project, Phase II in Ghana (October
1991–September 1997)
Ghana:
The Infectious Diseases Project at the Noguchi Memorial Institute
for Medical Research (January 1999–December 2003)
Kenya:
The Research and Control of Infectious Diseases Project in Kenya:
Phase II (May 1996–April 2001)
Kenya:
Research and Control of Infectious and Parasitic Diseases Project
(May 2001–April 2006)
Zambia:
Infectious Diseases Control Project (April 1995–March 2000)
Zambia:
The Strengthening of Laboratory Systems for HIV/AIDS and TB
Control Project (March 2001–March 2006)
Brazil:
The Clinical Research Project of State University of Campinas in
Brazil (April 1999–March 2002)
● Equipment Supply Program for AIDS Strategy and Blood Testing (1996–)
Provision of HIV testing equipment, testing kits, AIDS educational materials, and
other items to Philippines, India, Pakistan, Brazil, Tanzania, Ghana, Kenya, Mexico
and South Africa.
● Training in Japan
Virological Diagnosis Techniques of HIV Infection (AIDS) (1993–)
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The Third International Parasite Countermeasures Workshop was held based on the
Hashimoto Initiative. Eighteen administrators involved in the formulation of antiparasite measures from 13 countries in Asia and Africa visited Japan for training.
treatment has been developed for AIDS. Furthermore,
treatment to delay the onset of symptoms involves the
long-term use of a number of medications, which is
expensive. Enormous cost is also required to control
opportunistic infections*5 such as tuberculosis and in
infection prevention programs.
Tuberculosis
It is estimated that approximately 1.9 billion people,
or one-third of the global population of six billion, are
already infected with the tubercle bacillus. Every year
eight million of these people contract the disease.
HIV/AIDS Control Plan (1996)
Seminar on Epidemiology and Control of AIDS/ATL Diseases (1998–)
South Asia HIV/AIDS Control Plan (1998–)
● Third-country Training
Philippines: Laboratory Diagnosis of HIV and Opportunistic Infections in AIDS
(1997–2000)
Kenya:
Blood Screening for Viral Hepatitis and HIV/AIDS (1999–)
● Community Empowerment Program
Thailand:
Northern Thailand AIDS Prevention Care Through Community
Organization
South Africa: Adolescent Sexual Health HIV/AIDS Project
Zambia:
Zambia HIV Prevention Borders Initiative
Zimbabwe: Reproductive Health Care for Young People
Mexico:
Sexual Health Program for Street Children
● Grant Aid
Viet Nam:
The Project for Prevention and Control of HIV/AIDS Transmission (2000)
Tuberculosis
● Project-type Technical Cooperation
Cambodia: National Tuberculosis Control Project in the Kingdom of Cambodia
(August 1999–July 2004)
Myanmar:
Leprosy Control and Basic Health Service Project (April
2000–March 2005)
Nepal:
The National Tuberculosis Control Project Phase I, II (April
1987–July 2000)
Nepal:
Community Tuberculosis and Lung Health Project (September
2000–August 2005)
Philippines: Public Health Development Project (September 1992–August 1997)
Philippines: Tuberculosis Control Project in the Philippines (September
1997–August 2002)
Yemen:
The Tuberculosis Control Project I-III (1983–1993, 1993–1998,
I
Malarial and Other Parasitic and Vector-Borne Diseases
● Project-type Technical Cooperation
Laos:
Joint Japan/WHO Technical Cooperation for the Primary Health Care
Project in the Lao People’s Democratic Republic (October
1992–September 1998)
Feature/The Fight Against Infectious Diseases
August 1999–August 2004)
The Infectious Diseases Project at the Noguchi Memorial Institute
for Medical Research (January 1999–December 2003)
Zambia:
The Strengthening of Laboratory Systems for HIV/AIDS and TB Control
Project (March 2001–March 2006)
Solomon Islands: The Project for Promotion of Primary Health Care in Solomon
Islands (September 1991–September 1996)
● Training in Japan
Laboratory Works for Tuberculosis Control (1993–1994)
Tuberculosis Control for Administrative Medical Officers (1993–1995)
National Tuberculosis Programme Management (1996–)
Tuberculosis Control Laboratory Management (2000–)
Managing Tuberculosis at Intermediate-Level (2000–)
● Community Empowerment Program
The Philippines: Relief Program of Indigent Tuberculosis Patients
● Grant Aid
Cambodia:
The Project for Improvement of the National Tuberculosis Center (1999)
China:
The Project for Improvement of Equipment for the Tibet Tuberculosis
Control Center (1994)
China:
The Project for Tuberculosis Control in Poor Areas (2000)
Philippines: The Project for Establishment of the National Tuberculosis Reference
Laboratory (2000)
Yemen:
The Project for Expansion of National Tuberculosis Control Program (1991)
Yemen:
The Project for Expansion of Tuberculosis Control in the Southern
Governorate (2000)
Ghana:
Malarial and Other Parasitic and Vector-Borne
Diseases
JICA has also provided Technical Cooperation in
the area of parasitic and vector-borne diseases. This
includes work against malaria in Indonesia, Sri Lanka,
Afghanistan and Tanzania, and control programs
against oncheriasis and Chagas’ disease in Central and
South America.
