Policy Recommendations Released to Redesign Universal Healthcare and Health Diplomacy as an Integrated System Toward 2040

Two policy review papers, jointly analyzing Japan's healthcare system and international health strategy, have been published in The Lancet Regional Health – Western Pacific as part of a special Japan issue by The Lancet Group—the first in approximately 15 years. These papers present policy recommendations for a comprehensive redesign of healthcare and diplomatic policies toward 2040. The special issue is led by Professor Shuhei Norimura from the Division of Global Health Policy at the International Research Institute of Disaster Science, Tohoku University, with the Japan Center for International Exchange (JCIE) serving as the secretariat. A total of 25 researchers and policy practitioners from Japan and the Asia-Pacific region participated in the authorship.

[Overview]

The 2011 Lancet Japan special issue showcased the achievements and challenges of Japan's 50-year universal healthcare system to the world. Fifteen years later, domestic challenges such as aging, workforce shortages, and fiscal constraints are pressuring reforms, while shrinking international health funding and geopolitical fragmentation make it increasingly difficult for any single country to address global threats alone—such as infectious diseases, unstable pharmaceutical supply chains, antimicrobial resistance, and disasters exacerbated by climate change. Based on discussions among domestic and international experts, the two papers jointly examine domestic reforms supporting universal healthcare and health diplomacy in the Asia-Pacific region. They propose three major transitions as policy recommendations for 2040: (1) from a hospital and volume-based system to one centered on community living and health outcomes; (2) from aid to human security diplomacy that supports regional safety and economic resilience; and (3) from one-way knowledge sharing to a reciprocal relationship where Japan also learns from Asia.

[Key Highlights]

The domestic policy paper recommends a shift from a 'hospital and volume-centered' model to a 'community and health outcomes-centered' approach to ensure the sustainability of universal healthcare under conditions of aging, workforce shortages, and fiscal constraints. [Link to domestic policy paper]

The international policy paper positions health as a diplomatic and security issue essential to the safety and economy of the Asia-Pacific region, advocating a shift from health as 'a sector of aid' to 'human security diplomacy.' [Link to international policy paper]

For further details, please refer to Tohoku University's press release.

[Online Briefing Announcement]

To mark the publication of these papers, an online briefing will be held to present their specific contents and facilitate dialogue with the authors. This is a valuable opportunity to directly ask the authors about the underlying issues and core recommendations. We invite your participation.

Date and Time: July 28, 2026 (Tuesday), 1:00–2:00 PM JST

Format: Zoom meeting

Registration: https://us02web.zoom.us/meeting/register/njc_fNblSNO8R4zwZ7UpzA

Speakers (Biographies)

Shuhei Norimura – Professor, Division of Global Health Policy, International Research Institute of Disaster Science and Graduate School of Medicine, Tohoku University (Chair)

Naka Igarashi – Visiting Professor, Graduate School of Business Administration, Keio University

Haruka Sakamoto – Visiting Associate Professor, Graduate School of Public Health, St. Luke’s International University (Lead Author, International Policy Paper)

Co-organized by

International Research Institute of Disaster Science, Tohoku University

Japan Center for International Exchange (JCIE)

[Contact Information]

(For research inquiries)

Division of Global Health Policy

International Research Institute of Disaster Science

Tohoku University

(For media inquiries)

Global Health and Human Security Program

Japan Center for International Exchange (JCIE)

Japan Center for International Exchange (JCIE)

The Japan Center for International Exchange (JCIE) is a nonprofit foundation promoting policy dialogue and international cooperation at the citizen level. Guided by the belief that international stability and development require not only government diplomacy but also cross-border understanding and collaboration among diverse civil actors, JCIE acts as a pioneer of citizen diplomacy, connecting Japan with the world and contributing to solving global challenges.

Under the framework of 'human security,' JCIE conducts international exchange, policy dialogues, and advocacy on multifaceted themes including diplomacy and security, democratic resilience, global health (international health), global human mobility, and women's empowerment. In response to the Japanese government's 2016 launch of the 'Asia Health Initiative,' JCIE launched a new program on 'Aging in Asia and Regional Cooperation,' partnering with the Economic Research Institute for ASEAN and East Asia (ERIA) to conduct policy dialogues, award programs, and information dissemination on aging and elderly care in Asia.