Abortion in Japan

Memorandums and information about abortion situations and problems in Japan

Ishikawa Prefectural Assembly Bill No. 6 (Opinion Calling for Careful Review of Approval of Oral Abortion Pills)

Translation from original Japanese

original


Assembly Bill No. 6
Opinion Calling for Careful Review of Approval of Oral Abortion Pills

In December 2021, a British pharmaceutical company applied for the first time for approval of an oral abortion pill manufactured by the company for use in Japan.

The World Health Organization (WHO) has recognized the drug's safety and designated it an essential medicine to disseminate widely. More than 80 countries and territories have approved the drug. However, Japan has not approved the drug at this stage.

The two oral abortion pills submitted for approval, Mifepristone and Misoprostol, have been shown to have the potential to cause massive bleeding requiring surgery and bacterial infections as side effects.

Since its approval in September 2000, there have been reports about 26 deaths despite frequent warnings and reminders not to take the pills without consulting a medical institution. In Japan, there was a report in 2008 that a woman who purchased and took drugs with these two active ingredients through private importation over the Internet suffered profuse bleeding, cramps, and abdominal pains and was hospitalized.


In addition, young (teenage) pregnant women are more likely to have abortions out of a single-minded desire not to let their parents know about their pregnancies. Also, there is concern about the rising sexual abuse of women, such as being forced by men to use oral abortion pills readily. As a result, there is concern that the rate of sexually transmitted diseases and abortion among teenagers will increase, that this will accelerate the trend toward younger ages, that this will hurt children, both physically and mentally, and that they will increasingly lose respect for their tiny lives.

Therefore, we strongly request that the government further strengthen its counseling and support systems for women suffering from unexpected pregnancies--not limited to abortion--and that it take careful measures, such as stimulating broad public debate and listening carefully to the opinions of the public, in its approval screening process.

We submit this letter of opinion under Article 99 of the Local Autonomy Law.

March 16, 2023

To:
Chairman of the House of Representatives
Chairman of the House of Councillors
Prime Minister
Minister of Internal Affairs and Communications
Minister of Education, Culture, Sports, Science and Technology
Minister of Health, Labour and Welfare
Minister of Promoting the Advancement of Women
Chief Cabinet Secretary

Postponed deliberation on abortion drug

The Japanese Ministry of Health, Labor, and Welfare's deliberations on the approval of the abortion drug MEFEEGO PACK (Mifepristone + Misoprostol), scheduled for today, are expected to be postponed.

This is because the Ministry has not been able to sort through the 12,000 public comments collected from the public in February.
It has not yet been decided when the next deliberation will take place.

The four items scheduled for discussion today were：
1. whether or not the drug Mefeego Pack should be designated as a biological product or a specific biological product
2. whether or not a marketing authorization is granted;
3. whether or not a reexamination period is designated; and
4. whether or not the designation as a poisonous or deleterious drug is required.

I was concerned whether the abortion drug to be approved would be strictly controlled as a deleterious drug, similar to gemeprost (product name Pregrandin), which is exclusively used for mid-term abortions in Japan.

The Japanese government has approved Misoprostol as a prescription drug to treat gastric ulcers, but has also designated it as a deleterious drug.

We need to carefully watch the future moves of the MHLW.

Sapporo High Court: Forced sterilization was unconstitutional

Mainichi Shinbun (morning edition) March 17, 2023

This is my private translation from the paper

Second trial for forced sterilization: The government lost again.
Sapporo High Court: No application of exclusion period


The Sapporo High Court ruled on March 16 that the former Eugenic Protection Law (1948-96) was unconstitutional and awarded the government 16.5 million yen in damages in a lawsuit filed by Kikuo Kojima, 81, of Sapporo, who claims that he was forced to undergo sterilization under the law. The high court reversed a January 2021 ruling by the Sapporo District Court, the court of first instance, which dismissed the claim on the grounds that the right to claim compensation expires after 20 years from the date of the tortious act. Judge Yuko Otake stated that the degree of human rights infringement in the surgery was "severe," and that the application of the period of exclusion was limited because it was "extremely contrary to the principles of justice and fairness.
　This is the third case of a second instance of a similar lawsuit, following the Osaka High Court and the Tokyo High Court, in which the high court ruled in favor of the government.


