Breaking Barriers and Building Bridges: Makiko Kawabe on Empowering Japanese Women and Advancing DEI
In this exclusive interview for World Economic Magazine, we have the privilege of speaking with Makiko Kawabe, a distinguished leader in the fields of healthcare policy, aging research, and inclusive innovation. As the Co-Founder and CEO of JWIBA, as well as a Visiting Professor at Tohoku University’s Advanced Graduate Program for Future Medicine and Health Care, Makiko has dedicated her career to fostering impactful collaboration between Japan and the United States. Her extensive expertise spans long-term care systems, dementia care, care management, and the advancement of AgeTech solutions.
With over 15 years of experience consulting for Japan’s Ministry of Health, Labour and Welfare, Makiko’s work has significantly contributed to policy development and the promotion of equitable healthcare solutions. Beyond her policy contributions, she is a strong advocate for Diversity, Equity, and Inclusion (DEI), leading initiatives to support Japanese women navigating global career opportunities, particularly in Silicon Valley.
In this conversation, Makiko offers profound insights into the challenges facing Japanese women in international roles, the evolving landscape of family caregiving, and the innovations driving healthier, longer lives. She also shares her reflections on how cultural heritage and cutting-edge technology can intersect to create human-centered solutions. Through her leadership, Makiko continues to shape a more inclusive and equitable future.
Que- Your career has centered on promoting healthy longevity in Japan and Asia. What inspired you to pursue this field, what challenges have you encountered, and how has this shaped your role as Co-Founder and CEO of JWIBA?
Makiko: I started my career as a policy consultant, with my primary client being Japan’s Ministry of Health, Labour and Welfare (MHLW). A few years before I entered the field, Japan introduced a public long-term care insurance system in response to its rapidly aging population. However, after its implementation, the number of users increased dramatically. As a consultant, my work focused on finding ways to deliver better quality services to the elderly while operating within limited financial resources. Through my involvement in policy development, I came to realize that even in a country like Japan, where systems are well established, policies and institutions alone have their limitations. At the same time, working on various projects with the Ministry solidified my personal mission—to ensure that older adults receive equal access to better quality care.
After a long journey in the policy side, I began exploring the potential of the private sector and moved to California in 2022. At Stanford University’s US-Asia Technology Center, I conducted research on the startup ecosystem in the healthy longevity sector in both Japan and the United States. Later, I joined Sompo Digital Lab, the open innovation arm of one of Japan’s largest insurance companies, which also leads in senior living. Around the same time, I co-founded JWIBA with my friends in the Bay Area.
Before coming to the Bay Area, I saw Silicon Valley as the center of technology and a place where many Japanese companies sent their male expatriates. However, after arriving, I was surprised to find a significant number of female expatriates as well. I also met many women who had put their careers on hold due to their partner’s overseas assignments and were struggling with career disruptions. My co-founders and I bonded over the idea of creating a community where these women could support each other in both their professional and personal lives. Unlike Japan, California naturally embraces diversity and inclusion, and people actively work to respect and integrate diverse perspectives. I was inspired by this cultural environment, which is fundamentally different from the structured DEI efforts often seen in Japan.
Throughout my career, I have specialized as a consultant in the caregiving sector, where many roles are traditionally held by women. Now, as a co-founder and leader of JWIBA, I have gained even deeper insights into Japan’s unique social structure.
Japan is the fourth-largest economy in the world, yet it ranks 118th in the Global Gender Gap Index. While the patriarchal family system was officially abolished in 1947, its ideology remains deeply ingrained in society. Japan’s long history of economic success has further reinforced these traditional norms, shaping people’s behaviors—often unconsciously. Addressing these deeply rooted biases is essential not only to support women’s career development and childcare responsibilities but also to create a society where everyone, regardless of gender, can better balance work and family life.
While JWIBA’s activities are primarily focused on supporting the careers of women accompanying expatriates, my personal interests go beyond that. I aim to contribute to DEI-driven innovation between Silicon Valley and Japan and to address the triple burden of career, childcare, and elder care, which makes it even more difficult for women to take on leadership roles. If Japan truly wishes to build a more inclusive and equitable society, it must proactively and intentionally tackle these challenges.
Que– Your survey shows 74.2% of women actively pursue Silicon Valley assignments, compared to 36.4% of men, yet structural barriers remain. What are the biggest challenges Japanese women face in securing and succeeding in these roles, and what organizational changes are needed to address them?
Makiko: As highlighted in the 2023 JWIBA survey, when women in Japan decide to take on an overseas assignment mainly around their 30’s, they often find themselves navigating key life stages such as marriage, pregnancy, and childbirth (Source 1, p.4). Unlike their male counterparts, they are frequently forced to make difficult choices about how to balance these milestones with their career advancement.
