Kiyoshi Kurokawa's blog （en）

Discussing Pharmaceutical Evaluation Process at Seoul, Energetic Youths of Japan

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The problem of “Drug Lag” in Japan - that approval of pharmaceutical products take longer time and thus is behind western countries - had been being pointed out by many since quite a while ago.

One of the endeavors to address this issue is “ICH -International Conference of Harmonization”, a conference launched about 20 years ago by Japan, USA, and EU.  It continues its activities to date, and I had been a part of it.  Last year, we held a joint conference (Ref.1) of Japan, Korea, UK, and USA to discuss the issue of “Cancer Clinical Trials”

Growing countries such as China and Korea have already introduced the system into their country, and it was to discuss mainly on this theme that I went to Seoul from 14th (Mon) as an overall moderator of the one and a half day conference by the invitation of a pharmaceutical company. 

Upon my arrival, I went right away to see Mr. Richard Samans at the “Global Green Growth Institute”　 , an organization founded by current President, Mr. Lee Myung-bak with Mr. Han Seung-Soo (Ref.1), the first Prime Minister of the Lee administration, as the Head of the Board.  Mr. Samans and I are friends from the time he was working for the World Economic Forum.

On the following day, I led the one and a half day conference to discuss from various aspects the pharmaceutical evaluation/assessment issues with special focus on the evaluation system in Japan, Korea and China.

After dinner at the hotel, I decided to stroll a bit at the “Myondon” street, a shopping area.  Here I saw many young people, and felt a good energy.  I saw the new shop which UniQlo, a Japanese casual clothing shop, just opened as its flagship shop close to ZARA and H&M.  It was a good feeling to see this energetic Japanese enterprise performing actively at this busy area.

Another good feeling was that after the one and a half day conference, we became acquainted with each other, and I could sense that many new exchanges were about to begin.

It was about a two hours’ flight from the Gimpo airport to Haneda Airport.  From Haneda, I went directly to Swiss Embassy.  A reception for “Global Shapers Community” (Ref.1) was being held.  I always enjoy seeing young people working actively in various fields.  Being with them also gives me energy.  After the reception, I spent about an hour with a reporter from “The Economist”, partly to be interviewed, and then went back to my home at around 11pm.

It was a long but a very fulfilling day.

 

CSIS-HGPI Conference at Fukushima

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CSIS is a famous Think Tank located in Washington D.C. which is well known among Japanese.  Our Health and Global Policy Institute (HGPI) has worked with CSIS on a number of joint projects beginning last year as I have previously talked about on this site. 

In the early days of this year, HGPI together with CSIS engaged in various activities including meetings with members of the Japanese Diet and some of the results of these activities were presented to the public in a report. 

In particular, CSIS rapidly responded in the wake of 3.11 by coming up with proposals for the rebuilding of Japan and they are also working together HGPI in the fields of health and medical care.  This site has reported (Ref.1) on these activities.

A gathering was held to announce this “Partnership for Recovery and a Stronger Future: Standing with Japan after 3-11” on November 3rd, 2011 in Washington D.C. followed by a similar gathering in Tokyo during the week of November 7th.  This report can be accessed via the web as well. 

A gathering was held in Fukushima on Friday, November 11th to report primarily on the joint activities with HGPI. (Please click here for the programs) The meeting was extremely productive with approximately 70 attendees, and I am extremely grateful to those who participated on a day when Fukushima was in a light drizzle.  

Among the participants were Michael Green, Stephen Morrison and Brian Biles from CSIS. While Seiji Maehara, Chairman of the Policy Research Committee, of the Democratic Party of Japan had to cancel at the last minute due to matters related to the Transpacific Strategic Economic Partnership, participants from the Japanese side included Mitsuru Sakurai (in Japanese), Acting Chairman of the Policy Research Committee of the Democratic Party of Japan (he is a former Senior Vice Minister of Finance and physician from Tohoku University), Masao Uchibori (in Japanese), Vice-Governor of the Fukushima Prefectural Government, Kazuhiko Toyama who owns transportation-related companies in Fukushima and Ichiro Tsuji (in Japanese) of Tohoku University. 

Dr. Seigo Izumo (in Japanese) who participated in this event resides in Boston, but he jumped in from an early juncture with radiation measurements and medical treatment policies.  Dr. Izumo is a Japanese doctor who was behind me in school.  After graduation from medical school, he went overseas and embarked on an illustrious career as a professor of internal medicine at Harvard with a specialization in cardiac medicine.  He is now working more on the business side and is engaged in work that allows him a more flexible schedule. 

