By Nicholas A.R. Fraser
[Video Link: Panel 1]
[Video Link: Panel 2]
On Monday February 6, 2023, the Program on U.S.-Japan Relations gathered a group of scholars to examine two major policy issues that will pose serious challenges for Japan, Asia, and the world: managing pandemics and climate change. As Prime Minister Fumio Kishida notes in a recent article in The Lancet, improving public health infrastructure with a focus on human security is a key priority for Japan in the coming years as it continues to play a leading role in global governance. In recent years, the Japanese government has also announced its intention to play a leading role in addressing climate change (see below). Widely seen as a historic model for sustainable economic growth and Asia’s first consolidated democracy, how Japan is able to navigate public health and environmental issues will have a significant impact on how China and other countries in the region and the world meet such challenges.
The first panel, “Development and Governance Challenges in Public Health,” brought together Yanzhong Huang (Council on Foreign Relations), Kathryn Ibata-Arens (DePaul University), and Joseph Wong (University of Toronto) to discuss development and governance challenges in public health with a focus on lessons learned from the COVID-19 pandemic.
Professor Ibata-Arens applied insights from her 2019 book to explain how patent monopolies in the global north can limit access to new drugs and treatments in the global south. Due to the current patent system, new discoveries in biotech largely occurs within siloes. Such a system makes it very hard for firms and governments to effectively respond to new public health crises such as pandemics because actors need to share resources and ideas to develop solutions. In previous decades, sharing information and pooling resources (or creating global commons) was essential for tackling public health crises. The first anti-biotics (penicillin and insulin) patents were shared. More recently, outbreaks of SARS in the early 2000s could have infected and killed many more people than they did, but were effectively contained due to collaboration through the Human Genome Project. The frequency and severity of declining biodiversity makes the spread of disease more likely in the future. Japan has a key role to play here in part because it has pioneered pragmatic information sharing decoupled from profit-seeking through institutions like the Takeda Garden for medicinal plants in Kyoto.
Dr. Huang discussed China’s role in global health leadership before and during the COVID-19 pandemic. Prior to the COVID-19 pandemic, China was expanding engagement in global health governance, it has been moving toward net donor status since 2005. China also supported Margaret Chan’s rise to leader of the World Health Organization (WHO) and actively worked with her successor to include traditional Chinese medicine in that organization’s broader knowledge base. In 2013, China also launched the Health Silk Road (sharing information and logistics to relating to public health) as part of its larger Belt and Road Initiative infrastructure project. Despite these developments, China’s contribution to global public health remained largely symbolic on the eve of the COVID-19 pandemic. The COVID-19 outbreak created a new opportunity for China to take on more of a leadership role. In the past two years, China’s zero COVID policy kept infection and death rates comparative low, while its vaccine diplomacy provided 2.1 billion doses to 121 countries (1/3 of vaccines used excluding China by March 2022). The WHO’s April 2021 report also helped China’s public image by disputing conspiracy theories about COVID-19 targeting China. Yet, by 2022, the unsustainability of the zero COVID policy, the spread of new variants (weakening the efficacy of China’s initial vaccine), and growing public skepticism toward China have limited that country’s capacity to lead on public health issues opening up more space for Japan and the US to play a greater role.
Professor Wong’s presentation reviewed the policy lessons learned from the COVID-19 pandemic and highlighted Japan’s opportunity to play an agenda-setting role for global public health at the upcoming G7 conference in Hiroshima. The COVID-19 pandemic showcased the development and application of scientific expertise in real time. Real time responses by countries had great variance, reflective of capacities and pre-dispositions. Over time we do see convergence, but no one knew how long the pandemic would last placing a premium on durable policy solutions. Though it seemed unprecedented, it was not. In fact, countries that had learned how to effectively manage previous pandemics fared better than those that had not. In Asia, the experiences of South Korea (from dealing with MERS in 2015) and Taiwan (from responding to SARS in 2003) illustrate successful policy learning. South Korean and Taiwanese responded to COVID-19 early and quickly. South Korean and Taiwanese responses reflected both countries’ investment in universal single payer healthcare systems supported by sophisticated interoperable data sharing across units that proved critical in successfully containing outbreaks of COVID-19. Yet even these countries allow some people to be excluded from public health policies (indigenous in Taiwan, unemployed in South Korea). To improve public health policy, policymakers must overcome citizens’ post-traumatic stress that comes from living through a pandemic. Political will and creativity are essential to realize truly universal public health policies.
