Expo Connections

From 1970 to 2025, Osaka has played host to chamber member company opportunities and innovations.

Japan has been chosen three times as the site of the world’s fair. The first was in 1940, when Tokyo was to host an event that would have commemorated the 2,600th anniversary of the country’s founding. The onset of World War II put an end to that plan. But two other times—in 1970 and this year—the global celebration has come to Osaka, putting Japan in the spotlight. Both celebrations of global unity and culture presented opportunities for members of the American Chamber of Commerce in Japan (ACCJ). The ACCJ Journal spoke with two Corporate Sustaining Member companies about those experiences. 

Expo ’70: Aflac

Aflac celebrated its 50th anniversary in Japan last year, and is today the country’s leading provider of cancer and medical insurance in terms of policies in force. The company’s entry in the market was inspired by a visit to the very event Osaka is hosting this year: a world’s fair.

John Amos, Aflac’s first chief executive officer and one of three brothers who founded the company, observed Japanese people wearing surgical masks during his trip to Expo ’70. He figured that people who were that keen on preventing the spread of colds and the flu must be health conscious and would understand the need for cancer insurance, Aflac’s core product. He was right.

Principal founder John Amos (center) watches Deputy Prime Minister Takeo Fukuda perform the traditional kagami-biraki sake barrel-breaking at Aflac’s grand opening party in 1974.

For the Columbus, Georgia-based company to bring that protection to the people of Japan took some effort. Cancer insurance was unprecedented at the time and required approval from several government ministries and agencies. There were no nationwide statistics on cancer hospitalizations, so the Aflac team had to gather the data from scratch. It took four years, but in October 1974, Aflac obtained its license, and the next month launched Japan’s first cancer insurance product. Sales took off right away.

Today, Aflac Japan has 4,874 full-time employees, and its products are sold by approximately 6,600 sales agencies and some 114,000 licensed associates employed by those agencies. More than 20,000 Japanese post offices and 360 banks—nearly 90 percent of all banks in Japan—serve as points of sale for Aflac.

“Localization has been an important factor in our success,” notes Andrew J. Conrad, senior vice president, general counsel, and compliance officer for Aflac Life Insurance Japan Ltd. “For example, back when Aflac first started selling cancer insurance in Japan, doctors and families typically hid cancer diagnoses from patients. They believed that knowing the diagnosis would be too stressful and hinder the patient’s recovery. Accordingly, in those early days, Aflac had to devise ways to pay claims without letting the patient know. This included sending documents in plain white envelopes, sending documents to family members at predetermined addresses, and making calls outside the home.”

Another way in which Aflac adapted to the local culture was to give its trademark duck—celebrating its 25th birthday this year—a softer, quieter character. It’s more consensus-minded than its US counterpart. In fact, for a time, there was a Maneki Neko Duck—the Aflac Duck dressed as a traditional beckoning cat good-luck charm.

In addition to insurance, Aflac focuses on two other areas in Japan: childhood cancer and youth scholarships. Three Aflac Parents Houses—two in Tokyo and one in Osaka—serve as comprehensive support centers for children with cancer, or other serious diseases, and their families. They provide accommodations for children undergoing treatment at hospitals away from home. Families can stay for ¥1,000 per night per person, with no charge for the affected children. More than 150,000 people, including those from overseas, have stayed at an Aflac Parents House. And through its scholarship fund, Aflac has helped more than 3,600 high school students who have had childhood cancer or lost a parent to cancer.

Aflac is looking ahead to the next 10 years and beyond with a new long-term management vision called “By Creating ‘Living in Your Own Way, Create New Shared Value,’” explains Conrad, who also serves as senior vice president of Aflac International, Inc. and is an ACCJ governor. “This vision highlights Aflac’s practice of using the company’s unique knowledge and resources to address societal issues in a manner that meets customer needs and creates economic value over the long-term.”

Japanese society has benefited greatly from Aflac’s dedication to helping others, and it all started among the pavilions of the Osaka expo.

Expo 2025 Osaka, Kansai: IBM

Another ACCJ Corporate Sustaining Member is making a societal difference at this year’s expo. IBM Japan, Ltd. is giving guests the opportunity to try its AI Suitcase, a luggage-shaped robot that guides people with visual impairments to their destinations.

IBM Japan is working as a member of the Consortium for Advanced Assistive Mobility Platform, commonly known as the AI Suitcase Consortium, which leads the development as well as the demonstration at the expo. AI Suitcases are being used in the Smart Mobility Expo Robot Experience of the Future Society Showcase Project.

