Preparing Health Systems for Shocks

Japan’s Experience of Enhancingthe Resilience of its Health System Health Systemsfor ShocksPreparing Japan’s Experience of Enhancingthe Resilience of its Health System Disclaimer This work is a product of the staff of The World Bank with external contributions. The findings, interpretations, andconclusions expressed in this work do not necessarily reflect the views of The World Bank, its Board of ExecutiveDirectors, or the governments they represent. The World Bank does not guarantee the accuracy of the data includedin this work. The boundaries, colors, denominations, and other information shown on any map in this work do notimply any judgment on the part of The World Bank concerning the legal status of any territory or the endorsement oracceptance of such boundaries. Nothing herein shall constitute or be considered to be a limitation upon or waiver ofthe privileges and immunities of The World Bank, all of which are specifically reserved. The report reflects informationavailable up to January 2024. Copyright Statement The material in this work is subject to copyright. Because The World Bank encourages dissemination of its knowledge,this work may be reproduced, in whole or in part, for noncommercial purposes as long as full attribution to this work isgiven. Any queries on rights and licenses, including subsidiary rights, should be addressed to World Bank Publications,The World Bank Group, 1818 H Street NW, Washington, DC 20433, USA; e-mail: pubrights@worldbank.org. Exchange rate Throughout the report, the exchange rate of US$ 1 = ¥131.50 is used unless stated otherwise, which is the officialexchange rate for the most recent year (2022) average made available by World Bank Open Data, Link (accessed inJanuary 2024). Contents Acknowledgments............................................................................................................................... 4Acronyms.............................................................................................................................................. 5Executive Summary............................................................................................................................ 7 1.Introduction13 1.1Background. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .131.2Objective and Scope of the Report. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .141.3Structure of the Report. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17 2.Country Context19 2.1Japan’s Governance Structure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .192.2Japan’s Demographics and Key Health-related Issues. . . . . . . . . . . . . . . . . . . . . . . . . . . . .202.3Disasters in Japan. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .212.4Pandemics in Japan. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22 3.Japan’s HealthSystem25 3.1Health Services in Japan. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .253.2Finance and Insurance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .273.3Key Regulations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .303.4Key Actors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .313.5Quality Infrastructure Supporting Health Systems. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .323.6Opportunities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .46 4.Japan’s Disaster Medicine and Infectious Disease Control48 4.1Disaster Medicine in Japan. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .504.2Infectious Disease Control in Japan. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .524.3Key Regulations and Governance Mechanisms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .544.4Key Actors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .584.5Key Health Systems Developments since the COVID-19 Pandemic. . . . . . . . . . . . . . . . . .684.6The Road Ahead. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .73 Annex. Relevant reports for health system resilience in Japan.......................