　According to the complaint, Kojima was admitted to a mental hospital in Sapporo around 1960, when he was 19 years old, after his relationship with his family deteriorated and his life became unstable. Without a doctor's examination, she was diagnosed as having schizophrenia (now known as schizophrenia) and sterilization was forced on her without her consent.
　The court ruling stated that the former law was "unacceptable under the Constitution, which is based on the fundamental principle of individual dignity. It criticized the legislation as having been enacted for "extremely inhumane purposes. The court ruled that the surgery violated Article 13 of the Constitution, which guarantees the right to the pursuit of happiness, Article 14, which stipulates equality before the law, and Article 24, which stipulates the formation of a family.
　With regard to the exclusion period, he pointed out that even after 1996, when the discriminatory provisions of the old law were removed, no relief for damages was provided until the Lump-sum Benefits Law was enacted in 2019. The court found that the state prevented the plaintiffs from obtaining the information necessary to exercise their right to claim damages, and did not apply the law.
　In contrast, the one new judgment applied the exclusion period starting from the time of Kojima's surgery. It held that the right to claim compensation was extinguished around 1980.
　In response to the ruling, the Ministry of Health, Labor, and Welfare (MHLW) commented, "We will examine the ruling closely and take appropriate action after consulting with the relevant ministries and agencies.


Tears of happiness" at the reversal of the court decision
Ms. Kojima, the plaintiff, was the first to file a lawsuit under her own name.


　The Sapporo High Court ruled in favor of the plaintiffs in a lawsuit over forced sterilization under the former Eugenic Protection Law, following rulings by the Osaka and Tokyo High Courts on March 16. In response to the ruling, the plaintiffs urged the court to abandon their appeal, saying, "The government should reflect on the inhumane acts it has committed.
　Immediately after the ruling, plaintiff Kikuo Kojima, 81, of Sapporo, held up a piece of paper in front of the High Court that read "Victory" in his own words. He mumbled, "I'm so happy," and his wife Reiko, 80, gently wiped away his spilled tears. I am so happy," he said. They looked at each other and shared their joy.
　Mr. Kojima was 19 years old when he underwent the surgery. When he returned home from an outing, he was handcuffed by a police officer who was waiting for him and taken to the hospital. He was forced to undergo the surgery after being told in an unreasonable manner, "If people like you have children, it will be opium. I resisted, but they forced me to take off my underwear and pinned my arms and legs.
　He became a cab driver at the age of 21 and married Reiko at 38, but for a long time he could not tell her about the surgery. Every time he picked up a family in his cab, his heart ached, saying that he would never be able to have children. It was only after a woman in Miyagi Prefecture filed the nation's first lawsuit over forced sterilization in January 2018 that he was able to tell Reiko about the surgery.
　In May of the same year, Kojima-san became the first person to file a similar lawsuit, revealing her real name. When she decided to file the lawsuit, the faces of people who had been hospitalized at the same hospital where she had undergone the surgery came to mind. He thought, "If I reveal my name, maybe they will notice.
　After losing the case in the first instance, in late February, just before the second trial, he began to adopt a female cat. The cat injured her right leg in a car accident and has been sterilized. Kojima himself has a disability in his right leg, and he feels that the cat "looks just like him. He named her "Kanako" in the hope that her wish would come true.
　At a press conference after the verdict, Kojima said, "I couldn't sleep last night wondering what would happen (with the verdict). On the 28th, a rally will be held in Tokyo to seek an early and full resolution of the Eugenic Protection Law issue. Kojima said, "At the rally, I would like to ask the prime minister for a sh pill and appeal to him so that the country will never do such a thing again.