Enabled by artificial intelligence (AI), various sensors, and human–machine interfaces, the device autonomously navigates a user from point A to point B based on what the user asks for through voice interaction. The device is equipped with three cameras—positioned on the left, front, and right—which enable it to see the surroundings and describe them through audio, including how many people are nearby and what objects or structures are around.

The device’s capabilities have evolved significantly since its development began in late 2017. Until around 2023, AI Suitcase mainly used deep learning technology for image recognition of surrounding pedestrians. But the consortium began incorporating AI in 2024 as the technology rapidly advanced. AI has enabled new features, such as flexible voice-based interaction and detailed audio descriptions of the surrounding environment.

“The AI Suitcase project is a cornerstone of our work in the accessibility research domain,” explains Hironobu Takagi, senior manager of the accessibility research team at IBM Research in Tokyo. “Chieko Asakawa, IBM fellow and chief executive director of Miraikan, has defined this grand challenge as ‘real-world accessibility,’ which combines AI, software, computer–human interaction, robot operation, and human social behaviors.”

Miraikan is the commonly used name for the National Museum of Emerging Science and Innovation, located in Odaiba. The popular innovation hub has been offering daily demonstrations of AI Suitcase since April 2024.

Takagi, who has been a researcher with IBM since 1999, says that, working with key partners, the company is successfully showcasing “tech for good” not only to Japanese society but the whole world through Expo 2025.

“Our experience at Miraikan has given us great confidence in the practicality of AI Suitcase,” he noted. “The know-how we developed at Miraikan, such as how to safely operate the AI Suitcase on a daily basis and how to explain its use briefly, has proved highly valuable, especially at Expo 2025.”

As of May 1, more than 216 groups had already participated in AI Suitcase since the opening of Expo 2025 on April 13, with 200 more reservations already booked for the first two weeks of May. Participants commented on how surprised they were that the robot had guided them safely, and said they hoped many people would experience this technology, because it is useful for society. One visually impaired person also commented that it was the best highlight of the Expo.

Still, this is one of many test runs for the life-changing technology. “Given that the current version of AI Suitcase is still a research prototype, very expensive to build, and operable only in limited environments, we have many hurdles to overcome—technically, socially, and legally—before it can be deployed in the real world,” admits Takagi. “But to make technologies like AI Suitcase truly practical, it is essential to offer members of the general public hands-on experiences and to broaden society’s understanding. If you have a chance to visit Osaka or Tokyo, we invite you to try AI Suitcase at the expo or Miraikan.”

Driven by Innovation

Lilly Japan’s Simone Thomsen reflects on six years of leading with purpose and ACCJ collaboration.

When Simone Thomsen arrived in Kobe in 2019 to guide Eli Lilly Japan K.K. as president, she fulfilled one of her longtime career goals. Over the past six years, she has been a critical player in the mission of the American Chamber of Commerce in Japan (ACCJ), serving on the Board of Governors, helping launch the Healthcare x Digital (HxD) initiative, and mentoring young professionals. The ACCJ Journal talked to the 23-year Lilly veteran about her experiences in Japan, the value that ACCJ programs provide, and the mission of the President’s Circle company.

Has leading Lilly Japan been what you expected?
It’s been an amazing journey. The number of medical innovations we have brought to Japanese patients is really impressive. I always knew we had a very strong pipeline, but working with the team here has been impressive for me.

Between 2020 and 2024, we launched 11 new products and received 15 new indications for diabetes, oncology, immunology, Alzheimer's disease, and migraine.

Dealing with three years of Covid-19 was not in my plan, but it was important and interesting.

In January 2023, I became the first female chair of the Japan-Based Executive Committee (JBEC) of the Pharmaceutical Research and Manufacturers of America (PhRMA). That was a new experience for me. There’s a lot going on in the healthcare system and policy, which I have worked on with the PhRMA president, JBEC, and other companies.

Did I envision all that in 2019? No. Looking back at that time, I’m proud of what we have done to support Japanese patients, and how we operate at Lilly Japan as a well-developed organization. The company has grown and matured since then. Our colleagues in Japan would say they’re working for a much better organization today compared with six years ago.

How has the pharmaceutical market changed?
In 2019, Japan was the number two pharmaceutical market globally. Now it ranks sixth. One reason for this shift could be the result of the Japanese government policy decisions in recent years. In the past, the pharmaceutical industry in Japan was viewed as a key growth sector. We are ready to partner with policymakers to try to revitalize the industry while also addressing the challenges brought by a super-aging population.

In the decade since 2016, I have seen many negative ad hoc pricing reforms. I believe there have been
approximately 60 such changes.