The second panel, “Development, Climate Change, and Climate Migration,” featured Yves Tiberghien (University of British Columbia), Joana Lewis (Georgetown University), Nicholas A. R. Fraser (Policy Innovations Fellow, Program on U.S.-Japan Relations, Harvard University) to talk about the policy problems that climate change poses.
Professor Tiberghien discussed recent developments in Japan’s approach to tackling climate change and promoting low carbon technologies. In the early 2020s, we are beginning to see a significant real acceleration in green technology and efforts to mitigate the effects of climate change. Policymakers are beginning to realize that leading on these issues has not only environmental but also economic and geopolitical consequences. Moreover, because carbon subsidies remain embedded in legacy industrial policies and the quickening pace of climate change, states must play an active role in guiding the development of green technologies. China and (more recently) the US are moving in this direction, but other countries lag behind. The 3/11 disaster disrupted Japan’s response to climate change. After a period of gradualism under Prime Minister Shinzo Abe, his successor Yoshihide Suga made climate change a major priority of his cabinet. In the fall of 2020, he announced Japan’s pledge to reach net-zero emissions by 2050. In April 2021, he officially committed to a 46% decrease of emissions by 2030 (from 2013 levels), a significant jump from the 25% reduction pledge made in the 2015 Paris Agreement. Prime Minister Kishida has upheld the commitments made by Suga and emphasized the GX strategic vision, with a particular emphasis on nuclear energy and ammonia and hydrogen processes for coal, in addition to intensifying solar and wind energy development. Under the GX (Green Transformation) strategy, state-led industrial policy is back.
Professor Lewis discussed the geopolitics behind China’s transition to a low carbon economy. The current decade is pivotal for addressing climate change as policymakers in countries around the world must limit emissions by 45% by 2030 to ensure that temperatures do not rise higher than 1.5 degrees Celsius. To meet such a goal, we need secure, resilient, and sustainable supply chains supporting low carbon technologies. While firms are scaling up, low carbon technologies are geographically concentrated in a few countries. China must play a leading role in promoting low carbon technologies for several reasons: first, it is one of the largest carbon emitters; second, it is one of the largest manufacturers of green energy; third, its industrial and trade policy restricts market entry and strengthens China’s trade position; finally, China creates broader political, economic, and security anxieties for Europe and the US. This complex situation means that efforts to work with China to effectively tackle climate change are at risk of being derailed by geopolitical conflict. The EU and US must actively work with China soon to reduce the likelihood of more radical and costly transition (that is more probably after 2030).
Dr. Fraser presented an overview of his ongoing work on public attitudes towards refugees in the context of migration induced by climate change. Since the creation of the 1951 United Nations’ Refugee Convention, policymakers and publics have seen refugees as people fleeing persecution. But natural disasters can also force people to flee. Japan’s own 3/11 disaster created significant numbers of internally displaced people. One policy implication of climate change will be how states manage people fleeing the effects of climate change or climate refugees. For this reason, it will only become more important for policymakers to figure out how to persuade their citizens to support hosting refugees. Previous studies show that voters are anxious about sudden arrivals, possible security threats, and long-term socio-economic integration but they do not explain why natives might support hosting refugees. Commitment to human rights and humanitarian dispositions (a propensity to help those in need) predict support for refugee admission. Because humanitarians want to prioritize helping the neediest, they most strongly support admitting refugees fleeing circumstances beyond their control such as natural disasters. Preliminary findings from recent work (done by Fraser) suggests that policymakers in Japan and elsewhere can appeal to citizens’ humanitarian concerns.
This conference provided a unique opportunity to investigate public health and climate change together as ongoing challenges for global governance, and consider how states like Japan, China, and the US have important leadership roles to play. Most speakers highlighted the geopolitical dimension of managing pandemics and climate change. No government pursues any policy without some consideration of it will impact its short- and long-term geopolitical interests, as well as how it would affect its relations with its own citizens in either democratic or authoritarian contexts. In this sense, effective global leadership on issues like public health and climate change demands policymakers to learn from previous policy failures and successes, while confronting new geopolitical and domestic political environments