Japan's 1st abortion pill takes step closer to approval

PHARMACEUTICALS, Nikkei Asia, AYA ONISHI and KAZUHIRO OGAWA, Nikkei staff writers, January 28, 2023 03:31 JST

Japan's 1st abortion pill takes step closer to approval: Treatment would give women option other than surgical procedure
Japan's 1st abortion pill takes step closer to approval - Nikkei Asia

TOKYO -- A panel of experts under Japan's Health Ministry has given initial approval for an oral abortion pill for the first time on Friday, a major step for women in a country seen as lagging behind the rest of the developed world in reproductive health.


In March, a separate advisory body reporting to the health minister will deliberate whether to approve the pill, after which the minister will make a final decision.


While abortion pills have been available in some other countries for about 30 years, this would be the first available in Japan if final approval is declared. Until now, abortion has only been possible in the country through surgical procedures.


"I'm very happy that oral abortion pills are being considered for approval in Japan, where only surgical methods have been available. It will be an important step in the promotion of women's health care," said Mikiya Kitamura, head of the Japanese unit of Linepharma, the British pharmaceutical company that submitted the approval request.


Linepharma filed for approval for the pill, marketed in Japan as Mefeego, in December 2021. Due to a high level of societal interest, the government will solicit public opinions through an online platform.


Mefeego consists of two separate drugs, mifepristone, which suppresses the progesterone activity necessary to maintain a pregnancy, and misoprostol, which causes uterine contractions. The two drugs are taken at different times, ultimately expelling the contents of the uterus.


The treatment can be used within nine weeks of the beginning of pregnancy under the supervision of a doctor certified to perform abortions. Mefeego likely will not be covered by Japan's public health insurance.


A domestic clinical trial was conducted on 120 pregnant women who wanted to have an abortion, and 93% of them successfully aborted within 24 hours. Side effects such as abdominal pain and vomiting occurred in about 60% of patients, but most were reported to be mild or moderate.


Currently, there are only two surgical methods of abortion available in Japan, the dilation and curettage method, in which the contents of the uterus are scraped out with a metal instrument, and dilation and evacuation, in which the contents are sucked out with a tube.


The World Health Organization recommends abortion pills and the evacuation method, saying the curettage method is outdated and should not be performed.


These procedures typically cost more than 100,000 yen ($770), adding a large financial burden to the physical and emotional stress that women go through.


"It's important to expand options for women," said Masakazu Terauchi, a professor at Tokyo Medical and Dental University who is also an obstetrician and gynecologist.


Since abortion pills have side effects, efforts to deepen society's understanding as a whole, including that of partners, are also essential.


The approval of oral abortion pills has been in focus as part of the larger issue of women's reproductive health, which includes abortion rights. Japan has been said to lag behind other countries in public understanding of abortion and contraception.


An international survey on contraceptive methods conducted by the United Nations in 2019 found that only 3% of women in Japan use a birth control pill, compared to 33% in France and 14% in the U.S.


Access to contraceptives in Japan has been improving thanks to the spread of online consultations.


About 690,000 people had registered for the online birth control pill prescription app Smaluna as of December, up roughly 40% from a year earlier. About eight in 10 of those users are in their 20s to early 30s. When asked about the purpose of taking the pill with multiple answers allowed, 60% of users answered "contraception."


Japanese digital advertising company CyberAgent also started an online pill prescription service called Lunatomo last year.

1st oral abortion pill steps closer to approval in Japan

KYODO NEWS - Jan 27, 2023 - 21:42 | Feature, All, Japan

english.kyodonews.net

TOKYO - A pharmaceutical advisory body for Japan's health ministry on Friday expressed no objection to the manufacturing and marketing of an abortion pill, bringing the medication a step closer to becoming the first of its kind to gain approval in the country.

Abortions in early stages of pregnancies in Japan are currently limited to surgical procedures, and the oral pill, if approved, is seen as a new option that could lighten both physical and mental stress on women.

The health ministry said it would gather public opinion and debate the matter further with its pharmaceutical subcommittee as the abortion pill had garnered "deep societal interest and necessitates careful discussion."