The medical care related themes are focused around the three pillars of radiation, coping with psychological issues and reforming how medical care is provided, and a goal is to create an “Open Platform” that facilitates cooperation between the United States and Japan.  

When we returned to Tokyo, six of us, Michael Green, Stephen Morrison, Brian Biles, Seigo Izumo, Yoshiji Makino (in Japanese) (a freelance journalist who is known for his opinion pieces) and myself gathered for dinner.  Everyone was greatly pleased with the conference and we discussed what should be the next steps.  It was, all in all, an extremely fulfilling day. 

As a final bit of food for thought, Dr. Izumo carried a Geiger counter while we were walking about and actually recorded readings of over 10 uSv/hs!

 

Announcement of the November 11th (Friday) Conference

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The Center for Strategic and International Studies (CSIS), a prominent Think Tank based in Washington DC,  is poised to release the final report of its ‘U.S.-Japan Partnership for Recovery Task Force after 3.11’   in Washington and Tokyo.   In Washington DC, the announcement was made today. In Tokyo, a symposium will be held next week in collaboration with Keidanren.

HGPI, the think tank in Japan which I chair,  had partnered with CSIS on issues of healthcare (Ref.1).

Upon this occasion, HGPI-CSIS will hold a conference for a dialogue between Japanese and U.S. experts, inviting Dr. Michael J. Green, CSIS Japan Chair, Dr. J. Stephen Morrison, CSIS Senior Vice President and Director of the CSIS Global Health Policy Center, Mr. Seiji Maehara,  Chairman of the Democratic Party of Japan’s Policy Research Committee, Dr. Mitsuru Sakurai, former Vice Minister of the Ministry of Finance, in the afternoon of Friday, November 11th, in Fukushima. 

If you have time, please come and join us.  For details on program, venue, and application form, please see here (for Japanese version, please click here).

I hope you will be kind enough to tolerate any inconvenience which you may experience at the venue, due to the circumstance in Fukushima.

Again To Doha, Qatar

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The Hamad Medical Corporation of Qatar launched the vision of Academic Health System and I was invited to attend its unveiling.  The outdoor temperature in Doha was approximately 45℃ (115 F), very hot, and in addition to the heat, the city was in the midst of the Ramadan.

I made use of this opportunity to visit the Qatar Foundation (Ref.1, 2) again.  From here, I extended my visit to Cornell Medical College in Qatar, Texas A&M University in Qatar, and Qatar Science Technology Park.

These Universities use the same curriculum and same texts as in the United States and the faculty members are recruited according to the same qualification criteria as in the States, so the students graduating from these universities receive degrees equivalent to the home Universities.  The students of medical schools, after graduation, are matched for residency and the list includes first class hospitals in the United States such as Johns Hopkins and Cleveland Clinics.  Just take a look at the web site of the Qatar Foundation and you will find much information about variety of special programs they run with many universities.

Famous Think-Tanks such as Brookings and RAND are also opening their branch offices in Doha recently.

These places of education and research not only have cutting edge utilities, but are very open and international. I think it would be nice if we developed programs with Japanese researchers or enhanced exchange programs for students, graduate students, and research fellows.

Hamad Medical Corporation is now building a number of new hospitals as well as reinforcing their research laboratories.  While expanding hospitals that are about a quarter of a century old, they also manage to keep providing health care very actively.  Emergency medicine, especially traumatic wound is a huge department here.  They have a large number of patients from traffic accidents and construction accidents.

Many staffs and Doctors are from overseas but they are working very aggressively.

I think the Academic Health System is a nice ambitious program, too.  It has a strong vision for structuring a “Healthy Community” and is determined to “Expand Globally”.

Although the Middle East today has a number of unsteady elements after the Tunisian resistance and revolution, Qatar is by far more peaceful.  Why not have more exchanges with them?

August 6th: Hiroshima, Fukushima and Global Health Summer Course

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August 6th is the date of the A-Bombing of Hiroshima.

The ceremony in Hiroshima took place, as always, in the stifling heat of summer, and I have to wonder how the words offered up by Prime Minister Kan were heard by the people of Hiroshima, the people of Fukushima and the Tohoku victims. 

What kind of country will Japan become?  I feel like we have been trapped in a 5-month-long nightmare.  The situation surrounding the Fukushima cleanup and its ultimate disposition is still murky.  In addition, nothing has been clarified for Tohoku in terms of how to handle the current situation on the ground, plans for the future and what will be the ultimate role of the state.  Moreover, attention seems to be more focused on what are essentially tempests in a teapot with resistance being exhibited by the old guard, generic scandals and Ministry of Trade, Economics and Industry personnel matters.  There is a growing sense that Japan is becoming a pitiful excuse for a country. 

