The essence of the distrust of the Abe administration's anti-corona measures is the "Expert Meeting".
The essence of the distrust of the Abe administration's anti-corona measures is the "Expert Meeting".(The original Japanese version is posted to Diamond Online on May 19, 2020) Masato Kamikubo, Professor of Policy Science, Ritsumeikan University Abstract Public opinion is low on Prime Minister Shinzo Abe's series of decisions regarding measures against the new coronavirus. I think the reason is that there is a problem in the decision-making process of the Abe administration. In particular, I think that the essence of the problem is that the "experts' meeting," which spearheads corona countermeasures, was launched in the same pattern as "peacetime" without assuming an emergency. Considering the low evaluation of corona countermeasures, we should consider a radical review of Japan's policy making system. The people are uncomfortable and dissatisfied with the decision-making style that experts announce their theory in the media and SNS, and the government follows it.The Shinzo Abe administration lifted the "Emergency Declaration" nationwide on May 25. Prime Minister Abe remarked strongly at a press conference that he "demonstrated the power of the "Japanese model"." In addition, Abe said, "(Antonio) Guterres, Secretary-General of the United Nations, has evaluated that Japan's response to infectious diseases is an outstanding example in the world." Furthermore, he emphasized, "Japan is able to control the number of infected and dead persons per capita by far over the G7 and other major developed countries. We are garnering the world's expectations and attention. We were proud of the success of Japan's new coronavirus countermeasures.”However, the Abe administration's approval rating is low. The latest opinion poll of the Mainichi Shimbun reports that the approval rate is 27% and the disapproval rate is 64%, and it is at a record low level. The public's evaluation of the Abe administration's measures against the new coronavirus is not high.This paper examines the Abe administration's decision-making, focusing on the “experts” who have been attracting attention in corona countermeasures. There is no day when people called "experts" do not appear on TV wide shows and Internet news sites. The Expert Meeting is in charge of spearheading Japan's measures against coronavirus. In Advisory Council, bureaucrats can exercise powerful power, and experts only give "approval."It has been pointed out for some time that the prime minister's office and the Cabinet Office are becoming more active in policy making in the Abe government. However, the policy issues handled by the prime minister’s office and the Cabinet Office are a small part of the whole, and only the ones that Prime Minister considers to be the most important for maintaining a high approval rating. For example, Katsunobu Kato (current Minister of Health, Labor and Welfare), who is one of closest allies to Mr. Abe, once served as the seven ministers who seemed to be completely unrelated, such as "Minister for 100 million active roles" and "Minister in charge of the North Korean abduction issue". It was because the Abe government believed that it was the most important to deliver policies in a timely manner.On the other hand, the majority of policies are carefully planned and implemented by each ministry without the involvement of the Prime Minister's Office or the Cabinet Office. The beginning of policy making is the “Advisory Council” established in each ministry. "Experts" are involved in the committee.The author once wrote a paper about the "Pension Reform Act" council that was enacted in 2004 during the Junichiro Koizumi government. Hiroko Ota, who was a member of the Council on Economic and Fiscal Policy (CEFP) in the Cabinet Office at the time, pointed out in her book that "the fundamental reform of the system was rejected when the Ministry of Health, Labor and Welfare (MHLW) submitted a reform draft to the Council in December 2002." Ohta went on to say, "Dramatic reform of the system had to be taken up as an agenda item by the Council and Social Security Council Pension Committee in MHLW before it was considered by the CEFP. MHLW did not put the inconvenient reform plan on the ground, so it was impossible to discuss it.” Ohta argues that those who have the authority to set the agenda can exercise tremendous power during the policy-making process because they can select only the issues that are in their favor and bring them into the policy-making process.At the advisory council of each ministry and agency, the bureaucracy, which serves as the secretariat, sets the agenda and invites experts as unsworn witnesses. The bureaucracy listens to their opinions, prepares minutes, and prepares the next bill. Experts are essentially just participants in the question and answer session. Consequently, it is important that bureaucrats have total control over the debate in the council.What is the role expected of experts in the advisory council? While the author was studying in the UK, the author once met a Japanese economist who came to the UK at sabbatical. He said of his experience as a member of advisory council, "The role of scholars is to give bureaucrats the advice for giving approval to what they want them to do.Therefore, the young researchers who are engaged in the world's most advanced research are rarely appointed to the Advisory Councils. By the recommendation of academic societies, powerful scholars who once made great achievements are appointed. They are sometimes called "Goyo-gakusha (scholar pander to the government)."On the other hand, most of the bureaucrats who actually plan policies are undergraduates such as the University of Tokyo. Many officials in Ministry of Finance come from the Faculty of Law at University of Tokyo, and they are basically generalists rather than specialists. Many bureaucrats have the opportunity to study abroad at one time, but the large number of bureaucrats are undergraduates, so that only a master's degree can be obtained in study abroad. The number of bureaucrats who can obtain a doctorate is limited. They have some expertise in policy, but it is based on their administrative experience. As a result, the policy proposals made by the bureaucrats are not theoretical but are realistic based on the current system.Although there are the Advisory Councils in Western governments such as the United States and the United Kingdom, they are not the only opportunity for experts to