Linepharma KK, a subsidiary of British pharmaceutical Linepharma International Ltd., applied for manufacturing and marketing approval for its abortion pill "Mefeego" in Japan in December 2021.

Why is spousal consent required for abortion?: Japanese women are still bound by a 70+ year old law whose legislative intent is "unclear.

Huffingpost Japan, 2022 Nov. 16, by Nodoka Konishi

Using Google translate. Original is in Japanese.

The consent of the spouse is required, and there is an "abortion crime". A group made up of researchers held a meeting, arguing that the current state of abortion in Japan is out of line with international standards.

Spousal consent required. It costs about 100,000 yen. There is an "abortion crime"

On November 14, a group of researchers called " #Safer Abortion Action " held an in-house rally at the House of Councillors Members' Office building, claiming that the current state of Japan's artificial abortion does not comply with international standards. .

Officials from the Ministry of Health, Labor and Welfare and the Ministry of Justice also attended and answered questions from the organizations, but many questions were raised from the sponsoring organizations, members of the Diet, and general participants.

Looking at the world, the situation of abortion in Japan is
At the rally, he explained the abortion guidelines published by WHO . He introduced that the law recommends the complete decriminalization of abortion and that it does not require the consent of a spouse or family member to be a requirement for abortion.

In Japan, "abortion crime" is established in the penal code for abortion. In the Maternal Protection Act, for physical and economic reasons that "may seriously harm the health of the mother", "artificial abortion can be performed with the consent of the person and the spouse." and has not been "completely decriminalized".

Also, in principle, the consent of the spouse is required, and there are many cases in which consent is sought even if the other party is not the spouse. In 2016, the United Nations Committee on the Elimination of Discrimination against Women recommended that Japan abolish the requirement for spousal consent .


Why Do You Need Spousal Consent? The purpose of the legislation is unknown

Groups submitted questions in advance to the Ministry of Health, Labor and Welfare and the Ministry of Justice.

Regarding the reason why the consent of the spouse is required, the Ministry of Health, Labor and Welfare said that it was established when the former Eugenic Protection Law, which later became the Maternal Protection Law, was enacted by lawmakers in 1948. It is difficult to give a clear answer as to whether it was something like that."

In addition, a British pharmaceutical company is currently applying to the Ministry of Health, Labor and Welfare to approve the use of oral abortion drugs in Japan, but even if it is approved, it will be operated in accordance with the Maternal Protection Act, so the person in charge of the Ministry of Health, Labor and Welfare "We believe that the consent of the spouse is required," he said.

Regarding these answers, the audience raised voices such as "That's why women's rights are restricted."

At the rally, a "request for international standard abortion medicine" was submitted to the Minister of Health, Labor and Welfare and the Minister of Justice. They called for prompt approval of oral abortion drugs, not to make the cost too high, and a review of the abortion crime and maternal protection law.

　　

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BATTLE FOR REPRODUCTIVE RIGHTS CONTINUES IN JAPAN

Fair Planet, 2002.10.23

BATTLE FOR REPRODUCTIVE RIGHTS CONTINUES IN JAPAN
OCTOBER 23, 2022
topics: ABORTION
by: Sasha Kong
located in: Japan
tags: aboriton, Japan, Reproductive Rights, women's rights


Japanese women who want to have an abortion still need their husband's consent under the law, and many have limited access to emergency pills. Some experts believe there is growing momentum now to amend the law.


When a woman in Japan goes to a hospital to have an abortion, doctors not only charge her a high rate, but also request proof of consent from the father.


In a country where over 95 percent of sexual violence cases go unreported and victim blaming remains endemic, some women reportedly even had to gain consent from their rapist in order to terminate the unwanted pregnancy.


As Japan considers whether to legalise abortion pills for the first time, media attention over the issue has rekindled a heated debate over the nation's abortion law requiring male consent, which critics and women’s rights advocates believe should be reviewed.