A feeling of gloom and doom is hanging over everyone because the world at large may again be on the edge of an economic collapse. Just what exactly should Japan do under such ominous circumstances?

Many people attribute the current political state of affairs to the (Japanese) public at large, but it is actually more of a push back to the tyranny of the “Cartels of the Mind.” Universities and the media (which seems to just cast ‘talent shows’ and ‘dining spots’) also bear a heavy burden.  I have repeatedly made the point in this blog, that we in Japan have been almost exclusively focused on economic growth with industries being unable to function in the globalized world of the past 20 years. I recently wrote about some of these same points in the official journals of the New Komeito and Liberal Democratic Party.

A couple of days ago, I introduced the “Global Health Human Resource Training Seminar -- Global Health Summer Program 2011” (Ref. 1).

The morning of Saturday August 6th marked the end of the two-week course.  Four different teams gave presentations on the topic for this year which was policy proposals aimed at the eradication of polio throughout the world in the expansive Fukutake Lecture Hall at the University of Tokyo Hongo campus. Everyone presented well-thought-out and unique proposals and it was extremely difficult to score the presentations. A combination of the various proposals present by each of the four groups might actually make for a good project in the future.

I actually took to my bed during this two-day period, because I had an absolutely awful cold, but I woke in the morning and finally felt able to put in an appearance.

It was definitely well worth the effort, because the participants have given a lot of thought to the wheres and whys of the task at hand.  Many of them commented that they had never really given any thought to such problems before and this activity allows them to greatly expand their horizons and way of thinking.

I went to lunch with the students and many individuals who supported their activities.  Many commented that they were starting to think about their next career path from a different perspective.  It is always a pleasure to interact with those individuals who will be responsible for leading us into the future.

This event marked the gathering of a group of approximately 20 passionate and driven students, some of whom have studied in the United States and France while others have gotten real life experience in places like Africa.  I really enjoyed interacting and getting to know such students who are looking to build a global career.

I left early to get home, pack my bags, and head off to Narita to depart for Qatar.  I will be participating in the unveiling of the Academic Health System Initiative.  This undertaking is quite something particularly in the heat of the summer and at the beginning of Ramadan.

I will report back later on how things go in Qatar.

Discussion With CSIS: Health Policy and Restructuring Japan After ‘3.11’

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As I have mentioned earlier this year on my web site, we, the Health and Global Policy Institute (HGPI), are collaborating with CSIS, a well known Think Tank of the United States, on health policy issues.

The topics for our collaboration for this time are: 1. Payment System of Hospitals and 2. Application of ICT.

Since we now have drafts of the reports on the two themes, I came to Washington DC to jointly present interim reports and discuss the issues with the invited specialists from outside.

I arrived at Dulles airport from Narita at 10:40am, and headed directly from the airport to CSIS.  We discussed over lunch on the ‘recommendation for the restructuring of Japan’ which CSIS started to develop after ‘3.11’.

This theme is very complicated, to say the least, and there is no end in our discussion.

However, I enjoy discussing. Health care system issue is a huge problem and it takes a tremendous amount of time to achieve any reforms.  We are searching for realistic policies and the ways to apply those policies in order to bring about the desired changes in the existing systems.
 
It seems to me that the key is how to use the ‘3.11’ as a chance agent to restructure current social system.  Of course, we must develop good and deep understanding in the broad range of the public, and the process of how we do this is very important.

Japan has huge burdens; aging society, chronic diseases burden, expansion of income disparity, stagnating economy, and on top of that we are at the brink of bankruptcy.  We have hardly any time left for reforms.  If we do not turn this great crisis of ‘3.11’ to an oppoutunity for big chance , I seriously think that Japan could collapse.

 

Washington DC: A Solid 30 Hours Visit and Sense of Fulfillment

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I left for Washington DC on May 9th (Mon), right after the ‘Golden Week’ holidays.  Arrived at 2pm on the same date, checked in to the hotel, took a brief rest, and headed to the Carnegie Institution of Science to see Dr Richard Meserve (Ref.1), a long time friend. Dr. Meserve is also one of the key persons of the nuclear power plant policies of the United States, so I came to see him to discuss issues related to the Fukushima nuclear plant.  I understand that Mr Fujita (in Japanese), member of the House of Councillors, visited him just recently, too.
 
