Japan’s Incrementalism in the World Bank’s Global Financing Facility

The Global Financing Facility (GFF) for Women, Children and Adolescents is a multi-stakeholder global partnership that aims to improve health and nutrition of women, children and adolescents in developing countries. According to statistical data reported by the GFF in December 2021, undernutrition is related to about 45 percent of child mortality, and anemia leads to some 20 percent of maternal mortality in the world. Moreover, as many as 149 million children under the age of five suffer from growth inhibition due to malnutrition.

Establishment of the GFF

In 2007, the Health Results Innovation Trust Fund (HRITF) as a multi-donor trust fund was set up by the World Bank. A program, “Every Woman Every Child” (EWEC), was launched in 2010 by former UN Secretary-General Ban Ki-moon to advance health and well-being of women, children, and adolescents, but it lacked sufficient financial support. To address such global health and nutrition issues, the GFF was established by the United Nations and the World Bank at the Financing for Development Conference held on July 13, 2015 in Addis Ababa, Ethiopia.

The GFF mobilizes additional funding through the combination of grants from a multi-donor trust fund (the GFF Trust Fund), financing from the International Development Association (IDA) and the International Bank for Reconstruction and Development (IBRD) and utilizing other domestic and external resources. The GFF is housed at the World Bank and work with several external financiers, such as the US Agency for International Development, the Swedish International Development Cooperation Agency, and the Islamic Development Bank.

The GFF began its support for four “frontrunner” countries (Congo, Ethiopia, Kenya, and Tanzania) and expanded it to other partner countries in Africa, Asia, and Latin America. As a multilateral partnership, the United Nations, the World Bank Group, and the governments of Canada, Norway, and the United States participated in the launch of the GFF. Notably, the Bill & Melinda Gates Foundation, Canada, Japan, and the United States announced new financing commitments of US$214 million in total. This is an additional commitment to the previous funding of US$600 million and US$200 million made by Norway and Canada to the GFF Trust Fund.

So far, the GFF has supported 36 low-and middle-income countries, accelerating achievement of Universal Health Coverage (UHC) and the Sustainable Development Goals (SDGs). The GFF’s activities have contributed to reducing mortality rates of pregnant mothers, newborn babies, and children under five years old despite the outbreak of the coronavirus pandemic.

Japan’s Contributions to the GFF

Prior to the establishment of the GFF, Japan made financial contributions to the improvement of health and nutrition situations the world over. In 2009, the Japanese government set up the Japan Trust Fund for Scaling Up Nutrition (SUN) Investments (or the Japan Trust Fund) in cooperation with the World Bank. Given this background, the Japanese government started to make financial contributions to the GFF. The Japan International Cooperation Agency (JICA) also donated US$190 million to the GFF, and since then, JICA has been a key partner of the GFF for co-financing, governance, and advocacy activities.

Japan’s financial commitments to the GFF are based on its postwar experience of economic recovery during which the World Bank and the international community had financially supported the reconstruction of Japan after World War II. At the UHC Forum held on December 13, 2017 in Tokyo, the Japanese government announced that it would invest US$50 million in the GFF. In the forum, Kato Katsunobu, Minister of Health, Labour and Welfare, stated: “I firmly believe that these early-stage investments for UHC by the whole government were an important enabling factor in Japan’s rapid economic development later on.” Likewise, Japan’s global health policy and activities of the GFF overlap to a great degree as argued by Mabuchi Shunsuke, a senior advisor of the Bill & Melinda Gates Foundation, in a report published by the Japan Center for International Exchange (JCIE) in 2021.

At a national political level, Takemi Keizo of the ruling Liberal Democratic Party (LDP) mentioned the significance of the GFF during the Committee on Foreign Affairs and Defense of the Upper House on March 12, 2019. As a coalition government partner of the LDP, Komeito has also been vocal about strengthening the GFF given that “human security” is one of the core pillars of Japan’s foreign policy. On December 2, 2021, Kometio officially asked the Japanese government, especially the Ministry of Finance, to secure sufficient financial support for the GFF prior to the Tokyo Nutrition for Growth Summit 2021 to be held in the following week. State Minister of Finance Okamoto Mitsunari replied that the government would take the party’s request into consideration. On December 7, 2021, an international event entitled, “Investing in Nutrition: Role of Catalytic Financing” was held as an official event of the Tokyo Nutrition for Growth Summit, which was organized by the Japanese government in conjunction with the GFF, the World Bank Group, the Japanese Ministry of Finance, and the JCIE. Clearly, Japanese lawmakers and policy makers were aware of the significance of the GFF even in the middle of the coronavirus pandemic.

Tackling International and Domestic Poverty

One of the major partners of the GFF in civil society is Save the Children that has called on governments, private sectors, and other stakeholders to fund the fight for reproductive, maternal, newborn child and adolescent health (RMNCA-H). Hand in hand with Save the Children, the GFF plans to raise US$1.2 billion and save additional five million lives in the world by 2025. The contribution ratio of the Japanese government among all donors for the GFF is only 3.3 percent in contrast to other top donor countries, such as Norway (29.5 percent), Canada (22 percent), the Netherlands (4.3 percent), and Germany (3.8 percent). Notably, the donation to the GFF by the Gates Foundation amounted to 18.1 percent, which is nearly six times larger than Japan’s contribution. This signifies that the international community expects Japan as the third largest world economy to make further financial contributions to the GFF.

At the same time, the Japanese government would need to pay special attention to domestic poverty among children in Japan. Whereas children in developing countries suffer from absolute poverty, one in seven children in Japan lives in relative poverty as pointed out by the research of the Nippon Foundation. According to the Comprehensive Survey of Living Conditions by the Ministry of Health, Labour and Welfare, relative poverty of single-parent households in Japan had been the worst among countries of the Organization of Economic Cooperation and Development (OECD) as reported by Mainishi Shimbun on November 27, 2017. Prime Minister Kishida has argued that his government would facilitate a “virtuous cycle of growth and distribution” as a “new form of capitalism”.

Keeping this in view, it is fair to argue that the Kishida administration is expected to make further financial contributions to reducing both global absolute poverty through the support for the GFF and domestic relative poverty in collaboration with domestic programs to end child poverty by Save the Children Japan, as well as through the establishment of a new agency for children and family affairs to be initiated in April 2023.