Japan is among the only three countries in Asia that require spousal consent for abortion, along with former Japanese colony Taiwan and Southeast Asian country Indonesia.


Currently in Japan, women can only have an abortion within 21 weeks after the last menstruation through surgical intervention - a procedure that costs roughly USD $1,750. Oral abortion medication isn’t an option for Japanese women yet, even though it is available in dozens of other countries around the world.


Abortion was legalised in Japan in 1948 in a bid to eliminate the so-called "inferior" newborns in Eugenics Protection Law. The law was later renamed and amended, and now allows women to terminate their pregnancy for economic reasons, but male consent is still needed.


And although the law only requires married women to obtain permission from their husband to terminate a pregnancy, several reports show that many hospitals and clinics in Japan ask unmarried women to obtain consent from the father in order to avoid being sued.


RESTRICTED ABORTION ACCESS
"Why this spousal consent clause still exists seems very hard to understand," Dr Isabel Fassbender, assistant professor at Doshisha Women's College of Liberal Arts who penned a study about the politics of reproduction in contemporary Japan, told FairPlanet.


She added that the clause is being defended by "many Japanese policymakers desperately clinging to the 'tradition’ of patriarchy.' "


Less than a decade ago, a Japanese lawmaker even suggested banning abortion as a tactic to boost Japan’s birth rate.


"The ones who hold power and decide [reproductive policies] at the end are people, mostly men, who do not support or are even familiar with the idea of reproductive and sexual rights," Dr Fassbender added.


"On an official level, the debate is dominated by male experts who have their own economic interests and who often argue in the context of socio-political circumstances, especially the low birth rate in Japan."


The United Nations expressed concerns over Japan’s abortion law, citing a high rate of teenage abortion and suicide. It recommended that the country amend its law to expand abortion access to women and remove the requirement of spousal consent.


Tokyo’s response to the report was to reiterate that under the law if the man cannot indicate his intention, the woman's consent alone is sufficient to access abortion - as is the case in instances involving domestic violence.


It further stated that women’s health centres should "develop a counseling system by assigning specialised counsellors," to ease unexpected pregnancy qualms.


However, Japanese women are subjected to societal pressure when they try to have an abortion, Dr Fassbender said.


"It seems difficult to find someone to talk to for some women when they find out about an unwanted pregnancy," she explained. "Usually, these are cases of women who are in very isolated situations, not rarely raised in abusive and negligent environments.


"In addition, there is a lot of stigma regarding pregnancies in teenagers or university students, which adds to these young women's dire situations."


Japan’s sex education programmes, Dr Fassbender believes, could be part of the reason, as sex remains taboo in the nation. The expert said that many in Japan are completely unaware about the existence of emergency day-after pills and that contraceptives for women are both expensive and only available upon prescription.


Medical experts from the Japan Association of Obstetricians and Gynecologists - who are, it should be noted, mostly men - oppose easing access to emergency pills, claiming that "women seeking emergency contraceptives, or people behind them, may be involved in the sex industry or a criminal organisation who might transfer drugs to other."


Oral contraceptives - which only about 3 percent percent of women in Japan are using - took decades to reach the market in Japan; yet activists say that Viagra - a drug treating erectile dysfunction - took only several months to be approved.


Dr Fassbender expects these experts to "turn the [abortion pill] application down."


COMMUNITY SOLUTIONS
In some extreme cases, Japanese women who were denied abortion access resorted to abandoning their newborns or even killing them. To prevent this from happening, two hospitals in Japan - in Hokkaido and Kumamoto - offer "baby hatches" where parents can leave their babies anonymously.


Dr Fassbender urged hospitals to increase the number of baby hatches for women and to boost accessibility, among other measures.


Aiming to offer free emergency pills to young women, an advocacy group called Sowledge has also started a crowdfunding platform earlier this year. The group also makes toilet papers printed with sex education information in order to bridge the sex-ed gap in schools. The campaigners said that sex education programmes tend to teach students only about sexual violence and neglect covering sexual intercourse.