In fact, studies show that while many Japanese women express an interest in working abroad early in their careers, their enthusiasm significantly declines before they reach their 30s. One major factor behind this is Japan’s traditional personnel system, including policies governing overseas assignments, which have historically been designed with the assumption that male employees will relocate with their wives—who are typically full-time homemakers (Source 1, p.8). As a result, these systems fail to accommodate the needs of women who wish to work, raise children, and gain international experience simultaneously.
Moreover, as I mentioned earlier, unconscious bias remains deeply ingrained in Japanese organizations. There is often an implicit expectation—reinforced by companies, families, and society—that when women accept an overseas post, they must sacrifice something. The pressure to be a “good employee,” a “good mother,” and a “good wife” all at once can gradually erode the motivation of working women, making it even harder for them to pursue international opportunities. And despite facing such pressure, women who still aspire to gain overseas experience must take a proactive stance and advocate for themselves. If they don’t speak up, they simply won’t be considered. This is exactly what the survey results reveal.
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Que– How have international assignments influenced individuals’ perspectives on Diversity, Equity & Inclusion (DEI), and how do men and women differ on this issue?
Makiko: The 2024 survey we conducted was the first to include not only Japanese women but also Japanese men with experience working in Silicon Valley. On page 8 of the source document, we present a graph comparing skills acquired by gender, and the key takeaway is that there was no significant difference between men and women in terms of the skills they gained while working in Silicon Valley. In fact, a substantial proportion of both men and women reported strengthening a wide range of skills.
However, a higher percentage of men reported a shift in their values regarding DEI. This suggests that exposure to California’s DEI-driven culture may be playing a role in reshaping the perspectives of Japanese men.
On the other hand, when looking at the skills that were useful after returning to Japan, men generally reported finding them more applicable than women did. This disparity appears to be influenced by the positions they assumed upon returning to Japan, further highlighting the differences in post-assignment career trajectories between men and women.
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Que- Makiko, you’ve spoken publicly about the growing need for support services for family caregivers. What innovative approaches or solutions have you seen, either in Japan or Silicon Valley, that could alleviate their burden?
Makiko: With an aging population and more women entering the workforce later in life, increasing attention is being given to the declining well-being of the sandwich generation. Many find themselves juggling multiple responsibilities—work, child-rearing, and caring for aging parents—all at once. While Japan has a long-term care insurance system, it primarily covers elderly care and lacks direct financial support for family caregivers, unlike Germany. In the U.S., public support is minimal, creating an environment where private-sector-led innovation is more likely to emerge.
Reports indicate that a quarter of healthcare sector investments are directed toward AI, and the same trend holds in the field of healthy longevity. At CES 2025, I saw significant growth in the AgeTech sector, which bridges welfare and medical technology. A variety of solutions were on display using AI, from radar-based contactless sensors enabling aging in place, AI-powered apps offering real-time coaching for at-home rehabilitation, etc. Notably, Panasonic Well, which took the keynote stage, introduced Umi, a new service aimed at easing the challenges of both childcare and eldercare for the sandwich generation. By integrating AI-driven solutions to prevent caregiver burnout, it represents a promising step toward enhancing overall well-being.
Que- Looking ahead, what is the one change you would all like to see for Japanese women in Silicon Valley within the next decade? How do you see your work contributing to this vision?
Makiko: As JWIBA continues its activities, we are receiving increasing interest in collaboration from communities formed around Japanese companies’ overseas postings in regions such as China, Taiwan and the UK, etc. By fostering connections beyond Silicon Valley in the context of DEI and supporting one another, I hope to contribute to advancing DEI in Japan—with Silicon Valley ideally serving as a central hub for these efforts.
Looking ahead, my hope is that in 10 years, Japan’s gender gap will have closed to the point where initiatives like these are no longer necessary. More importantly, I would like to see a shift in mindset within Japanese organizations—one that recognizes DEI not as a women’s issue, but as a broader challenge that affects everyone.
Spotlight on Leadership and Progress:
Makiko Kawabe’s unwavering dedication to driving positive change in healthcare policy, innovation, and gender equality serves as an inspiring example of leadership in today’s interconnected world. Her ability to bridge diverse perspectives across Japan and Silicon Valley has not only fostered groundbreaking collaboration but has also empowered women to excel on the global stage.
As Makiko envisions a future where gender disparities are diminished and inclusive leadership becomes the standard, her work remains a testament to the power of resilience, cultural exchange, and forward-thinking innovation. Through her advocacy for family caregivers, commitment to healthy longevity, and leadership in DEI, Makiko continues to influence the economic and social fabric of both nations.
At World Economic Magazine, we celebrate leaders like Makiko Kawabe who exemplify the spirit of progress and inclusion. Her insights offer valuable lessons for policymakers, business leaders, and innovators alike, driving us closer to a more equitable and prosperous future.
