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| In Africa and other countries with poor health infrastructure and non-existent state welfare support, the burn of care is undertaken by the family. Evidence from Africa and Asia, including a recent WHO study in Zimbabwe, concluded that this burden is borne primarily by older women. They are providing this care under extreme conditions of poverty, stigma and lack of support. In his view in coping with the issues of aging, Dr. Chow summarized an important concept and action which are cited below: "FRAMEWORK FOR COLLECTIVE ACTION": There are (3) major pillars which are regarded as the basis for forming collective action; First pillar is PUBLIC HEALTH STRATEGIES, the sub-sections of which are (1) prevention which include specifically osteoporosis, (2) treatment, and (3) care which is further subdivided as (a) Acute, (b) chronic, (c) palliative, and (d) supportive. (4) is R&D which is new drugs and diagnostics? (5) is S&T, which include innovation linking to the enhancement of R&D. (6) is education and training of national work forces aiming at enhancement of health work process. (7) is surveillance and epidemiology which are for better detect and analyze dist of disease and health status of elderly. (8) is infrastructure which is for hospice and clinics as well as community care facilities? Second pillar is MOBILIZING CIVIL SOCIETY which is subdivided into (1) building alliances, coalitions and partnership. (2) is strategic & operational synergies mutual reinforcement. (3) both public/ private and NGO sectors such as NAPCA who is one of the main sponsors of this symposium. Third pillar is Supporting Political Leadership which includes (1) national community levels,(2) make case for continued sustained investment; health & social wellbeing of the elderly and (3) is assertive & appreciative citizenry who can reinforce the need for continued investment. Commenting on the importance of the role that foundation of resource mobilization is very critical for the success of coping the issues of aging and its relevant matters, Dr.Chow cited that financial support either on the bilateral relationship between Japan and the United States or multiple relationship involving developed and developing nations. He stated that the mobilization of expertise is another aspect of importance which requires for the enhancement of science & medicine and social / behavioral. Ambassador Chow introduced importance of (3) major concepts and actions which will advance and enhance to deal with the pressing issues facing the increasing population of aging. He named it as "3C" which is the key to the success of mobilization of the required resources to its maximum effectiveness. They are (a) communicate, (b) collaborate and (c) cooperate. The next is for "3P", which stands for (a) people, (b) programs - process and (c) product - outcomes. Lastly, "3D" which is (a) quantity(more), (b) quality (better) and (c) Intensity (now). Ambassador Chow concluded his opening remarks by saying that this type of symposium is so important to have shared concerns and knowledge on the issue of aging facing both Japan and the United States and implementation of measures to lead the aging period of the elderly to enable more independent and meaningful. He said that WHO continues to play an important role not only for the sake of health of human being in the world but also the emerging issues such as the issues of aging. He cited that WHO appreciates greatly for invaluable assistances and supports being extended by Japan financially and human resource way and emphasized that each nation should continue to support for the activities that WHO has been carrying out for the past years and the years ahead.Following the opening remarks by Ms. Watanabe, Mrs Wissel and Ambassador Chow, the floor was open for other delegates to make their views, opinions and remarks. President Igata, MD, Dr. Mokuno and Mr. Fong relating to some of the issues as referred to by the above cited delegates who made their opening remarks. Each delegates also focused on some of the pressing issues on the aging and the relative policy and systems which are in place and for the future both in Japan and the United States.
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