NEWS

Dear Prime Minister Sanae TAKAICHI

We, the Japanese members of the C7 Global Health Working Group, representing over 300 civil society organizations across five continents, respectfully address you in the spirit of constructive partnership regarding an urgent coordinated response to the Ebola Viral Disease (Bundibugyo Virus ) outbreak at the forthcoming G7 Summit in France.

The world today faces an era in which invisible infectious threats cross borders in an instant. Yet at this very moment, the international cooperative framework itself is being tested, as some major countries have withdrawn from multilateral institutions or increasingly prioritised bilateral approaches over collective action. We in civil society believe that it is precisely in such times that we must deeply honour the value of the international order built through the blood, sweat and wisdom of those who came before us — an order that, while imperfect, has protected countless lives over more than seventy years.

Since May 2026, the outbreak centred in the Democratic Republic of Congo and Uganda has escalated rapidly, with WHO declaring a Public Health Emergency of International Concern (PHEIC) on 17 May 2026. The affected region — particularly Ituri Province in eastern DRC — has long been afflicted by armed conflict involving multiple non-state actors, forcing many residents to flee violence. Health systems are fragile, and immense humanitarian needs exist, while attacks on health facilities and severe restrictions on humanitarian access have become routine. Compounding these challenges, sharp reductions in assistance from major donors, including the United States, have led to the withdrawal of many international organisations, leaving critical gaps in routine immunisation, maternal and child health, nutrition, water and sanitation, and care for survivors of sexual violence. In such settings, neutral humanitarian actors such as Médecins Sans Frontières (MSF) and the International Committee of the Red Cross (ICRC), working alongside the DRC Red Cross, play an irreplaceable role in building community trust, conducting safe and dignified burials, and maintaining humanitarian presence where few others can operate.

In such complex settings, the Humanitarian-Development-Peace (HDP) Nexus approach is indispensable, and the coordinating functions of specialised agencies such as OCHA have never been more critical. Today’s outbreak starkly illustrates that, under circumstances where multilateral cooperation faces internal pressures, neither unilateral action nor fragmented responses can contain a crisis of this nature swiftly and effectively. Behind the statistics lie the realities of health workers standing at the frontline, communities too fearful to seek medical care, and the most vulnerable children and families bearing the heaviest burden. Viruses know no borders, and neither should solidarity.

The “health and medical security” framework that your Cabinet has positioned as a key pillar of national strategy is precisely designed to address such crises. Reflecting on your diplomatic engagements where you have expressed

confidence in the capacity of world leaders to bring peace and prosperity to the global community, we recognise in such statements a considered understanding of what leadership demands in this moment: not the assertion of unilateral will, but the rare capacity to bring others forward together toward a more peaceful and prosperous world. It is in that spirit of principled multilateral engagement that civil society looks to Japan’s leadership.

Japan’s longstanding philosophy of human security and its health and medical security policy exist, we believe, precisely to serve as a bridge in such moments — between the powerful and those placed in vulnerable situations, between national interest and global solidarity. Indeed, to control the Ebola Viral Disease outbreak on the ground in northeastern DRC, it is essential to build trust through two-way dialogue connecting the responding governments and the international community with local communities. This demonstrates the validity of the philosophy and policy principles Japan has long advocated. We also note with appreciation the establishment in March 2026 of the International Peace Mediation Unit within the Ministry of Foreign Affairs, which demonstrates Japan’s commitment to strengthening its capacity for conflict prevention and peaceful resolution — capabilities that are directly relevant to addressing the complex humanitarian contexts in which health emergencies such as this outbreak occur. This Ebola outbreak presents an excellent opportunity to translate this vision into concrete international action, with Japan exercising leadership within the G7 in partnership with civil society.

During the 2014-2015 West Africa Ebola outbreak, Japan earned high international recognition through multifaceted contributions including approximately USD 173 million in funding channelled through WHO, UNICEF, the World Bank, OCHA pooled funds and other multilateral partners, provision of approximately 720,000 units of PPE — including initial consignments airlifted by Self-Defense Force aircraft — and expert deployment through JICA. During the 2018 outbreak in North Kivu Province, eastern DRC, Japan also provided favipiravir (Avigan), an antiviral drug manufactured by a Japanese company, to the Government of the Democratic Republic of Congo. As a founding contributor to the Pandemic Fund and a longstanding major donor to Gavi, the Vaccine Alliance, Japan has consistently demonstrated its commitment to multilateral mechanisms as the most effective vehicle for rapid and equitable crisis response. Japan’s respect for African ownership in Ebola response was further demonstrated at TICAD 7 in 2019, when the third Hideyo Noguchi Africa Prize was awarded to Dr. Jean-Jacques Muyembe-Tamfum of the DRC, a virologist whose pioneering work on Ebola exemplifies the African-led scientific leadership that the international community must support and build upon.

Building on the Africa Health and Wellbeing Initiative (AfHWIN) reaffirmed at TICAD 9 in August 2025, Japanese public–private partnerships are contributing to local manufacturing and technology transfer in Africa, including diagnostics, PPE and other essential health products. Institutions such as the Kenya Medical Research Institute (KEMRI), whose laboratories and research capacity have been strengthened through decades of Japanese cooperation with JICA and Nagasaki University, now serve as regional hubs for genomic surveillance, rapid diagnostics and capacity building across East Africa, including in the current outbreak response. Today, Japan continues to establish a distinctive model of crisis preparedness through its substantial multi-year investment in SCARDA, contributions to CEPI under the 100 Days Mission, support for ASEAN CDC (ACPHEED), and the Tokyo UHC Knowledge Hub jointly operated with the World Bank and WHO.

