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Another lesson from the Japan Medical Association
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     EDITOR—Kondo describes one aspect of the Japan Medical Association in its relationship with Japanese politics, emphasising the importance of transforming itself from a lobby group to an academically grounded professional association.1

    His editorial did not mention the association's international efforts. Since 1984 it has tried to improve the quality of health professionals in the world through the Takemi programme at the Department of Population and International Health at Harvard School of Public Health. It also initiated an international health project in rural Nepal to narrow the gap between the urban rich and the rural poor from 1992 to 2005. I was director of this school and community health from 1996 to 2001 and learnt how communities could improve health systems in rural Nepal.2

    As a result of the project's activities in rural Nepal, King Birendra awarded a medal to Eitaka Tsuboi, then president of the Japan Medical Association, in 2000. The Nepalese ministry of health has tried to institutionalise school health in Nepal since then; the current national school health policy is supported by the Japan Medical Association in cooperation with other international agencies such as Save the Children.

    Among the world medical associations, only the Japan Medical Association has directly implemented international health activities in developing countries for more than a decade. This is something it can teach other medical associations, although it is ending its innovative work in developing countries this year and consigning it to history.

    Masamine Jimba, assistant professor

    Department of International Community Health, University of Tokyo, Tokyo 113-0033, Japan mjimba@m.u-tokyo.ac.jp

    Competing interests: MJ was a director of the Japan Medical Association's Nepal project from 1996 to 2001.

    References

    Kondo J. The iron triangle of Japan's health care. BMJ 2005;330: 55-6. (8 January.)

    Jimba M, Wakai S. Learning from low income countries: what are the lessons? BMJ 2004;329: 1183. (9 November.)