Dr Fassbender said it is important to "[actively] involve young women in decisions that are about their bodies.


"That might be the biggest issue,” she said.


ARTICLE WRITTEN BY: Sasha Kong

ASAJ: Request for Abortion Pills of International Standard

On November 14, 2022, the Safe Abortion In-House Rally/Administrative Negotiation

This is my private translation.

Request for Abortion Pills of International Standard

On November 14, 2022, the Safe Abortion In-House Rally/Administrative Negotiations "Oral Abortion Pills Available under International Standards!" was held and the following written request was submitted to the Minister of Health, Labor and Welfare and the Minister of Justice.


November 14, 2022


Minister of Health, Labor and Welfare
Minister of Justice　


Written request for abortion pills of international standard



Today we gathered at the "Safe Abortion In-House Rally/Administrative Negotiations" (organized by #Action for Safer Abortion Japan) to demand oral abortion pills to be available under international standards. Regarding the oral abortion pills currently under review, we request the following five points


The safety and effectiveness of oral abortion pills are internationally recognized. Please approve it immediately.


Abortion pills should be accessible to anyone who needs them. Do not make it expensive. Do not require hospitalization.


Make evidence-based, current, and accurate information about abortion pills available to all.


Please initiate a review of the Criminal Code Abortion Offenses and the Maternal Body Protection Law.


Create a mechanism to reflect the voices of the people concerned and the public in the deliberation and decision-making process on related systems and measures.

All participants of 2022.11.14 Safe Abortion Household Meeting "International Standard for Oral Abortion Pills!"
#Action for Safer Abortion Japan(ASAJ)
safeabortion2020@gmail.com

First trimester abortion in Japan

Dr. Rowlands's articles on Japan

First trimester abortion in Japan
Authors
Sam Rowlands, Emeka Oloto
Publication date
2022/5/12
Journal: British Society of Abortion Care Providers
Issue: 12 May
Publisher: British Society of Abortion Care Providers
Description:
There are signs that mifepristone may be coming to Japan–after it became available in China and France in 1988. Mifepristone is now approved for use in early medical abortion in 82 countries (https://gynuity. org/resources/list-of-mifepristone-approvals). Based on more than thirty years of clinical study, the safety, effectiveness and acceptability of mifepristone and misoprostol used for early medical abortion is beyond any doubt. 1-3
Linepharma has applied for marketing approval for a combi-pack of mifepristone and misoprostol in Japan (https://exbulletin. com/world/1357452/). If approved, this would provide choice of a medical abortion for the more than 150,000 Japanese women who currently have surgical abortions each year. Acceptability and satisfaction with the abortion process is greatest when women can choose between methods and receive their preferred method. 4
Scholar articles
First trimester abortion in Japan
S Rowlands, E Oloto - British Society of Abortion Care Providers, 2022

Legalised non-consensual sterilisation–eugenics put into practice before 1945, and the aftermath. Part 1: USA, Japan, Canada and Mexico
Authors: Jean-Jacques Amy, Sam Rowlands
Publication date: 2018/3/4
Journal: The European Journal of Contraception & Reproductive Health Care
Volume: 23
Issue: 2
Pages: 121-129
Publisher: Taylor & Francis
Description:
In the late 19th century, eugenics, a pseudo-scientific doctrine based on an erroneous interpretation of the laws of heredity, swept across the industrialised world. Academics and other influential figures who promoted it convinced political stakeholders to enact laws authorising the sterilisation of people seen as ‘social misfits’. The earliest sterilisation Act was enforced in Indiana, in 1907; most states in the USA followed suit and so did several countries, with dissimilar political regimes. The end of the Second World War saw the suspension of Nazi legislation in Germany, including that regulating coerced sterilisation. The year 1945 should have been the endpoint of these inhuman practices but, in the early post-war period, the existing sterilisation Acts were suspended solely in Germany and Austria. Only much later did certain countries concerned – not Japan so far – officially acknowledge the human rights violations …
Total citations: Cited by 30

