To mark the occasion of our 100th HGPI Seminar, HGPI CEO and Board Member Mr. Ryoji Noritake gave a lecture titled, “The History of HGPI and its Future Prospects.”

At this event, Mr. Noritake talked about the history of HGPI since its establishment, its role as a non-profit, independent, non-partisan, private health policy think tank, and the unique characteristics and issues one encounters when operating a non-profit organization.

<Key points of the lecture>

• Since Health and Global Policy Institute (HGPI) was established in 2004, it has been a domestic frontrunner in planning and organizing symposiums for discussing healthcare policy in a manner that surpasses the boundaries of the ruling and opposition parties.
• Similarly, HGPI has been ahead of the curve in taking action for visionary policy agendas like regenerative medicine and women’s health. In addition to establishing the Citizens’ Healthcare Policy Committee Project in 2008, we have also conducted projects for patient advocacy such by co-hosting the Cancer Patient Leaders’ Workshop with the American Cancer Society (ACS)
• HGPI’s defining value is generating policy proposals by holding fair and equal discussions with global multi-stakeholders from industry, Government, academia, and civil society. HGPI has been included in the Global Go To Think Tank Index Report presented by the University of Pennsylvania for eleven years running. In January 2020, we were ranked third in the “Global Health Policy Think Tanks” category (up from fourth place in 2018) and second in the “Domestic Health Policy Think Tanks” category (up from third place in 2018).
• In the future, HGPI will expand to a certain size while maintaining output quality while transforming from an interpersonal network into an organizational network. Furthermore, while improving our ability to disseminate information, HGPI will respond to paradigm shifts in society by expanding the themes of its initiatives into various fields beyond healthcare and flexible work styles.
• I believe the world will definitely become a better place if we can go beyond our positions and hierarchies to engage in discussions on level playing fields and with open minds.

■ HGPI and Me

Health and Global Policy Institute (HGPI) is an independent, non-profit, non-partisan think tank established in 2004. HGPI was initially called “Healthcare Policy Institute Japan,” and we adopted our current name in March 2005.

I was born in 1982. In 2005, while attending university at the Keio University Shonan Fujisawa Campus, I heard someone was looking for “students willing to help establish an organization called Healthcare Policy Institute Japan.” It sounded interesting, so I joined as a student intern. That was the start of my work at HGPI. At the time, we were working in a one-room office in a building in Nagatacho, with everyone seated around a big desk. Together with then-Chairman of the Science Council of Japan Dr. Kiyoshi Kurokawa and HGPI’s first President Mr. James Kondo, the four or five of us worked together surrounded by mountains of paperwork.

On February 18, 2006, HGPI held a symposium titled, “Health Policy for the Japanese Public – Time for Direction-Setting.” After opening remarks by then-Chief Cabinet Secretary Mr. Shinzo Abe, we hosted a lively discussion with a diverse group of stakeholders, starting with former President of the University of Tokyo Professor Takeshi Sasaki and then-Deputy Director of Health, Labour and Welfare Professor Tetsuo Tsuji. That event kicked off a trend inherited by “Healthcare Policy Summit,” which we still hold almost every year, but at the time, the sight of an expansive discussion held on a level playing field in healthcare policy was still a rare one.

Looking back on other events like the “The Road to Clinical Application,” a symposium on stem cell regenerative medicine held on August 18, 2005, or “Low Birthrate and Women’s Health,” a policy proposal symposium held on March 12, 2005, we can see that HGPI has always been an early adopter of agendas and a source of recommendations for policy items that will feature in global discussions in the upcoming ten to fifteen years. When formulating policy recommendations, HGPI has always emphasized holding global discussions on level playing fields with multi-stakeholders including representatives from industry, Government, academia, and civil society; healthcare professionals; and patients and other healthcare beneficiaries.

Furthermore, after identifying “the healthcare policy the public truly desires” through hearings and public opinion surveys with diverse stakeholders, we emphasize formulating policy recommendations based on data and facts. At the Healthcare Policy Summit held on February 16, 2008, we held a discussion that surpassed the boundaries of the ruling and opposition parties on topics including healthcare funding, consumption tax, and Regional Medical Care Visions.

As for my personal path, after my student internship, I joined HGPI as a full-time associate fresh out of university in 2007. In 2008, together with Professor Kenichi Hanioka, my boss at the time, I helped kick off the Citizens’ Healthcare Policy Committee Project, which aimed to achieve citizen- and patient-driven healthcare policy. One way we pursued that goal was by co-hosting the Cancer Patient Leaders’ Workshop together with the American Cancer Society (ACS), where we exchanged opinions on topics like national and prefectural cancer control measures while hearing about experiences and lessons from the United States.

