The TRIAD project aims to design a multi-layered governance architecture—local, national, and international—that enables trustworthy and resilient AI-driven data utilization. Confronting Japan’s demographic decline and the resulting strain and disparities in medical resources, TRIAD seeks to establish a sustainable data ecosystem aligned with the principles of Data Free Flow with Trust (DFFT). Collaborating with Chino City, Shinshu University, the Tokyo Medical Association, and Niigata Prefecture, the project empirically examines an “exit-based regulation” model for community-level data circulation. At the national and global levels, TRIAD works with the OECD and Japan’s Digital Agency to co-develop a healthcare-agnostic DFFT framework and with the WHO and AI Safety Institute (AISI) to propose certification schemes ensuring transparency, accountability, and safety in medical AI. Outputs include policy briefs, interim and final reports, a WHO casebook, AI checklists, and a comprehensive publication. Ultimately, TRIAD contributes to legislative reforms—such as revisions to the Act on the Protection of Personal Information and the Next-Generation Medical Infrastructure Act—and to the development of interoperable international rules harmonized with initiatives like the European Health Data Space (EHDS), fostering a globally trusted, resilient, and intelligent data governance model.