Coronavirus disease 2019 (COVID-19) is thought to have emerged near the end of 2019. Although four years have passed since its emergence, COVID-19 is still spreading. The World Health Organization (WHO) has reported nearly 7 million deaths associated with COVID-19, but some estimates put the actual death toll at more than 21 million.

Humans have grappled with countless infectious disease threats throughout our history. It is no exaggeration to say that human history is a history of coexistence with infectious diseases. Yet, in modern times, the degree of damage due to infectious diseases varies significantly between regions. For instance, most deaths attributed to the “3 major infectious diseases,” tuberculosis, malaria, and HIV/AIDS, occur in low- and middle-income countries in Asia and Africa. Furthermore, in the 21st century, epidemics of emerging infectious diseases have been occurring one after another, mainly in Asia and Africa.

However, the COVID-19 pandemic followed a completely different pattern. Significant death tolls were seen in the US and high-income countries (HICs) in Europe which were previously thought to have conquered infectious diseases. Although the COVID-19 deaths have been calculated differently depending on the country and cannot be easily compared, as of early May 2023, the number of COVID-19 deaths in Japan was about 75 thousand, while that of the US exceeded 1.1 million. The UK reported over 220 thousand deaths. The number of deaths per capita in the US and the UK is approximately 5.5 times that of Japan. If Japan had the mortality as the US and UK, simple arithmetic will show that more than 400 thousand people in Japan would have died. Countries in the Asia Pacific, such as Singapore, South Korea, and New Zealand, also had fewer deaths per capita than the US and European HICs.

Various discussions regarding the differences in COVID-19 morbidity and mortality between Asia and developed Western countries have been held, but the exact cause of the differences is still unknown. It is likely that the differences are not only due to access to health care and recent experience of emerging infectious disease epidemics but also cultural backgrounds and people’s views of disease/life/death that have been cultivated over a long history of coexistence with infectious diseases. Post-COVID-19 global pandemic response frameworks are currently being discussed. However, it is inadequate that Western countries, who suffered greatly from COVID-19, are leading such discussions without adequately reviewing their responses to COVID-19.

In fall 2020, Tohoku University established the “System Design of Inclusive Society with Infectious Disease (SDGS-ID),” which leads interdisciplinary research on infectious diseases. In January 2023, we launched “A Workshop on Exploring Current and Post COVID-19 Societies‘’ which brought together researchers in the natural sciences, medicine, and the humanities/social sciences. These groups discussed why the COVID-19 responses between Asian and Western countries were different. They also discussed future issues of global health governance.

In line with Tohoku University’s goal of creating a sustainable society by linking comprehensive knowledge to action, an initiative called SOKAP (Sustainability Open-Knowledge-Action Program) was launched. As part of SOKAP, we started a research program called SOKAP-Connect, which is based on the SDGS-ID. Through SOKAP-Connect we have begun a project entitled "Tohoku University Interdisciplinary Collaboration for Global Preparedness and Local Resilience to Next Pandemics (SOKAP-TUPReP).”

In this project, we will discuss (1) historical background, (2) cultural background of infectious diseases (including views on disease/life/death), (3) social disparities, and (4) global health governance with researchers from the natural sciences and the humanities/social sciences. Our goal is for researchers from around the world to work together to deepen discussions on various social issues that have emerged from the COVID-19 pandemic and compile them into international recommendations.