We hope that Japan will, while fully respecting the ownership and leadership of the African Union, Africa CDC and WHO, as well as the hard-won expertise of the DRC health sector that has confronted and overcome repeated Ebola outbreaks, support France’s leadership and champion actions at a scale comparable to past efforts. Notably, the Pandemic Fund has already approved emergency financing of up to USD 220 million for the current Ebola response; Japan, as a founding donor, is uniquely positioned to reinforce this mechanism and encourage fellow G7 members to follow suit. We respectfully invite Japan to take the lead on the following:

Expanding emergency funding through multilateral mechanisms, including the Pandemic Fund, WHO, UNICEF, Gavi, the World Bank and OCHA pooled funds — building on Japan’s established role as a founding and major donor to these institutions, and recognising OCHA’s critical coordinating role in conflict-affected areas such as eastern DRC;

Strengthening support for humanitarian actors operating in complex emergencies, including the ICRC and the Red Cross and Red Crescent Movement, whose neutrality and community presence in conflict-affected areas such as Ituri Province are irreplaceable for safe and dignified burials, contact tracing and community engagement — functions that no other organisation can readily substitute;

Providing technical cooperation for health worker protection through JICA’s surveillance and diagnostic capacity strengthening, leveraging KEMRI and similar Japan-supported research institutions as regional hubs, and promoting the HDP Nexus approach to address the compounding crises in the affected region;

Accelerating R&D and ensuring equitable access to diagnostics and therapeutics, including through the 100 Days Mission and SCARDA’s capabilities, and supporting Unitaid’s market-shaping role to ensure that validated diagnostics and new treatment candidates — including those specific to the Bundibugyo virus — reach the most vulnerable populations rapidly and affordably;

Supporting African countries’ health system strengthening and local manufacturing capacity through the UHC Knowledge Hub, Global Fund investments, and the AfHWIN — building on the commitments made at TICAD 9 and engaging constructively with Africa-led initiatives such as the emerging health sovereignty agenda, which calls for a fundamental shift from aid dependency toward African ownership of health systems design and delivery.

Japan is also well-placed to champion a more effective and efficient global health architecture — one that embodies renewed multilateral commitment and genuine partnership with African sovereignty and ownership. The current outbreak reinforces the importance of clear mandates under African leadership: building on the Joint Continental Preparedness and Response Plan launched by Africa CDC and WHO on 5 June 2026, the DRC Government and health sector provide leadership and ownership, Africa CDC coordinates continental partnership, WHO concentrating on its core normative and standard-setting functions; specialised humanitarian agencies such as OCHA, UNICEF and WFP leading operational coordination and logistics; and organisations such as the ICRC maintaining the humanitarian access and community trust that only principled neutrality can secure. At a time when multilateralism faces pressure from within, Japan — as a major donor to all these institutions and a consistent advocate of the rules- based international order — can use the G7 Summit to demonstrate that investing in well-functioning, mandate- aligned multilateral and humanitarian institutions is not a burden, but the most efficient and humane path forward.

This structural question is inseparable from the unfinished business of the Pandemic Agreement. In May 2025, the World Health Assembly adopted the WHO Pandemic Agreement, leaving one critical element to be finalised: the Pathogen Access and Benefit-Sharing (PABS) system. Despite six formal sessions and two extended meetings of the Intergovernmental Working Group (IGWG) over the past year, Member States were unable to reach agreement by the May 2026 deadline, extending negotiations by up to one year to the 2027 World Health Assembly. This delay, occurring in parallel with moves by some countries to pursue bilateral pathogen-sharing arrangements outside the WHO framework, represents a serious setback for equitable multilateral governance.

However, the negotiations have seen meaningful progress. Delegates achieved common ground on establishing minimum allocation floors for medical countermeasures during PHEICs and on requiring access fees from entities using the PABS system. The fundamental tension — whether such fees primarily fund system operations or constitute benefit-sharing from pathogen-derived profits — remains unresolved, but the space for compromise has clearly widened. Japan, with its advanced pharmaceutical industry and deep commitment to equitable access, is uniquely positioned to bridge the gap between developed and developing country positions.

By strategically connecting the G7 outcomes to the September 2026 second UN General Assembly High-Level Meeting (UN HLM) on Pandemic Prevention, Preparedness and Response (PPPR) and to the September 2027 third UN HLM on Universal Health Coverage (UHC), Japan can demonstrate its vision of “crisis-resilient UHC” grounded in health and medical security to the international community. The Independent Panel for Pandemic Preparedness and Response has already warned that “the world cannot afford to wait any longer” and has specifically identified the September 2026 UN HLM on PPPR as a critical opportunity to build political momentum towards a fair and effective PABS mechanism under the WHO Pandemic Agreement. The lessons of this outbreak — the critical importance of Africa leadership and ownership, local manufacturing capacity, functional surveillance networks, equitable access to diagnostics and treatments, coherent humanitarian-health coordination, and the protection of humanitarian access in conflict settings — must be reflected in both the PPPR and UHC political declarations.

We hope that the G7 Summit will serve not merely as a forum for dialogue among advanced economies, but as a symbol of genuine international solidarity in preparing for the pandemics of the future. We sincerely hope for enhanced Japanese leadership at the G7 Summit, building on Japan’s proven track record and your Cabinet’s policy commitments. The spirit of human security — protecting every person’s life and dignity regardless of where they were born — is Japan’s most enduring contribution to the international order. We, as civil society, stand ready to continue our cooperation as constructive partners. Please accept our highest consideration.

June 9, 2026
Japanese Members of the C7 Global Health Working Group (Representing over 300 civil society organizations across five continents)