‘Last One Mile Support’ and Future Responses to Infectious Diseases Discussed at G7 Commemorative Event

On April 25, 2023, Komasawa Makiko, research fellow at the JICA Ogata Sadako Research Institute for Peace and Development (JICA Ogata Research Institute), took part in “Bottom-up Stocktaking of Lessons Learned From ‘Last One Mile Support’ and Technical Consultation on Equitable Access and Delivery of Medical Countermeasures,” a JICA-supported event held by UNICEF to commemorate the hosting of the G7 Summit in Japan.

The objective of the event was to share the Japanese government's priority initiatives, such as the “Last One Mile Support” initiative for developing cold chains to deliver COVID-19 vaccines to vaccination sites and improving the ability of healthcare professionals to conduct vaccinations—to which Japan has contributed 18.5 billion yen to 78 countries and regions. Based on examples of the international community and countries' responses to COVID-19, it also aimed to identify needs for equitable access and delivery of Medical Countermeasures (MCMs) to prepare for future crises. Approximately 100 people participated and engaged in lively discussions, including government officials from the Global South, global health experts from G7 and G20 countries, development partners, and researchers.

At the beginning, opening remarks from the United Nations Children's Fund (UNICEF), the Ministry of Foreign Affairs of Japan, and JICA were delivered. Then, a representative of UNICEF gave a report on its accomplishments in distributing vaccines to 138 countries, with approximately 600 billion yen received from 38 organizations and foundations around the world as Last One Mile Support. UNICEF also reported on the achievements of the Access to COVID-19 Tools Accelerator (ACT-A), a framework for international collaboration to speed up the development and production of three medical tools for COVID-19—those being diagnostic testing, treatment, and vaccines—as well as lessons learned from ACT-A. Representatives from health ministries in Somalia and the Philippines also shared the lessons learned by combating COVID-19 in their own countries, and the future challenges in their health systems.

After these reports, Komasawa presented a case study of Uganda, concerning the achievements of Japan’s support through the “Last One Mile Project.” She also shared the results of the research project "COVID-19 Study for Universal Health Coverage (UHC) and Resilient Society" conducted by the JICA Ogata Research Institute. As part of the project, Komasawa has been working on the "Impact of COVID-19 Measures on the Essential Health Care Service in Uganda." In her presentation, she summarized that mobility difficulties caused by lockdowns were a bigger impediment to accessing health services, such as maternal and child health care, malaria and HIV testing, than the impact of COVID-19.

Many of the presenters emphasized that under the philosophy of "one team, one plan, one budget," governments and the international community worked together to quickly establish vaccine cold chains.

In the last session, it was discussed that coordination and collaboration between central governments and the health delivery systems at the end of such chains is vital. Participants agreed that involving community health volunteers at the ends of chains is an effective measure, especially in reaching those who have difficulty accessing vaccines, as experienced in the Philippines and Uganda, and that such efforts should be further strengthened in the future.

Project | COVID-19 Study for Universal Health Coverage (UHC) and Resilient Society

Project | Impact of COVID-19 Measures on the Essential Health Care Service in Low- and Middle-Income Countries

Expert | KOMASAWA, Makiko