ABSTRACT
Recent studies reveal that Sub-Saharan African (SSA) countries are now experiencing rapid scaling up of health services and improvement of health status. It is reported that services related to HIV/AIDS, tuberculosis and malaria are rapidly expanding especially after 2005. According to the latest household surveys (such as Demographic and Health Surveys and Malaria Indicator Surveys) conducted after 2000, annual rate of reduction in under five mortality rate of 5% or more is observed in more than 10 countries. This revolutionary change in SSA was triggered at least partly by development assistance for health (DAH), which increased 5 folds after 2000. On the other hand, DAH to SSA by the Japanese government (bilateral basis only and excluding contributions to multi-lateral organizations and global health partnerships such as GFATM) represents merely 1% of the total, which is equivalent to $0.1 per person living in Africa. The impact, therefore, may be limited. Increase in quantity of DAH including partial support for recurrent expenditures, contribution to rule making and monitoring of DAH use within the partner coordination framework, better targeting on selected number of countries, focus on health systems strengthening, and scientific and multi-sectoral analysis of success factors of high-performing countries, are recommended as future directions of Japanese DAH to SSA.