Further, since the concept of primary health care
(PHC) was hammered out in the 1978 Alma-Ata
Declaration, JICA has implemented strategies to combat
parasitic diseases in countries such as the Solomon
Islands, Malawi and Zimbabwe as part of PHC projects.
In the Solomon Islands, JICA conducted a primary
health care promotion project based at the Malaria
Education and Research Center, which was established
with the support of Japanese Grant Aid. The results
included a reduction in the number of malaria patients
in the capital of Honiara, the pilot area.
In recent years, JICA has established bases for
human resources development and research activities in
Asia and Africa based on the Hashimoto Initiative for
Global Parasitic Disease Control, drawing on Japan’s
post-war experience in parasitic disease control. In
order to give concrete shape to the concept of
Chapter 1
Many tuberculosis patients are poor women of
reproductive age, and this means the disease has a
major impact on families, children and society. Because
symptoms are chronic and treatment takes time, the
vicious cycle of poverty and tuberculosis problems
presents a serious challenge.
Control measures against tuberculosis are an area
where the experience and knowledge gained from
Japan’s post-war success can be utilized, and JICA is
currently conducting projects in Cambodia, the
Philippines, Nepal and Yemen.
These projects have been implemented in a collaborative manner with the World Health Organization
(WHO) and are based on the Directly Observed
Treatments Short-course*6 (DOTS) strategy. In particular, JICA’s anti-tuberculosis project in the Philippines
has contributed to the WHO in establishing its worldwide DOTS strategy. The success of the project was
well received and became the prototype for subsequent
WHO anti-tuberculosis programs.
There is also a new threat from the sharply increasing
number of people infected with HIV who are at high risk
of contracting tuberculosis as an opportunistic infection.
Therefore, combined strategies to address tuberculosis
and AIDS have become a major issue.
Thailand:
The Project for the Asian Center for International Parasite Control
(March 2000–March 2005)
Ghana:
The Noguchi Memorial Institute Project, Phase II in Ghana (October
1991–September 1997)
Ghana:
The Infectious Diseases Project at the Noguchi Memorial Institute
for Medical Research (January 1999–December 2003)
Kenya:
Research and Control of Infectious and Parasitic Diseases Project
(May 2001–April 2006)
Malawi:
Community Health Sciences Project (September 1994–August 1999)
Zimbabwe: The Project of Infectious Diseases Control (July 1996–June 2001)
Guatemala: Project of Research for Control of Tropical Diseases in Guatemala
(October 1991–September 1998)
Paraguay:
The Research on Chagas’ Disease and Other Parasitic Diseases
(March 1988–March 1993)
Paraguay:
Community Health Project in Paraguay (December 1994–November 1999)
Solomon Islands: The Project for Promotion of Primary Health Care in Solomon
Islands (September 1991–August 1996)
● Training in Japan
Seminar on Parasite Control Administration for Senior Officers (1993–1998)
Echinococcosis Control Measures (1994–2000)
Seminar on Parasite Control Administration for Senior Officers—A Step Towards
Primary Health Care— (1999–)
● Japan Overseas Cooperation Volunteers
Dispatch of volunteers such as malaria control, community development, laboratory technician and nursing to Laos, Guatemala, Niger and Senegal.
