maternal and child health. In addition to these issues, over the past decade, new and
diverse challenges have emerged simultaneously. For example, there are emerging
and re-emerging infectious diseases such as COVID-19, the direct and indirect health
impacts of climate change, AMR, the rising burden of non-communicable diseases
(NCDs) and mental health conditions globally, and the various challenges associated
with an aging population, including dementia. There are also frequent conflicts and
disasters to be addressed.
Above all, the health impacts of climate change extend beyond direct factors such
as heatstroke and floods. It also alters the distribution of infectious diseases like
malaria, affects food security though its impact on agriculture and livestock, causes
rural depopulation and urban slum growth due to large-scale population movements,
and increases the risk of zoonotic disease outbreaks due to wildfire migration. The
effects on global health, including Japan, are extensive.
Furthermore, one of the significant issues related to new global complex
challenges is the aging population, which is highly relevant to Japan. Currently, Japan
has an aging rate, the proportion of the population aged 65 and over, of around 30
percent, making it the most aged country in the world. Aging is expected to continue
to progress, with the aging rate projected to reach nearly 40 percent by the middle of
this century. The responses required include not only maintaining social security
systems such as health insurance, long-term care insurance, and pension systems
but also addressing health issues that couple with aging population, such as, but not
limited to, dementia and mobility impairments. These responses extend beyond the
health sector to include maintaining overall societal vitality. As global aging progresses,
the world is paying close attention to Japan’s approach to addressing this issue.
To date, various funding mechanisms have been established to address specific
health challenges, such as The Global Fund to Fight Aids, Tuberculosis and Malaria,
Gavi, the Vaccine Alliance and CEPI (for vaccines), Global Financing Facility (for
maternal and child health), and the Pandemic Fund (for health crises). However,
addressing new and diverse health challenges through such individual mechanisms
alone can lead to overlap, fragmentation, and sustainability issues. To respond to
diversification of global health challenges, efforts should be accelerated to strengthen
health systems with a common approach aimed at achieving resilient and sustainable
UHC.
Moreover, since the “Global Health Strategy” was released in 2022, geopolitical

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