- Japan's Self-Defense Forces are participating in Balikatan 26, conducting joint medical training including US-2 amphibious aircraft search and rescue and patient evacuation scenarios.
- The Japan Joint Staff stated the exercise supports strengthening defense cooperation with allies and maintaining integrated joint operational capabilities in the region.
Japan’s Self-Defense Forces are participating in Balikatan 26, the U.S.-Philippine hosted multinational exercise, and the capabilities they brought to the training reflect a force increasingly oriented toward the kind of joint, combined operations that the Indo-Pacific security environment demands.
The Japan Joint Staff released imagery showing the Japan Maritime Self-Defense Force’s US-2 amphibious aircraft conducting search and rescue operations and patient evacuation as part of joint medical training during the exercise. The US-2’s appearance in a multinational exercise hosted by the United States and Philippines is operationally significant — the aircraft is one of the most capable search and rescue platforms in the world, and its presence in Balikatan 26 signals that Japan is contributing specialized, high-value capability to the combined force rather than simply observing or filling a supporting role with generic assets.
The US-2 is a large, purpose-built flying boat operated by the Japan Maritime Self-Defense Force that is designed specifically for open-ocean search and rescue in rough sea states. Its ability to land on water in wave heights that would prevent conventional amphibious aircraft from operating gives it a rescue reach that few platforms globally can match. In a theater defined by vast ocean distances, island geography, and the constant possibility of maritime incidents, a platform that can land on open water to recover personnel represents a capability that coalition partners cannot easily replicate. The joint medical training component of Balikatan 26 — integrating the US-2 into a rescue and patient evacuation scenario alongside U.S. and Philippine forces — tests interoperability at the practical level of how personnel actually get recovered and moved from a point of injury to definitive medical care.
The Japan Joint Staff’s statement accompanying the imagery laid out the broader purpose framing Japan’s participation in terms that reflect the country’s evolving security posture: contributing to the creation of a security environment that does not permit unilateral changes to the status quo by force, connecting to regional peace, stability, and prosperity, and strengthening defense cooperation and coordination with allies and like-minded nations while maintaining and improving integrated and joint operational capabilities. That formulation — particularly the explicit reference to not permitting unilateral changes to the status quo by force — is language calibrated precisely to the Indo-Pacific security environment where China’s assertiveness in the South China Sea and around Taiwan has become the defining strategic concern for every military in the region.

Japan’s participation in Balikatan is not new, but the scope and character of that participation has evolved substantially as Tokyo has accelerated its defense buildup and expanded its security relationships. Japan’s 2022 National Security Strategy represented a generational shift in how the country frames its defense posture, and the practical expression of that shift includes deeper integration into multilateral exercises that would have been politically sensitive or operationally constrained in earlier periods. Bringing the US-2 into a joint medical and rescue training scenario with U.S. and Philippine forces is exactly the kind of interoperability investment that makes coalition operations function at the moment they are needed rather than having to improvise connections between forces that have never trained together.
The joint medical training dimension of the exercise connects to a capability gap that every military in the Pacific takes seriously: the ability to recover and treat casualties in a theater where distances from major medical facilities are enormous and the maritime environment creates unique challenges for patient evacuation. A warfighter injured on a remote island or at sea in the Philippine archipelago faces an evacuation problem that is fundamentally different from the land-based combat casualty evacuation the U.S. military refined in Iraq and Afghanistan. The US-2’s ability to land on open water to pick up survivors or patients and move them to a ship or shore-based facility fills a role in that evacuation chain that no helicopter or conventional fixed-wing aircraft can replicate at the same range and sea state tolerance.
The multilateral character of Balikatan 26 — with U.S., Philippine, and Japanese forces operating together across a range of training scenarios — reflects a deliberate coalition-building effort in the Indo-Pacific that has accelerated considerably over the past several years. Japan’s growing comfort with visible, substantive participation in exercises hosted by the U.S.-Philippine alliance is part of a broader pattern of Tokyo deepening its security ties throughout the region. The same Japan that once kept its Self-Defense Force’s international activities carefully bounded by constitutional and political constraints now brings specialized platforms like the US-2 to multinational exercises and participates openly in scenarios that build the operational muscle memory of coalition warfare.

