照会先：保健医療局結核感染症課 担 当：野村（内線2373）、勝又（内線2378） 直 通：03(3595)2257
There was a time in Japan when tuberculosis was referred to as the "national disease." That has changed dramatically, thanks to higher standards of living, medical and pharmaceu-tical advances, and the selfless efforts of those who long fought this dreaded disease. This success, however, has eng-endered the illusion that tuberculosis has been conquered forever and is now a disease mentioned only in history books.This false sense of security is, unfortunately, common not only in the general public, but also among members of the medical community and government officials.
Tuberculosis is by no means a disease of the past. In 1993,the World Health Organization declared a state of emergency with regard to tuberculosis and advised its member countriesto step up their efforts to treat and counter the spread of this contagion. In Japan, approximately 42,000 new cases were reported in 1997 alone.
In the same year, some 2,700 people lost their lives to thisdisease, making tuberculosis Japan's deadliest contagious disease.
Moreover, in recent years, Japan has come to face a wide range of serious problems pertaining to tuberculosis and calling for immediate action. These include the emergence of strains resistant to multiple drugs, the increasing fre-quency of group infections in schools,medical facilities,andfacilities for the elderly, the growing incidence of tuber-culosis among the elderly, and the presence of tubercular patients among foreign residents of Japan. It has now becomeapparent that, after many years of steady decline,the numberof new cases reported in 1997 marked the first increase in 38 years, while the morbidity rate increased for the first time in 43 years. There is a clear danger that these figureswill continue to move upward in the years ahead.
Conditions in Japan now indicate that the nation is at a critical turning point in its fight against tuberculosis, a turning point that may lead to its re-emergence as a nati-onal epidemic involving a vast increase in the number of patients infected by multiple-drug-resistant strains. This calls for a new awareness among each and every member of thepublic, including members of the health professions and government officials. We must not allow ourselves to be lulled into believing that tuberculosis is a disease of the past:rather, we must fight it,in the knowledge that it posesa serious threat to the health of the entire country.Failureto do so will certainly sow the seeds of future disaster.
For these reasons, the Ministry of Health and Welfare is he-reby declaring a state of emergency concerning tuberculosis.Henceforth, the Ministry shall work together with other re-lated ministries and government agencies, as well as with local governments and related organizations, to educate the public about the dangers of tuberculosis as a re-emergent epidemic, to implement countermeasures, such as medical examinations, provided for under the Tuberculosis PreventionLaw, and to actively conduct surveys of the occurrence of tuberculosis and promote special anti-tuberculosis programs.
Furthermore, we shall establish and expand a specialized medical care system to combat tuberculosis,endowing nationalsanatoriums with research center facilities to develop methods to fight multiple-drug-resistant tuberculosis and address related problems.
We call now on the general public and various private orga-nizations to join the fight against tuberculosis by instill-ing a new awareness of the dangers posed by this disease andby undertaking to promote the following types of actions.
1. We call on local governments to strengthen and upgrade the anti-tubercular capabilities of public health centers intheir respective districts,which represent the front line inour defenses against tuberculosis. Local governments are requested to take prompt and appropriate action from the standpoint of crisis management,including by conducting tho-rough medical examinations whenever a case of tuberculosis is reported.
2. We call on medical associations and hospital organiza- tions to direct their members to re-confirm their familiari-ty and basic knowledge of tuberculosis, to improve their diagnostic skills and technologies,to promote the preventionof intramural tubercular infections,and to provide informat-ion regarding appropriate responses when tubercular patientsare identified.
3. We call on organizations of facilities for the elderly and other types of institutions to direct their members to prevent the intramural transmission of tubercular infections,to provide information regarding appropriate responses when a tuberculosis patient is identified,and to conduct thoroughmedical examinations regularly and whenever necessary.
4. We call on research institutions and scientific associa-tions in fields related to tuberculosis to further promote research and training in its diagnosis and treatment.
5. We call on organizations directly involved in the fight against tuberculosis to redouble their efforts to combat tuberculosis, such as by disseminating correct information and knowledge more widely and frequently.
6. We call on each and every member of the public to informthemselves properly about tuberculosis. Furthermore,we stro-ngly urge the public to work to prevent the spread of tuber-culosis by undergoing regular medical examinations at every opportunity. Persistent coughs should not be regarded as merely a cold symptom: they should be examined by a doctor.
Japan must not return to the age when tuberculosis was the "national disease." To protect the health of the nation fromthe threat of tuberculosis, a new awareness of this threat must be developed in the Ministry of Health and Welfare, as well as among all related ministries and government agencies,local governments, related organizations, and each and everyindividual. All the forces of the nation must be united, based on this awareness, in the fight against tuberculosis. With the cooperation of all members of society, I firmly believe that we will prevail in this fight and ultimately overcome this disease.
In closing, I once again ask for your understanding and cooperation in this vital endeavor.
July 26, 1999
Minister of Health and Welfare
This is an English translation of declaration originally produced in Japanese. We did our utmost to ensure accuracy in our translation and believe it to be of the highest standard. However, in case of any discrepancies between the Japanese and English versions, the former should prevail as the official version.
Infectious Control Division