Message from the SRH/HRP Acting Director

22 June 2022 Departmental news Reading time: 3 min (840 words)

Message from the SRH/HRP Acting Director

Craig Lissner
Acting Director of Sexual and Reproductive Health and Research including UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction

Self-Care Month starts on 24 June, culminating with Self-Care Day on 24 July. This symbolic day, chosen because self-care can be practiced “24 hours a day/7 days a week”, is also a practical opportunity to reflect on a growing dimension of WHO’s pioneering work on health systems contribution for self-care interventions toward advancing primary health care (PHC) and realizing universal health coverage (UHC) for all.

WHO defines self-care as the ability of individuals, families and communities to promote health, prevent disease, maintain health, and to cope with illness and disability with or without the support of a health worker. This concept positions people as active agents in health management. Self-care interventions are the tools that support self-care.

Autonomy and empowerment through self-care
The autonomy and empowerment gained from self-care and the use and uptake of self-care interventions are crucial elements of sexual and reproductive health and rights (SRHR). Proven self-care interventions like self-administration of injectable contraception, pregnancy and HIV self-tests, self-sampling for HPV and other STIs, and self-monitoring of blood glucose or blood pressure are all known to help people reach their full health potential.

As health care challenges and solutions evolve, self-care interventions are some of the most promising new ways to improve the health and well-being of people everywhere, across many different areas of health. From health promotion, to disease prevention and control, self-medication and rehabilitation, the evidence shows self-care interventions save lives and enable people to take control of their health. This is exciting both for the people who make use of these interventions, and also for the health systems which make them available.

Self-care interventions are increasingly in the global spotlight, with the ongoing health, conflict, climate change and other humanitarian crises. During the COVID-19 pandemic, countries around the world were challenged to stop the spread of infection, while also reducing disruption to essential health services, and addressing broader implications of economic disruptions. At the same time, health systems were severely strained in an unprecedented way. As a result, countries have relied on laypersons, from community networks, peers, family, friends and neighbors to play an essential role in keeping themselves and one another healthy.

At its best, self-care interventions bring sexual and reproductive health (SRH) services closer to the people who need them and is the first line of defense in all health-related issues. Self-care interventions enable options and choice in the context of safe, supportive health systems. This is particularly useful in situations where stigma and discrimination create a barrier to access, especially in SRHR.

ThumbnailPromoting contraception choice for every individual
The importance of self-care, empowerment and choice in SRH comes out loud and clear in a new special supplement on WHO Values and Preferences in the journal, Contraception. Researchers reviewed the literature to find what people want when it comes to family planning. While there is great variation depending on geography and demographic, researchers also identified universal preferences for choice, safety and affordability.

Advocating for comprehensive sexuality education
Knowledge is power. This rings true in SRH, and yet this truth remains controversial in many contexts, at the detriment of young people and their communities. The evidence on how comprehensive sexuality education (CSE) is essential to autonomy and self-determination was a key focus at the Global Partnership Forum on CSE, where WHO colleagues joined experts and allies in support of widespread CSE as a proven way to appropriately develop the agency of young people for better health outcomes everywhere.

Access to abortion care

Choices and knowledge in sexual and reproductive health and human rights are essential, but are not guaranteed. This is where much work remains. Last month Dr. Zsuzsanna Jakab, Deputy Director-General WHO advocated strongly for choice through access to abortion care as health care. “Women should always have the right to choose when it comes to their bodies and their health,” she said, in a video recorded for the anniversary celebration of SheDecides. “While this is fundamental, women’s rights continue to come under threat.”

There is no UHC without SRHR
We are working to pave a clear path forward that clearly makes the linkages between SRH and UHC. In July, we will be launching new tools in the pursuit of achieving access to comprehensive SRH services within wider UHC-related reforms and through a primary health care approach. The tools include the “SRH UHC Handbook”, launching 12 July 2022 and the WHO, UNFPA and HRP Sexual and Reproductive Health and Universal Health Coverage Learning by Sharing Portal, launching 19 July 2022.