● Community Empowerment Program
Ghana:
Integrated Family Planning, Nutrition and Parasitic Control Project
● Grant Aid
Laos:
The Project for Malaria Control (1998)
Senegal:
The Project for Reinforcement of Mother and Child Health and
Measures Against Malaria (2000)
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Feature The Fight Against Infectious Diseases
promoting countermeasures against parasitic diseases
from the perspective of South-South cooperation*,
JICA has advanced projects that are the focus for cooperation in human resources development and research
in Asia and Africa. In March 1999, JICA began a
project at Mahidol University in Thailand that will
become the Asian center for human resources development for neighboring countries (refer to p.57).
Furthermore, in the spring of 2001, we began a project
at Kenya’s Central Medical Research Institute, to be the
center for East Africa. At the Noguchi Memorial
Institute for Medical Research in Ghana, which is
expected to be the regional core center for infectious
diseases control in West Africa, we are advancing
Figure 1-3
Trends in the Number of Polio Cases in the
Western Pacific Region
A child receiving a polio vaccine on National Immunization Day (NID)
(Bangladesh).
preparations for third-country training*, in order to
improve the skills of researchers in the field of parasites
from neighboring countries.
(People)
6000
5000
4000
3000
2000
1000
0
90
91
92
93
94
95
96
97
98
99
2000
(Year)
(WHO Western Pacific Regional Office data)
● JICA Partnership Program
Papua New Guinea: Integrated Cooperative Research for Malaria Control (2001)
Polio
● Project-type Technical Cooperation
China:
Polio Control Project in the People’s Republic of China (December
1991–December 1999)
Indonesia:
Fundamental Technology Transfer Project for Production of Live
Attenuate, Measles and Poliomyelitis Vaccines in Indonesia
(September 1989–August 1996)
Laos:
Joint Japan/WHO Technical Cooperation for the Primary Health Care
Project in the Lao People’s Democratic Republic (October
1992–September 1998)
Laos:
Pediatric Infectious Diseases Prevention Project in the Lao People’s
Democratic Republic (October 1998–September 2001)
Mongolia:
Maternal and Child Health Project in Mongolia (October
1997–September 2002)
Ethiopia:
Laboratory Support for Polio Eradication: LAST Polio Project (April
2001–April 2004)
● Equipment Supply Program for Measures Against Infectious Diseases
(Measures Against Polio)
Provision of supplies including vaccines and cold chain needed for immunization
to China, Viet Nam, Cambodia, Laos, Papua New Guinea, Mongolia, Bhutan,
Myanmar, Nepal, Yemen, Tanzania, Central Africa and Cameroon.
● Training in Japan
Virological Diagnosis Technique for Polio Eradication Programme (1991–)
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Polio
The eradication of polio was advocated at the 41st
WHO General Meeting in 1988, and since then Japan
has provided active support for the realization of this
objective. At the end of October 2000, it was
announced in Kyoto that transmission of the wild polio
virus had been eradicated in the Western Pacific region
(refer to Figure 1-3). This is a success story in which
aid from Japan, the largest donor* nation in the region,
produced visible results.
● Third-country Training
Ghana:
Vaccine Potency Testing and Polio Diagnosis Procedures (1991–1996)
Ghana:
Laboratory Diagnosis of Yellow Fever and Other EPI Viral Diseases
(Polio and Measles) (1996–1998)
● Japan Overseas Cooperation Volunteers
Dispatch of polio control volunteers to Bangladesh, Niger and Kenya.