After the visit which was for about 40minutes, I went on to CSIS.  Here, my purpose was to discuss with them the progress of the project with our HGPI  (Ref.1),  which I have reported to you earlier, (click here for the video), as well as to discuss how we could collaborate on the “Japan’s Recovery Plan After ‘3.11’”  by CSIS announced on April 20th.

After having a discussion for about an hour, I went to the National Academies of Sciences. Here, my focus was to exchange views with experts of the Science Academies on nuclear power/radiation and international relations; Drs Michael Clegg (Foreign Secretary), John Boright (Executive Director, International Affairs), Kevin Crowley (Senior Board Director, Nuclear and Radiation Studies Board), Richard Bissell (Executive Director, Policy and Global Affairs Division) joined.  I have been in touch with both Michael Clegg and John Boright for about a decade or so, from the time when the scientists started to be active in presenting policy recommendation for the global age, when I was serving as the vice president and later the president of the Science Council of Japan; and of couｒse in the last two months on Fukushima. 

They had understood well about the purpose of my visit, and it helped much in having a very constructive discussion.  It is very important, especially at time of crises, that you have such good personal relationship with mutual trust with experts of the world.
 
I do understand that there are many hurdles, but we must be aware that the Fukushima Nuclear Power Plant issue is not only in itself a great issue to the world, but how Japan handles this and all of the other problems that stem from it - such as risk management policies and their deployments, the effects of radiation on health, environment, agricultural or industrial products, or emission of radiology to the ocean - the entire response of Japan as a whole is being watched by the world.  When unpredictable crisis issues arise, the way the nation reacts and handles is a test and determines, like it or not, the most fundamental credibility of that nation.

In such circumstance, setting an independent commission consisting of international experts is a crucial, very important political process in securing the credibility of a nation today.

Look, for instance, at the BSE problem in Great Britain that started in the 1980s.  It took nearly 20 years for them to regain trust, even after they referred and acted to the independent EU committee and waited for their conclusions.

As the world goes global, international credibility/mutual trusts of nations is becoming increasingly important, and in this context how Japanese government reacts to the nuclear power plant issues, how it keeps the process of treatments/decision makings open, transparent, subjective is evermore crucial.  However, I regret to say that the government, companies, media, and the scientific community of Japan failed to recognize this at all. Therefore, it seems to me that they are unable to make any trustworthy, speedy actions or decisions and focusing instead on domestic circumstance, making policies that are too nearsighted.  The world at large recognizes somehow not-so-appropriate responses of Japanese leadership, which underlies, in my view, a quick decline of the reputation of Japan and spreading of unfavorable rumors or misinformation that harm the Japanese products and industries.

Next morning from 7am, I had a breakfast with Ambassador Fujisaki, and then spent the rest of the day having discussion with 10 or so of experts of an Aging Society Think Tank.  At lunch time I enjoyed a short but nice conversation with Dr John Howe, President of Project Hope, who just arrived at Dulles Airport from Johannesburg, and Drs Darrel Porr and Frederic Gerber (Dr. Gerber also came directly from Johannesburg) who was with us in Japan just last week, thanks to the thoughtful arrangement of HE Fujisaki.

After the lunch, I returned to continue discussion and made my presentation, then at 5pm, just before the closing, left for the Dulles Airport to fly to Zurich via London where I will head for St Gallen.

My visit to Washington DC was only for about 30 hours, tightly packed schedule, but it turned out to be an extraordinarily fulfilling stay.  I thank Ambassador Fujisaki and his staff at the Japan Embassy in Washington DC, and many others for their kind and wonderful support.

I hope this trip will be of some help to the current situation of Japan…..

 

Project Hope: New Team Arrives from US

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I have been reporting to you on Project Hope several times in this site.

A new team consisting of 5 members arrived from US in the afternoon of May 6th (Fri), the last day of the consecutive holidays we have in Japan as “Golden Week’.  We started the next day with a briefing.  George, who had also participated in the relief activities in Iraq with Fred, his predecessor, took initiative at this briefing.

I decided to join in the party in Saturday evening. All guests were Japanese, but two of them were doctors currently working in Missouri and NYC, and 3 (1 of them was male) were nurses at UCLA.  They all have medical license of the US. Dr. Shimabukuro, whom have I introduced to you earlier, advised them to participate in our project.  Dr. Kaku of PCAT who was with us last time, and a medical student of Todai who just returned from Iwate were present, too.  Dr. Hayashi is working in Iwate now.  This time, as was the last time, PCAT is supervising and advising the Japanese side.　