After the Great East Japan Earthquake in 2011, we participated in various initiatives to support areas affected by the disaster. In one such initiative, we collaborated with U.S.-based non-profit global health and humanitarian relief organization Project HOPE to establish a framework for dispatching Japanese healthcare professionals and other professionals based overseas to the affected areas as volunteers. This led to me working at Project HOPE for around four years after attending graduate school of the University of Amsterdam in the Netherlands and obtaining a Master of Medical Anthropology degree.

I conducted fieldwork in disaster-stricken areas of the Philippines and Vietnam. There, I was able to do highly rewarding work in which I listened to the stories of community members like fishermen and housewives, weaved ethnographies to discover what healthcare services were truly needed in the community, and then connected my findings to humanitarian aid. In an initiative with a global medical device manufacturer in Vietnam, we held fair and equal discussions that involved healthcare providers and industry representatives as well as people working in clinical settings, patients, and other healthcare beneficiaries. This experience gave me an acute awareness toward the seeds of innovation. Later, after participating in a project with the U.S. Navy, I returned to HGPI as a fellow in 2015. After serving as Deputy CEO, I have served as CEO since 2016.

■ Engaging multi-stakeholders

Based on my experiences at outside organizations before returning to HGPI, I feel that one of HGPI’s defining values since its establishment is “formulating policy recommendations while holding discussions with multi-stakeholders in industry, Government, academia, and civil society on a level playing field.” Looking at past HGPI activities such as symposiums like “Health Policy for the Japanese Public – Time for Direction-Setting,” the Cancer Policy Summit, and Healthcare Policy Summit, we can see that rather than representing specific positions or industries, organizations, or perspectives, HGPI has always hosted discussions on a level playing field while respecting the viewpoints of patients, the people around them, and other healthcare consumers.

■ Valuing a global perspective

Another one of HGPI’s strengths is its global perspective. All of the agendas for which HGPI issues policy recommendations like dementia, women’s health, and NCDs are issues Japan cannot solve on its own. Therefore, we value global multi-stakeholder discussions while advancing our projects.

■ Agenda setting

As early as 2005, HGPI had already presented policy proposals on regenerative medicine and women’s health. We identify agendas in healthcare policy and social security and get to work early on addressing issues that have yet to gain much attention and that we think will become important for Japan and the world. This is another legacy of HGPI. In the future, I would love to hear everyone’s suggestions as to which agendas you think HGPI should pursue.

■ Being a bridge for the “valley of death” in policy

By conducting research and public opinion surveys, we can identify evidence-based policies or the healthcare policies the public truly wants, to a certain extent. However, there is a “valley of death” that divides research – the results of surveys and analyses from researchers in the aforementioned efforts – and the actual reflection of those results in policy. After that, there is another “valley of death” in politics, during the act of implementing policy during the political process. We can say one of HGPI’s roles is to bridge these “valleys of death” and help policies become reality.

■ HGPI’s main projects and mission

Some of HGPI’s ongoing projects include a project for chronic disease control (namely, to find the best way to structure the healthcare provision system to respond to diseases like cancer, stroke, and heart disease); antimicrobial resistance (AMR); dementia (for building more dementia friendly and inclusive societies and developing novel therapies); mental health; global health; immunization and vaccination; and COVID-19 control (for building public understanding and promoting cooperation between industry, Government, academia, and civil society).

HGPI is advancing a variety of projects under our guiding principle, which is to serve as a non-partisan think tank that helps citizens shape health policies by generating policy options and, through conversations with multi-stakeholders including members of the public and parties most affected in Japan and abroad, to amplify the voices of citizens in proposals and statements in a global context to contribute to the realization of evidence-based health policies.

■ Our global outlook

HGPI has changed its English name twice, from “Healthcare Policy Institute Japan” to “Health Policy Institute Japan,” then to “Health and Global Policy Institute” about seven years ago. I think seeing the changes in our name shows we have continuously renewed ourselves as an organization and that we have made steady progress on our initiatives.

In January, 2020, HGPI was included in the Global Go To Think Tank Index Report presented by the University of Pennsylvania for the eleventh year running. We were ranked third in the “Global Health Policy Think Tanks” category (up from fourth in 2018) and second in the “Domestic Health Policy Think Tanks” category (up from third in 2018). I think that it is important we keep our sights set firmly on the future at all times, including when we issue statements on a global level.