● Grant Aid
Bangladesh: The Project for the Eradication of Poliomyelitis (1995–1997)
China:
The Project for the Eradication of Poliomyelitis (1993–1995)
India:
The Project for the Eradication of Poliomyelitis (1996–1997)
Indonesia:
Project for the Construction of the Facilities for Live Attenuated Oral
Poliomyelitis and Measles Vaccine Production (1991)
Pakistan:
The Project for the Eradication of Poliomyelitis (1996)
Côte d’Ivoire: The Project for the Eradication of Poliomyelitis (1997)
Ghana:
The Project for the Eradication of Poliomyelitis (1997)
Kenya:
The Project for the Eradication of Poliomyelitis (1997)
Tanzania:
The Project for the Eradication of Poliomyelitis (1997)
Other Infectious Diseases
● Project-type Technical Cooperation
China:
Expanded Program on Immunization Strengthening Project (June
2000–May 2005)
India:
The Project for Prevention of Emerging Diarrheal Diseases in India
(February 1998–January 2003)
Myanmar:
Leprosy Control and Basic Health Service Project (April
2000–March 2005)
I
Project for Strengthening of National Institute of Health Capabilities
for Research and Development on AIDS and Emerging Infectious
Diseases (March 1999–February 2004)
Turkey:
The Infectious Diseases Control Project in the Republic of Turkey
(October 1997–September 2002)
Ghana:
The Noguchi Memorial Institute Project, Phase II in Ghana (October
1991–September 1997)
Kenya:
The Research and Control of Infectious Diseases Project in Kenya:
Follow-up (May 1990–April 1996)
Kenya:
The Research and Control of Infectious Diseases Project in Kenya:
Phase II (May 1996–April 2001)
Zambia:
Infectious Disease Control Project (April 1995–March 2000)
● Training in Japan
Management and Technology in Microbiological Laboratory (1992–1998)
Patient Care for Infectious Diseases (1993–1995)
Seminar on Blood Transmitted Diseases (Special Reference to AIDS, ATL &
Hepatitis) (1993–1997)
Infectious Disease Medicine (1996–2000)
Seminar on Infectious Hepatitis, its Epidemiology and Control (1998–2000)
Diagnoses and Control of Rabies and Other Viral Zoonoses (1996–2000)
● Grant Aid
Bangladesh: The Expanded Program on Immunization Plan for Neonatal Tetanus
Elimination and Control of Measles (1998–1999)
Cambodia:
The Project for Improvement of Equipment for Immunization (1995)
China:
The Project for Improvement of Equipment for Immunization (1994)
China:
The Project for Virus Examination Equipment Supply (1997)
China:
The Expanded Program on Immunization Plan (1998)
Feature/The Fight Against Infectious Diseases
Thailand:
Other Infectious Diseases
There are many infectious diseases that have been
challenges in developing countries for many years in
addition to those described above.
In particular, it is estimated that more than 10 million
children aged five and under die every year. Ninety-nine
percent of these children live in developing countries, of
whom 63% die from infectious diseases (1998 WHO estimates). The main infectious diseases are acute respiratory
infections such as pneumonia, which kills approximately
2 million per year; diarrhea caused by salmonella and
cholera, which kills approximately 1.5 million per year;
measles (about 1 million); and malaria (about 1 million).
As part of measures to address these infectious
diseases, JICA has implemented cooperation that includes
human resources development through Technical
Chapter 1
The anti-polio project in China, which began in
1990, made a pioneering and significant contribution to
the eradication of polio in this region. In addition, we
have implemented Technical Cooperation projects and
polio countermeasures in both Laos and Mongolia. We
have also provided equipment and supplies that include
vaccines and cold chain transport needed for national
immunization days (NIDs), which are essential for
polio eradication, to various countries in Asia and
Africa. This aid comes to a total of approximately 3.1
billion yen (1993–2000, approximately 16 billion yen if
Grant Aid is included) and has contributed to a reduction in the number of polio patients.
Between 1989 and 1996, we conducted the
Fundamental Technology Transfer Project for Production
of Live Attenuate in Indonesia, and transferred production
technology for polio and measles vaccines.
Even today, nearly 6,000 cases of polio are reported
every year in approximately 30 countries. Many cases
are still being reported in Southwest Asia and Africa.
The eradication of polio cannot be accomplished by
some specific countries or regions. That is why it is
necessary to provide ongoing support for the global
eradication of polio while working in collaboration
with international organizations such as the WHO and
United Nations Children’s Fund (UNICEF).
Specially offered training, “Tuberculosis Control for Administrative Medical
Officers.” JICA has conducted training that targets people in charge of tuberculosis programs at the national level.
