Blog Post | Japan’s Doux Smart Power Diplomacy and the Future of Health Security in the Indo-Pacific
While the U.S. reconsiders its global commitments, Japan remains a stable partner, having cultivated the roots of its bilateral partnerships in the Indo-Pacific region and expanded its commitment to global health.
Roots, not Boots
In a world increasingly shaped by pandemics, climate change, and shifting geopolitical loyalties, Japan is showcasing a new foreign policy vision for health aid. Eschewing hard power military postering (e.g. boots on the ground), it leans into care, collaboration, and quiet innovation. Enter what I call doux smart power diplomacy or DSPD. An approach uniquely Japanese, DSPD fuses the doux, “gentle commerce” spirit of mutual economic benefit with a smarter, strategic application of soft power. Neither coercive nor news headline grabbing, DSPD is nevertheless impactful. Think roots, not boots.
Japan’s health diplomacy, while strategic, is neither narrow nationalism nor naïve altruism. DSPD occupies an intermediate space where diplomacy advances both national human security interests and collective good. By addressing regional health security, Japan enhances its standing as a reliable partner while avoiding appearing entirely self-serving.
DSPD represents a subtle yet strategic form of diplomacy that distinguishes itself from traditional hard power (coercion), soft power (attraction) and smart power (which traditionally combines elements of both). Indeed, Japan’s DSPD emphasizes partnerships rooted in mutual benefit and collective well-being without explicit economic or overt military threats. Grounded historically in Japan’s post-war Peace Constitution, this approach builds upon its track record in successful cultural diplomacy (such as "cherry tree diplomacy") and humanitarian cooperation, enabling Japan to navigate its liminal position between East and West, strategically yet in a gentle manner.
The liminal space that Japan occupies between East and West has widened. Surely, if Japan’s foreign aid used to be tied tightly to the U.S. alliance, this is changing rapidly. Meanwhile, Japan has stayed the course in Asia in particular through its health diplomacy—a strategic, socially entrepreneurial blend of public-private collaboration that has helped to improve health infrastructure and overall health outcomes in developing countries. From maternal care and building hospitals in Southeast Asia to diagnostics for neglected tropical diseases (NTDs) in Pacific island nations, Japan remains committed to its health aid, especially in Asia, balancing the void left by the United States’ departure. Goodwill, yes, but with strategic intent—and often, without the U.S. as partner, or recently, at all.
Doux Smart Power Diplomacy: What is it and How Does it Work?
What Makes DSPD “Doux”? Here are its core components:
- Doux means gentle, not weak.
- Smart means innovative, not manipulative.
- Power here derives from influence, not imposition.
- Diplomacy happens through care, not commands.
Japan’s DSPD doesn’t compete through loud posturing or hard power intimidation, instead quietly pursuing long-term, mutually beneficial ties—especially through its health aid and health infrastructure investments abroad, cultivating roots in the ground in target countries, for health system and local economic development. Further, Japan has excelled at the use of public private partnerships or “PPPs”. PPPs involve government and non-governmental organizations including companies and foundations who come together collaboratively in pursuing shared solutions to common problems that transcend national boundaries. Successful PPPs draw from complementarities in expertise and capacity between government and private sector actors, while spreading risk and cost-sharing across project participants. Likewise, economic benefits accrue to both domestic Japanese and international partners, for example, in creating business opportunities for social entrepreneurial ventures. The following Japan-led case studies offer potential best-practices in PPP centered doux smart power diplomacy in health:
- AHWIN – Asia Health and Well-Being Initiative
Japan has an ageing population. Other Asian countries are ageing quickly. AHWIN takes lessons from Japan’s “super-aged society” and longstanding universal health coverage (UHC) and shares them regionally, training caregivers, offering such technology as QR code nail stickers helping elderly to age-in-place, and building eldercare infrastructure. India and Vietnam were the first to have signed MOUs with Japan. Private firms are also involved, meaning that healthy aging becomes both a regional health challenge but also a mutually beneficial market opportunity.
- GHIT – Global Health Innovative Technology Fund
GHIT fills a market failure: vaccines and treatments for tropical diseases rarely generate significant profits for drug makers, so pharmaceutical companies usually avoid them. Japan has stepped in—with its foreign and health ministries, drug companies, and via partnering with global foundations—pooling resources to fund life-saving diagnostics and treatments. GHIT’s projects target malaria, TB, dengue fever, and others in its growing portfolio. Its international board is independent. Its science is proven. As such, Japan gains trust through doing good—while at the same doing well for its funders and socially entrepreneurial public and private sector investors.
- MEX – Medical Excellence Initiative
Japan’s domestic medical technology capacity is strong in imaging and devices. Other countries excel in digital health and AI. MEX creates hubs—like Medical Excellence Vietnam, “MEV” in Vietnam—for healthcare entrepreneurs to co-develop solutions. This model helps countries that have become too economically developed for aid (thus “graduating” out of aid eligibility), but not yet reaching the level of advanced innovation economies. It is a win-win: Japan expands its diplomatic influence and strengthens bilateral state-to-state ties; partners gain access to expertise and support. That is the doux smart power approach offered by Japan.
Why It Matters Now
Japan’s DSPD doesn’t rely on big budgets or military presence. It leverages what Japan has: credibility through delivering on promises, innovation, and a record of doing more-with-less. Critics might say it’s still strategic. It is strategic. But strategy doesn’t have to be cynical. Japan’s approach shows how diplomacy can be designed for collective human security, beyond narrow national interest.
A Model for the Future?
Could DSPD work in other domains—environmental challenges, food-scarcity, educational disparities? Possibly. The potential lies in the three pillars of doux smart power diplomacy:
- Combining public goals with private know-how through public-private partnerships (PPPs), leading to innovative outcomes.
- Introducing entrepreneurial cost-effective solutions to shared problems.
- Building trust over time, not through threat, but through cultivating long-term roots in the ground in countries around the world.
This is not about replacing the United States or outmaneuvering China. To be sure, Japan and other countries have an opportunity to increase their influence in countries worldwide.That being said, it is about carving out a third way—a diplomatic model that’s both principled and practical. DSPD cultivates roots in the region—trusted healthcare networks, resilient health infrastructure, healthier communities. It is not merely smart diplomacy or power projection. It is doux smart power diplomacy. In a world full of distractions of news headline grabbing politics and narrow aims for short-term wins, Japan might be paving the way for the smartest power of all: one that leads to true collective human security.
Kathryn Ibata-Arens, PhD, is a Japan Foundation Indo-Pacific Fellow, Ritsumeikan University, Kyoto, and Endowed Professor of Environmental Diplomacy at the Grace School of Applied Diplomacy, DePaul University. Her current research focuses on science and technology policy innovation, social entrepreneurship, and access to essential medicines in Asia.