Universal access to SRH services, and the promotion and protection of human rights, dignity, and empowerment of all people, are globally-agreed commitments underlying UHC. We are looking forward to a month ahead focused on expanding our understanding of how listening, learning, and responding to each other – especially to the voices of those most left behind – can help us achieve our goal of SRHR for all.

The LDP Platform in Transition

A few things I noticed in the LDP's Declaration of Establishment and Platform.


There are three types of LDP platforms: the one at the time of the founding of the party, the one for the 50th year of the founding of the party, and the one for the 55th year of the founding of the party.


The first platform was adopted on November 15, 1955, when the party was founded.
The second platform was formulated on November 22, 2005, the 50th anniversary of the party's founding.
The third platform was issued on January 24, 2010, the 55th anniversary of the party's founding.


This alone raises the question of why the party rewrote its platform in just five years, when it had remained unchanged for 50 years since its founding.


Let's take a look at how things have changed.


First, let us look at the 1955 Platform of the Party.

Politics belongs to the people, that is, its mission and duty is to stabilize the people's livelihood and promote the public welfare within, to restore the authority of independence and self-reliance without, and to adjust and establish conditions for peace. In view of this mission and duty, we hereby form the Liberal Democratic Party, based on the principles of democratic politics, and pledge to fulfill this duty together with the masses of the people at large.

Ten years have already passed since the end of the World War, the world has undergone dramatic changes, and with the development of atomic science, a new page is being written every day in the history of mankind. Today's politics must make a creative effort to envision the world at least ten years from now, and must be brave enough to make the most of what is sound in the past and present institutional structures, to eliminate what is old and useless, and to correct social deficiencies.

The political philosophy of our party is, first and foremost, to follow the path of parliamentary democracy. Therefore, we shall reject all forces or ideas that use violence and destruction, revolution and dictatorship as their political tools. Second, we regard individual freedom and the dignity of the individual as the basic conditions for social order. Therefore, we oppose tyranny of power and classism.

We seek progress in order, refine our intellect, implement progressive policies, establish the institutions of a culturally democratic nation, and strive for the great task of rebuilding our country.

We declare to the above.

The phrases "democratic nation" and "democratic politics" are used twice each. The word "democracy," which is mentioned eight times in the First Platform, is found only twice in the second Platform (one of which is "true liberalism and democracy," which may be suspected to be of a different character), and none in the third Platform. Similarly, the word "welfare," which is mentioned 10 times in the Rissho Declaration and Platform (including twice as "public welfare"), does not appear at all in the New Platform or third Platform. The term "human rights," which is mentioned four times in the First Declaration, appears only once in the Second Platform and none in the Third Platform.


The following gender perspectives appeared once in the Second Platform, but five years later, in the Third Platform, there is not a trace of them. The Second Platform says:

A society where men and women support each other


We aim for a "society in which men and women support each other," in which women actively participate in all fields, and in which men and women share responsibilities while recognizing each other's characteristics.


The third platform says, "human rights" has been dropped in favor of "respecting individuals who are self-reliant and self-help, creating conditions for such self-reliance, and enhancing mechanisms for mutual and public assistance," thus stressing the stance of self-help most, mutual assistance less and public assistance least.


In other words, the second and third platforms seem to be shifting in a more neoliberal direction that does not protect the people with each new one.


Moreover, why change them after only five years, when the third plank states:"...

Based on the reflection of the defeat in the general election of 2009, under the banner of freedom and democracy that we have defended since our founding, we would like to make a fresh start with a political philosophy of Japanese conservatism that is uniquely Japanese, seeking progress within order and fulfilling our international responsibilities, while changing only what is inappropriate for the times and defending what should be maintained.

In other words, the defeat in the elections has further shifted them in the direction of "conservatism”. Perhaps this was the time when the influence of the Nippon Kaigi grew stronger.


The current LDP platform is here (Japanese).

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