Publications by Author: Takemi, Keizo

2011
Reich, Michael R, Keizo Takemi, and Naoki Ikegami. 2011. “Fifty Years of Pursuing a Healthy Society in Japan.” The Lancet. The Lancet. Publisher's Version Abstract
In this Series in The Lancet, we review the past 50 years of Japan’s universal health coverage, identify the major challenges of today, and propose paths for the future, within the context of long-term population aging and the devastating crises triggered by the March 11 earthquake. Japan is recognised internationally for its outstanding achievements during the second half of the 20th century, in both improving the population’s health status and developing a strong health system. At the end of World War 2, in Japan, life expectancy at birth was 50 years for men and 54 years for women; by the late 1970s, Japan overtook Sweden as the world’s leader for longest life expectancy at birth. Japanese women have remained in the number one slot for 25 years, reaching a life expectancy of 86.4 years in 2009 (while Japanese men slipped to fifth longest living that year, at 79.6 years).

In 2011, Japan celebrates 50 years of kaihoken: health insurance for all. Universal health insurance was achieved in 1961, assuring access to a wide array of health services for the whole population. Since then, benefits have become more egalitarian while health expenditures have remained comparatively low: 8.5% of the gross domestic product and 20th out of countries in the Organisation for Economic Co-operation and Development in 2008. This achievement is all the more remarkable because the percentage of the population aged 65 years or older has increased nearly four-fold (from 6% to 23%) over the past 50 years.

2009
Reich, Michael R, and Keizo Takemi. 2009. “G8 and Strengthening of Health Systems: Follow-up to the Toyako Summit.” The Lancet. The Lancet. Publisher's Version Abstract
The 2008 G8 summit in Toyako, Japan, produced a strong commitment for collective action to strengthen health systems in developing countries, indicating Japan’s leadership on, and the G8’s increasing engagement with, global health policy. This paper describes the context for the G8’s role in global health architecture and analyses three key components—financing, information, and the health workforce—that affect the performance of health systems. We propose recommendations for actions by G8 leaders to strengthen health systems by making the most effective use of existing resources and increasing available resources. We recommend increased attention by G8 leaders to country capacity and country ownership in policy making and implementation. The G8 should also implement a yearly review for actions in this area, so that changes in health-system performance can be monitored and better understood.
2008
Reich, Michael R, Keizo Takemi, Marc J Roberts, and William Hsiao. 2008. “Global Action on Health Systems: A Proposal for the Toyako G8 Summit.” The Lancet. The Lancet. Publisher's Version Abstract

The G8 summit in Toyako offers Japan, as the host government, a special opportunity to influence collective action on global health. At the last G8 summit held in Japan, the Japanese government launched an effort to address critical infectious diseases, from which a series of disease-specific programmes emerged. This year’s summit provides another chance to catalyse global action on health, this time with a focus on health systems.

Global efforts to improve health conditions in poor countries have embraced two different strategies in recent decades, one focusing on health systems, the other on specific diseases. The interactions of these two strategies have shaped where we stand today.