We’ve also seen the move from biennial to annual price revisions. What that has done to the industry basically is to accelerate the decline of biopharmaceutical innovation in Japan. Globally, our industry has never been more productive. Every year, we’re investing ¥37 trillion just in R&D. Growth over the past couple of years has been around 99 percent. But in Japan, it has remained relatively stable, having grown only six percent. So, in the area of R&D investment, the gap between what is happening globally and in Japan is pretty striking. And it continues to grow.

Currently, 70 percent of global phase-three trials for any type of medicine are not conducted in Japan. That’s an issue for Japanese patients, because innovative medicines are coming to Japan much later. At a time when you have a super-aging population, you really want to have innovation coming to help you deal with the challenges.

As pharma and as Lilly, of course, we are heavily invested; we want to bring back investment. That’s why, as Lilly Japan and as the JBEC chair, we are in conversation to help the government understand that they need to make positive, bolder reforms.

How has the HxD initiative tied into your goals?
At Lilly, we believe that we can find synergy among medicine, science, and technology. It helps us to serve patients better, to create more engagement and better outcomes. So, we have always been looking at new technology and how it can help us. That’s why HxD was perfect for us and we became one of the founding companies in 2020, along with AstraZeneca and Bayer.

For example, we are focusing on how artificial intelligence (AI) and machine learning can be used to quickly screen millions of molecule options to select the best candidates, allowing us then to accelerate clinical development.

During the pandemic, using these digital technologies allowed us basically to keep all of our clinical development programs going, despite the restrictions. I think that showed us what it could look like and what we actually can accomplish with these tools. It also helped us increase accessibility for patients to enroll in clinical trials. That allowed us to drive diversity—you always want to have a diverse population for the clinical trial design.

We are also utilizing automation for quality control. Specifically, we have automated the visual inspection of our incretin pens, which are used to deliver medications. This technology allows us to increase production with enhanced accuracy and efficiency, thereby meeting the growing demand more effectively.

Tying this back to HxD, when the opportunity arose to collaborate with a few other Kansai-based multinationals with similar interests, we said, why not work with the ACCJ on healthcare digitalization. It’s such a big, important focus area.

How vital is inclusion to Lilly?
We advocate for inclusion because it drives innovation. An inclusive culture empowers employees to bring their unique perspectives and capabilities to work, fostering out-of-the-box thinking. As we are an innovation-based company, this approach remains unchanged.

We started focusing on women’s empowerment 16 or 17 years ago. At the moment, about 30 percent of our leadership roles are held by women, and more than 46 percent of executives are female—the highest number in the industry. Today we also have a strong LGBTQ+ ally network at Lilly Japan. We continue to be recognized as a gold PRIDE company, have participated in the Tokyo Rainbow Pride, and this year we took part in the Osaka and Kobe Rainbow Festas.

We have also been accelerating our accessibility strategy to ensure everyone working at Lilly, regardless of whether they have disabilities, has a seamless experience.

Terminology may shift over time, but our commitment to people will not change. It has been part of our recipe for success. If you work in an inclusive culture and feel welcome, heard, respected, and valued, then you feel a sense of belonging at that company. We’re here to remove barriers, and we will continue to do this for employees as well as the people and communities we serve.

How does the ACCJ factor into your work?
The chamber has facilitated the growth of Lilly Japan. As a President’s Circle member, we participate in the networking and learning opportunities provided by the ACCJ, and our brand visibility has increased.

Personally, I have been proud to serve as an ACCJ–Kansai governor on the Board of Governors. I feel it’s a win-win-win for Lilly Japan, me as a leader, and the ACCJ. By participating, you will have the opportunity to collaborate extensively, provide valuable insights, and influence various areas, particularly in advocacy. For our employees, this serves as an excellent occasion for learning and networking.

I mentioned HxD. ACCJ companies emphasized the importance of healthcare digitalization and proposed collaboration on its design. This initiative would not have been undertaken by Lilly without the involvement of the ACCJ and the opportunity to work with other entities.

We believe that company growth comes from continuous individual development. Networking, discussions, events, and learning offer new ideas that can create business opportunities when brought back to the company.

What advice do you have for women in business?
It starts with identifying your goal and being confident. You need to be passionate about that goal, love what you’re doing, and be good at what you’re doing. But you don’t need to be perfect. That’s a trap women sometimes fall into. Build out a network and use it. You will never succeed if you feel you just need to be excellent to move ahead, because you will hit a certain ceiling. Now, 30-plus years into my career, that’s the recipe I feel has worked for me.

When I started my journey in pharmaceuticals, I wanted to become the first female leader of a purpose-driven multinational company in Japan. Funnily enough, that was my objective. In 2019, I came here and that aspiration came true. So, I hope I’m proof that what I’m saying can work.