 Hello and welcome. My name is Jim Frederick. I'm the editor of Time International and thank you so much to all of you for being here. My esteemed guest is Yasechika Hasagawa, who is the president and CEO of Takeda Pharmaceutical. Welcome. Thank you very much for joining us. You're welcome. Thank you and good morning everybody. Today we will be concentrating on, as I said, one of the world's most pressing problems, which is the challenge of designing sustainable health systems for rapidly aging populations. What about that issue is top of mind to you and why has it become such an area of concern? Yeah, because, you know, a population related to the transformation is taking place in two fronts. In my opinion, one is the aging, but the other one is the growth of the population. If you take a look back the, you know, while the population growth in the last 80 years starting from 1950, we have only 2.5 billion populations back in 1950. But now in today, 2011, we have 7 billion already. And 2050, 100 years from 1950, we're gonna have 8.9 billion population, which is more than triple of the back in 1950. So very rapid growth of the population on a global basis, but at the same time since late 1990s and beyond, population, particularly in matured countries, are aging. So we are facing two problems simultaneously. That's why I am very much concerned about the way population is going because, as you may know, well aware, population projection is one of the most reliable prediction in the statistics. And the United Nations or World Bank also issued their prediction and also in the, for example, the United Nations called for the General Assembly to talk about the population growth and the aging population. And back in the 1990s, World Bank issued the same similar aging crisis type report. But because this is not so visible, so people, majority of the people, don't pay much attention. What about the disparity in the developed world versus the developing world? I'm glad you asked that question. In the matured, developed world, as I said, population growth is almost now plateauing. But at the same time, aging is progressing. So we are having a very difficult problem. If you look back, you know, many matured countries, developed countries, economic growth, when economy was rapidly growing, population was growing as well. So this population growth and economic growth come hands in hand together in most of the countries. But those days are over for matured and the developed countries. Still, we are, you know, nation leaders are talking about bringing their economy back to the growth trajectory. But it's going to be very, very difficult facing this situation alone. But on the other hand, developing countries or emerging countries, population rapidly, still rapidly growing. So they get a quote unquote, population bonus, accelerated economic growth. But once the population starts declining, we call this a population onus instead of bonus. So developed countries are already entering into the population bonus situation. So it becomes more and more difficult to bring this economy growth back to the growth trajectory. While emerging countries are represented by Russia, China, Brazil, they are enjoying the population growth along with the economic growth. They are getting the tailwind as a population bonus. That is the current situation. It would seem like there's funding problems on both sides. Developing countries which have a lot of people and comparatively not as much money. There's just not as many dollars per citizen for healthcare, regardless of the age. I think in the developed world, you know, I think it's particularly chronic in Japan, parts of Europe, where the welfare state is installed to varying degrees. How are these people going to be cared for? How does the funding work? Is there going to be enough money? Are the welfare states going to run out of money when more and more senior citizens need to be cared for in a more serious manner? You don't need to be a rocket science to solve this issue. It's easy, conceptually, logically, but implementation is a big problem. Because when you face declining population and the aging population like country like Japan, while you see population growth in neighborhood countries, just accept immigrants from those countries, that's a win-win situation. That's going to contribute to the economic growth of any given countries in the Asian community and also help Japan to grow the economy. So that should be very logical consequences. But because of the some difference in culture or mentality or resistance from the people, none of the countries have done this well enough with a few exceptions. But there are a few exceptions. Many countries are not doing this. And without knowing what's going to happen, very, very devastating to this situation is happening just like countries like China because of the one-child policy. Their family is going to be a four to one type family, four grandparents, two parents, one child. Can you sustain the social welfare system or social security system with this kind of family structure? No way. Well, if I can ask a follow-up then. I mean, we've already identified immigration as one possible route to doing so. And you've already indicated that in some countries, Japan, China, and other countries like that, that the immigration issue is, in terms of public debate, is really... Very sensitive. It's just not on the table for the foreseeable future. So what other insights have you developed in trying to solve the problem beyond immigration? Are there other ways? The country like Japan, who is not willing to open up the floodgate to the immigration immigrants, there is not much other alternative. But they have to be prepared to raise the tax, to manage the ever-increasing social welfare and social security costs. And by doing so, the problem is shifting the money from less income young people to the higher income elderly people. Normally, logically, that should be the other way around. But because of this situation, that's a reality in Japan. And the current administration is trying to fix that, but not only Japan, but any country. If the politician tried to raise the tax, nobody supported. So that's currently very, very much a predicament we are facing in Japan. But we have no choice but raising the tax. Okay, so we've now talked about three major ideas for supporting the increased healthcare costs. Immigration, taxation, and perhaps on a limited basis, actually kick-starting certain countries' birth rates. The other thing we can do is facing that kind of situation, that this is not also well, this countermeasure is not so popular either. People don't appreciate it, you know, extend their retirement age. In Japan, current mandatory retirement age is 60, but now it is going to extend to 65 on a stepwise manner. But people live much longer. Countries like Japan, people are living 86 to 88 on average. So if you consider retiring at the age of 60, people have 25, 28 years' life post-retirement. How come you can support those people with money they contributed while they are working on average maybe 40 years? But they are living 25 post-retirement years. Their contribution is not good enough. That's why, and still, Japan is relying on pay-as-you-go system, not full funded system. So young people's contribution is now shifting to the retired elderly people in Japan. This is not sustainable. If I could turn the conversation a little bit, we've just talked about four big and broad ideas about how to support a system on the funding level. Have you had any thoughts or insights or real change factor concepts on radical cuts and costs? Is there a way to bring health care costs down dramatically? That's inevitable. Let me talk about the Japan situation. Current pensioners, if he or she lives an average lifespan of 85 to 88, those people get 25 million U.S. dollar equivalent, more money than they contributed. But 25 million Japanese yen, not U.S. dollar, Japanese yen. But if you calculate that with people in teenage soon to start working and pay contribution monthly, they're going to get 25 million yen less than they contributed based on the current system. So this system is broken completely already and shifting the money from young and low income people to the high income elderly people, that's not fair and that's not sustainable. So we have to change. So there are several ways to fix this, but one thing for sure we need to do is cut back the existing pensioners pension, which is very, very painful and very unpopular, just like you said, those people are very, very passionate voters and the politicians are so much afraid of making them angry. So every time this subject comes up, they start talking about that, but sooner or later it just dies. It's amazing how fast a half an hour goes, we only have about five more minutes. So if I could, the final major question is with all of these insights that you've accumulated, do you have thoughts on new conceptual models or paths forward or an overarching message or theme or model that you think might be the way forward? Developing countries and the developing countries have to help one another by sharing not only their wealth but also technologies and ideas and also accepting immigration, immigrant. Beauty of accepting their students is if they come to their advanced countries and finish study or college or graduate school, maybe some of them may stay in the country where they studied. And even if they go back to their own mother country, they can fully utilize what they have done to rebuild or take off, help taking off the economic of that mother country. So it works in both ways. We have to start acting on this now. That's a message I'd like to get across today. Okay, call to action. Well, I hope the audience has enjoyed this conversation as much as I have. Mr. Hasagawa, thank you very much for joining us here today. And thank you to the audience as well. My pleasure, sir. Thank you very much. Thank you.