■ Our budgeting structure, governance structure, and personnel evaluation practices

Just like many NPOs, HGPI faces issues related to its budget structure. To be an attractive workplace for talented people and provide opportunities for career development while operating on a limited budget, how should an NPO improve its budget structure? This is often a theme of conversations I have with friends who are close to me in age and are operating NPOs. Themes that allow for effective fundraising are, by nature, very important items for society. However, it is difficult to maintain operations on this point alone.

All of our board members and auditors starting with HGPI Chairman Dr. Kiyoshi Kurokawa participate in HGPI’s activities without compensation. Our board of directors meets four times annually to make various decisions. Rather than financial gain, they are purely interested in Japan’s healthcare policy. This is HGPI’s governance structure. I am deeply grateful to all of our board members for their dedication and support and I would like to continue practicing sound financial management in the future.

Another one of the many challenges facing HGPI is evaluating member performance. For example, we cannot assign high marks to a project that generates lots of extra funding. If we did, people would receive high evaluations for doing nothing but keeping extra money in the budget. Of course, we do have to secure enough funding to cover personnel expenses, but our goal is not to have money left over. Therefore, we are currently implementing 360 degree evaluations while devoting much thought as to how to motivate and increase motivation among our staff.

■ Transforming from an interpersonal network to an organizational network

Evolving from an interpersonal network into an organizational network has been a point of focus for HGPI over the past five years. Shortly after HGPI was established, we operated with a staff of just a few people. We have grown into an organization that is currently about twenty people (including part-timers). In the future, rather than attracting talent because there is a specific individual on our staff, we have to transform into an organization that attracts people because they see value in our mission or in the content of our activities. For that reason, as well, I do not want to be at the forefront of HGPI; instead, I want to support the activities of our staff. My four main duties as CEO are vision sharing, fundraising, troubleshooting, and housekeeping (namely, duties for day-to-day organizational management). I believe serving as the “face of HGPI” should be left up to each member of our staff.

■ My beliefs

Policies and systems, starting with healthcare policy, improve by multi-stakeholders exchanging opinions from positions of equality. The world is sure to become a better place if we open up and hold discussions that surpass individual positions or hierarchies on a flat playing field. This is my belief.

Policies and systems like the social security system only function properly when every citizen views them as items that affect them directly. HGPI would like to contribute to helping each person feel personally invested in these topics.

At HGPI’s website, we have accumulated activity reports reaching back to when our organization was first established. Those reports portray what kinds of discussions were held and what types of recommendations were made at our various meetings in the past. Leaving written records of these processes is an important role of a think tank.

One of my favorite sayings is from the Analects of Confucius and is, “Those who resort to blandishments and fawning smiles are apt to lack compassion.” Just saying beautiful things will not actually make the world a better place. It is undeniable that communication is important and I would like us to strengthen our communicative abilities, but I also think steadily completing honest work is also important.

■ Issues and prospects

As for future issues and prospects for HGPI, we will have to strengthen our activities for delivery, starting from agenda setting and agenda shaping. In addition, to secure sufficient funding for personnel expenses and to grow to a certain size while still being an organization where staff members can advance their careers, it is essential we maintain and improve the quality of our output. I think an issue we must discuss in the future will be how to strike a balance between what we want to do and what we have to do to generate funding. In addition to our current projects, we will discuss which policy issues require new initiatives and work to become an organization with strong communication abilities while further improving the content of our activities.

Recently, due to changes in work styles and other developments, we have started to take on more staff who are working at HGPI as part-timers or as a second job in supporting roles as interns while attending graduate school. In this manner, I think we should transform into an organization that allows many people to participate in our activities in various forms rather than one that relies only on full-time staff. Moving forward, HGPI will further expand the themes it engages in beyond the perspectives of healthcare and healthcare providers. These will include robotics and AI; the effective use of technologies such as data health and digital health; individualization and communitization of care, starting with in-home care; transport and smart cities; and multi-industry collaboration involving fields like nutrition and communication. I look forward to holding discussions on diverse topics with every multi-stakeholder.

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■ Profile:
Mr. Ryoji Noritake (CEO, Boad Member, Health and Global Policy Institute)
Mr. Ryoji Noritake is the CEO, Board Member of Health and Global Policy Institute (HGPI), a Tokyo-based independent and non-profit health policy think tank established in 2004. He is a graduate of Keio University’s Faculty of Policy Management, holds a MSc in Medical Anthropology from the University of Amsterdam, the Netherlands. He served as a Visiting Scholar at the National Graduate Institute for Policy Studies (2016-2020) and a member of Tokyo Metropolitan Government’s Policy Discussion Roundtable for Super Ageing Society (2018). He is currently serving as a member of Salzburg Global Seminar’s Advisory Council and various health related committees in Japan and the world.

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