Indonesia:
Project for the Construction of the National Medical Center for
Infectious Diseases (1991–1992)
Indonesia:
The Expanded Program on Immunization Plan for Neonatal Tetanus
Elimination and Control of Measles (1998)
Laos:
The Project for Improvement of Equipment for Immunization (1995)
Uzbekistan: The Project for Provision of Vaccines for Children (2000)
Viet Nam:
The Project for Improvement of Equipment for Immunization (1995)
Viet Nam:
The Project for Accelerated Measles Control (2000)
Yemen:
The Project for Improvement of Cold Chain System (1998)
Palestine:
The Project for the Expansion of Immunization (1999), The Project
for the Expansion of Immunization (Phase II) (2000)
Angola:
The Project for Improvement of Child Health (2000)
Central Africa: The Project for Reinforcement of Mother and Child Health and
Measures Against Diseases (2000)
Ghana:
The Project for Improvement of the Noguchi Memorial Institute for
Medical Research (1997, 1998)
Guinea:
The Expanded Program on Immunization Plan (2000)
Kenya:
The Project for Strengthening the System for Immunization (1999)
Mali:
The Expanded Program on Immunization Plan (2000)
Tanzania:
The Project for Improvement of the Equipment for Immunization
and Micronutrient Program (1999)
Bolivia:
The Expanded Program on Immunization Plan (1998)
Haiti:
The Project for Improvement of Child Health (1997), The Project for
Improvement of Child Health (Phase II) (1999)
Nicaragua: The Project for Improvement of Child Health (1998), The Project for
Improvement of Child Health (Phase II) (2000)
19
Feature The Fight Against Infectious Diseases
Cooperation and the provision of equipment (such as
vaccines, medical examination equipment to combat
acute respiratory infections and diarrhea and essential
drugs*7) in order to support the Expanded Program on
Immunization*8 (EPI) in developing countries.
These diseases are not major challenges in developed countries. However, in developing countries,
where many children live with poor nutrition and substandard sanitation and without adequate medical
services, they are a significant and chronic challenge.
Future Issues and Strategies
As previously stated, JICA has used a variety of
methods to implement cooperation to combat infectious
diseases in many developing countries. However, the
threat of infectious diseases has not yet diminished.
Until now, JICA has implemented cooperation
focused on research on the viruses and bacteria that cause
infectious diseases, improvements in examination technology and preventative health education. Infectious
diseases are a hindrance to people’s lives. From this
perspective, it is necessary to pay attention to everything
related to the lives of human beings. In other words, in
addition to cooperation as implemented up to now, an
extremely wide range of cooperation that covers a variety
of fields is required. These fields include cooperation to
facilitate the supply of safe water, cooperation to enhance
resistance to disease through stable food supplies and
nutrition and literacy education so that people can obtain
the information they need to lead lives free from disease.
In the field of health and medical cooperation,
there are naturally limits to eradication of infectious
diseases one by one. Even in cases where cooperation
is devoted to one infectious disease, it is important that
attention is given to strengthening the system of supply
for medical services, improving people’s awareness of
health issues and expanding the effects of cooperation
to other infectious disease strategies and the prevention
of non-infectious diseases.
In the process of conquering infectious diseases in
post-war Japan, the public played the major role in
securing drinking water, establishing toilets, eradicating
flies, mosquitoes and mice, improving nutrition, and
school health care. On top of this social infrastructure*,
20
A young girl suffering from polio who cannot walk unaided.
The vaccine is ineffective once polio is contracted (Niger).
a health care system for immunization and maternity
and child health examination was established. While it
is not necessary for developing countries to follow this
process exactly, it is necessary for JICA to work in
harmony with international aid trends to combat infectious diseases and to steadily promote a wide range of
cooperation in order to decrease the threat from infectious diseases while promoting developing countries’
ownership* of cooperation.
Notes:
1. A previously unknown, newly recognized infectious disease that constitutes a public health problem either locally or internationally (WHO
definition).
2. A disease leading to dementia that is believed to originate from mad
cow disease in which the human brain becomes spongy.
3. A previously known infectious disease—for which the number of cases
had decreased to a level where it was no longer considered a public
health problem—that has begun to spread again with increasing
numbers of cases (WHO definition).
4. The virus that causes AIDS. It invades immune cells and decreases
immunity.
5. Infectious diseases that occur when the host’s immunity is lowered.
Caused by micro-organisms with low toxicity levels that are not usually
pathogenic.
6. A method of treatment in which a health worker checks each time a
patient takes a dose of medication.
7. Defined as medicines that meet the medical treatment needs of the
majority of people. A list of pharmaceuticals is defined by each country
with the purpose of supplying drugs effectively, safely and at low cost
with limited government finances.
8. A project to promote immunization against six major childhood
diseases including polio, measles and whooping cough.