This new team plans to be in Japan for 2 weeks to visit several areas in the Iwate Prefecture.  There activities are truely encouraging.

These activities, as they expand, will support the recovery of the disaster stricken places, people’s health, and eventually the creation of new Japan.

I firmly believe that such activities in an open, international team will eventually, though slowly, change the mind-set of our youths to be a global citizen.

Our Collaboration with Project Hope Continues

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Click here for the photos of the disaster stricken area the doctors visited

I reported to you in my recent posting that our HGPI (Health and Global Policy Institute) and Impact Japan have been collaborating in a project with Project Hope since ‘3.11’.

Two teams joined us already and had been to the stricken zones of Sanriku several times.  Dr. Shimabukuro returned to Japan again (but then went back to UCLA right after…) to join for the second visit.  Several other Japanese doctors working in the U.S. are also participating in our Project Hope team.  They all are a great help.

At the breakfast meeting of HGPI, consisting mainly of the member companies, I  quickly reported how this project is going on.  Then, Drs Frederic Gerber and Darrel Porr introduced the background of the Project Hope, followed by an explanation of some of their activities of this joint project.

I closed the meeting with a brief comment on the basic ideas  on how to make plans for the health care in future.
 
The meeting was very well received by the participants.  Given the situation of the disaster hit area, we think this project will continue for quite a long period of time and therefore are planning another breakfast meeting for larger audience, and ask the members of this Project to give briefing sessions in the future..

Drs Garber and Porr left Tokyo off to Iwate Prefecture immediately after our breakfast meeting.

Then, 4 days after their return to Tokyo, we had another De-briefing.  This time, they met the governor of Iwate Prefecture, with an extensive discussions sessionwith the administration of Iwate Prefecture. Drs Hayashi (in Japanese), Kaku (in Japanese), and Yoshida also participated in this De-briefing.  I became acquainted with these three doctors at the PCAT who joined our re-briefing session, and George who just arrived Tokyo from Project Hope to join us.

Dr. Gerber told me that he was leaving for South Africa the next day to participate in the inauguration of planning of Nelson Mandela Children Hospital  (Project Hope is playing a leading role here, too).
Dr Hayashi is working in international settings (in Japanese) including MSF (in Japanese), Dr Kaku (in Japanese) is working in Haiti and other places, Dr Yoshida is currently working at Harvard School of Public Health and also is a mother to 4 children.

They are all working, thus thinking, globally, so their conversation resonated very well. Good Thing.

 

Encounter at San Diego and An Unexpected Reunion

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I posted the other day on a meeting in San Diego in early April.

In one of the panels at the meeting, I talked about Project Hope, a Disaster Relief Project for the East Japan Disaster.  One of the participants came to me after the panel to ask about the details, and we had some discussion over what we have been doing with Project Hope.   The person was Dr Raymond Basri from New York.  He had a strong interest in disaster relief, and had participated in many disaster relief activities in the past including Afghan Wars and Hurricane Katrina.  Dr. Basri is also known for taking leadership at the ditching of an airbus at the Hudson River, New York City.

Dr. Basri and I have been exchanging e-mails several times, and then, I suddenly received an e-mail from him saying that “I plan to come to Japan 4 days from now, and hope to bring my daughter (an undergraduate) and son (a high school student) with me to visit the stricken area.  My daughter accompanied me at the Katrina time, but my son has no experience yet of being at the disaster area...”

I have been involved for these 3 weeks in the collaboration with Project Hope, ie, 3 doctors in the team 2, for 3 times to the stricken area.  We had meetings before and after each visit for briefing and de-briefing of their reports and following discussions.

With this background, I was fortunate enough to have help from many related people, and managed to have Dr Basri and his children arrive today at Narita, in the afternoon of Saturday, 4 days after receiving his e-mail.  They then transited to Haneda (it was at this point that I finally succeeded in getting in touch with them by e-mail and cell phone - truly at the very last minute…) where I met the three (photo above) before getting on board the flight to Akita.  I had 30 minutes for briefing and handing the local maps.  They will be picked up by a car from Akita to Miyako-city.  All of the arrangements were completed just a day before their arrival, very risky, but we somehow managed.  The family was to arrive at Miyako-city at midnight.

On Sunday, the next day, Dr Basri and his family visited a number of places, and we asked the people at the site to distribute the supplies he brought.

After staying two nights at the area on Saturday and Sunday, they will be leaving for New York from Narita in the late afternoon of Monday.

I thank all who kindly helped me for the arrangement despite such a very short notice.