Many people in the developed world might associate leprosy and leper colonies with a by-gone era.
By Jamie Miyazaki
But a Japanese committee revealed earlier this month that Japan ran leper colonies until 1996, despite medical evidence that they were unnecessary.
It found that "patients were treated as objects for research", patients' babies were killed and dead babies and foetuses of sufferers were preserved in macabre collections.
The report certainly made shocking reading. But its revelations about the motivation for the policy were not so surprising to those familiar with Japanese bureaucracy, pointing as it did to the cosy relationships between politicians, bureaucrats and business.
One health ministry scandal left hundreds infected with HIV
It concluded that the Health and Welfare Ministry, in conjunction with the powerful Japan Medical Association, was quarantining leprosy sufferers in order to secure larger budgets for the sanatoriums and to keep doctors employed.
Takesato Watanabe, a media ethics professor, said: "The medical lobby has a powerful influence on the government. They're big donors and so they get laws passed that are favourable to them."
No isolated case
And Japan's leprosy policy followed a long string of health-related scandals over the years.
One of the most notorious dated back to the 1980s, when more than 1,400 Japanese haemophiliacs were exposed to HIV as a result of the Japanese Health Ministry's failure to ban unheated blood products, despite knowing they risked being tainted.
A senior doctor on the health and welfare ministry's Aids research panel was accused of delaying heat-treated blood products to help a Japanese pharmaceutical company that was behind in developing new sterilised blood products.
More recently, food companies repackaged imported beef as Japanese beef to claim government compensation in the wake of a mad cow disease scare, and last summer Japan Dental Association (JDA) members were charged with bribing senior politicians while the government was reviewing medical fees.
"There isn't a history in Japan of taking doctors to account," said Derrick Buddles, a manager at medical-device manufacturer Stryker in Tokyo.
Dr Michio Nakayama, a professor of bio-ethics at Niigata University's medical faculty, agreed, saying that in hierarchical Japan, where criticism of those in power is socially difficult, both the Japanese medical profession and health ministry have long taken a "doctor knows best" approach and simply shrugged off or ignored criticism.
The health ministry is not the only sector to be beset by scandal. Many areas of Japan's administration, from the banking sector to its nuclear industry, have been tainted over the years.
But it is not just the establishment that is at fault. Japan's media has played a part.
"The mass media were impotent in providing relief to the hidden human rights violations," said the leprosy council's report into the defunct quarantine policy.
The problem is that Japan's press, while nominally free, is constricted by the complex environment in which it operates.
Japan's press is constrained by an archaic system
Most journalists belong to hundreds of exclusive press clubs or "kisha clubs" which are affiliated to the organisations they cover. Club members depend on their host organisations for information and scoops. In return, there is a suspicion that they refrain from reporting issues affecting those organisations too critically.
Until recently clubs could prevent non-members from attending or asking questions at their respective press conferences.
But times are slowly changing.
A new Freedom of Information Act is helping the public and media to gain access to more information that used to be under the government's control.
As a result, Dr Nakayama said, "some articles are pointing out what the medical professions do not like to disclose".
'Could try harder'
But Professor Watanabe still sees room for improvement, and not just in the medical and health sphere.
"At the national level, I don't think information relating to things like diplomacy and defence is being disseminated properly, still," he said.
In one famous example, TV station NTV broadcast a report about food aid that Japanese Prime Minister Junichiro Koizumi was intending to give to North Korea during a controversial visit to the country as Japan attempted to find a solution to the delicate task of normalising relations between the two countries.
The government responded by threatening to throw the station off the accompanying press trip to Pyongyang unless it revealed its source, although it later relented.
The collusion between Japan's powerful troika of politicians, business and bureaucrats both undermines the media's effectiveness and creates a system which breeds the scandals it should be uncovering.
Unless that atmosphere changes, Japan's leprosy scandal is unlikely to be its last.