TOKYO — When Prime Minister Shinzo Abe learned that the Avigan flu medicine would not be approved for the coronavirus by the end of May, he was furious. “That’s not what I was told,” he lashed out at aides.
Abe had hoped that having a treatment would give the public some peace of mind after the state of emergency was lifted. And that became a public promise when he told a press conference on May 4 that Avigan would receive the go-ahead by the end of the month.
After that, there was a routine exchange between Abe and health experts. “When can we get a treatment?” an irritated Abe would ask ministry officials. “I thought Avigan was good.”
As the longest-serving prime minister, Abe has expanded his clout over bureaucrats by leveraging his power over personnel appointments. Bureaucrats have become less willing to speak out, offering only what Abe wants to hear, with a combination of Abe’s complacency and bureaucrats’ retreat contributing to a recent series of missteps by the prime minister’s office.
Even before promising fast-track approval, Abe had repeatedly talked up Avigan. The prime minister had been emboldened by assurances from the health ministry that the drug could be approved based on data other than clinical trials.
“It was hard to give anything but a rosy view when the prime minister was pushing for a quick response,” a senior health ministry official acknowledged.
As of mid-June, Avigan has yet to receive the green light.
In the meantime, missteps continued.
The government’s plan to send two cloth face masks — or “Abenomasks,” as they came to be known — to each household met with a chilly reception. A proposed payment of 300,000 yen ($2,810) to households that lost income to the outbreak was changed to an across-the-board 100,000 yen after criticism from junior ruling coalition partner Komeito and elsewhere. And talk of using school shutdowns as an opportunity to move the start of the academic year to September has not led to concrete action.
A government cannot respond effectively in times of rapid change by relying purely on a massive bureaucracy. Past prime ministers sought to move toward a system led by elected officials.
When bureaucratic silos bogged down the response to the Kobe earthquake that struck Japan in 1995, Ryutaro Hashimoto, who became prime minister the following year, laid the groundwork for the prime minister’s office to take over in such situations. But in the wake of the March 2011 earthquake, tsunami and nuclear disaster, conflicting directives from the government of the Democratic Party of Japan created confusion.
After Abe began his current stint as prime minister in late 2012, such moves as the creation of the National Security Council under the prime minister’s office showed his ambition to create a government that can withstand crises. Its deft handling of North Korea, natural disasters and other issues bred pride that bordered on conceit.
The number of offices handling policy proposals and interministerial coordination under the Cabinet Secretariat, which supports the prime minister, has swelled from five to 40 since an overhaul, with staff more than tripling to 1,200. Yet despite this increase in resources, the government’s nerve center has not functioned properly during this unprecedented crisis.
Compare this with Taiwan, where the death toll has remained in the single digits.
President Tsai Ing-wen’s government established a cross-ministry central command center with broad legal powers on Jan. 20 — before the initial virus epicenter of Wuhan was locked down — and banned entry from mainland China on Feb. 6. Taiwan has made full use of existing infrastructure, including tracking mask purchases using chip-equipped health ID cards to ensure a stable supply.
While Japan’s state of emergency has been lifted, the crisis is not over yet. Investment in significantly expanded testing and building up the health care system will be essential for the public and companies to feel comfortable resuming business.
With these challenges and others highlighted by the pandemic, including the need to catch up in telemedicine and remote education, Japan’s Abe-led government faces a tough road ahead.