engage in policy making. The experts can have the opportunity to apply for professional posts in ministries at various levels since their youth. In ministries, many experts can participate in the process of drafting a policy draft, and the knowledge of leading-edge research will be reflected in the policy draft.In addition, since bureaucratic organizations do not adopt lifelong employment and seniority ranking, experts form a career by going back and forth between universities, research institutes, think tanks, etc. and ministries. This is called a "revolving door" and is sometimes compared with "Amakudari (Decent from Heaven) " in Japan, where bureaucrats move to the private sector after retiring from ministries based on lifelong employment.This "revolving door" will lead to the formation of a variety of "policy networks" between university and government officials. Experts individually apply to the posts of ministries without the recommendation of the academic society. Therefore, not only experts who are obedient to academic societies, but also experts with diverse theories participate in policy making. "Competition" between theories will refine policy proposals and increase the number of government options. Was the "Experts' Meeting" on coronavirus infections set up assuming peace times?The "New Coronavirus Infectious Diseases Control Experts Meeting" (hereinafter referred to as the "Experts Meeting") was established on February 14, 2020 under the "New Coronavirus Infectious Diseases Control Headquarters" in the Prime Minister's Office.At that time, the government did not seem to have taken the matter so seriously. The government did not take strong measures to ban entry from China and other countries. The government thought the spread of the coronavirus would stop soon, Chinese President Xi Jinping’s state guest visit to Japan would be also carried out as planned, and the Tokyo Olympic and Paralympic would be safely held. It seems that there was not much sense of "emergency" in the government. Therefore, the Expert Meeting was set up to advise the government from powerful veteran scholars, as well as a "peacetime" advisory council. There are 12 members in the Expert Meeting. The chair is Takaji Wakita, Director of National Institute of Infectious Diseases. Deputy Chairman Shigeru Omi, Chairman of the Organization for Promotion of Regional Medical Functions, has been known to the world for his work in the World Health Organization (WHO) for 20 years and his work on eradicating polio in the Western Pacific region.In addition, there are the leaders of the academic society in the Expert Meeting: Nobuhiko Okabe, Director of Kawasaki City Institute of Health and Safety; Hitoshi Oshiya, Professor of Microbial Sciences, Graduate School of Medicine, Tohoku University; Satoshi Kama, Executive Director of Japan Medical Association; Yoshihiro Kawaoka, International Research Center for Infectious Diseases, Institute of Medical Science, University of Tokyo; and Motoki Suzuki, Chief Director of Infectious Disease Epidemiology Center, National Institute of Infectious Diseases.On the other hand, regarding the measures against coronavirus, the medical technician of the Department of Tuberculosis Infectious Diseases, Ministry of Health, Labor and Welfare, set the agenda for the Expert Meeting. They have a doctor's license and play a central role in making administrative systems related to health care.Countermeasures against coronavirus in Japan were to suppress PCR test and wait for the spread of infection to end for preventing medical collapse. There are two reasons for this decision. One is that the new coronavirus has been certified by the MHLW as a "designated infectious disease". As a result, when a person is diagnosed as infected with coronavirus, the “Infectious Diseases Law” is applied, and in principle, even persons who are asymptomatic or mildly ill should take inpatient isolation measures at hospitals. The other is considering the vulnerability of the Japanese infectious disease medical care system, which did not experience severe acute respiratory syndrome (SARS) or Middle East respiratory syndrome (MERS). It seems a realistic policy, which seems to be a medical engineer, considering the current law and field capabilities.However, Masahiro Kami, President of the Institute of Health Care Governance, criticise that medical technicians could not follow discussions in academic journals such as the British medical journal "Lancet" and the British science magazine "Nature" that lead the world's discussions on measures against corona. He pointed out that medical technicians were not well informed about the characteristics of the new coronavirus, which had been gradually revealed in the world's most advanced research. As a result, they had long sticked to the first measure they had set, "waiting for the spread of infection to pass to end.In other words, medical technicians have a doctor's license, but are not experts in following the world's most advanced discussions. Furthermore, even the leaders of the expert conference had left the front line as researchers and were unable to follow the most advanced discussions. The problem is that the expert conference cannot critically verify "cluster measures"In MHLW, the "Cluster Countermeasures Group" was established on February 25, 11 days after the establishment of the Expert Meeting. The government appeared to have been waiting for the spread of coronavirus to pass. However, in response to the seriousness of the situation, the government finally launched a clear countermeasure for the new coronavirus.The cluster countermeasure group was formed by a total of about 30 people who belong to the New Coronavirus Countermeasures Headquarters of MHLW. "Cluster measures" were devised mainly by Hiroshi Nishiura, a professor of Hokkaido University who specializes in theoretical epidemiology, and Oshiya, a professor of the Graduate School of Tohoku University, who is also a member of the expert conference.According to Mr. Oshitani's "Concept of countermeasures against COVID-19" announced on March 29, cluster countermeasures were devised considering the characteristics of the new coronavirus, which is different from SARS and new influenza.SARS and the new flu became severe in all infected people. Therefore, the case was easy to grasp, and it was successfully contained by tracing the infection chain and breaking it. However, the new coronavirus is unable to find the entire chain of infection, as many infected individuals are mild or asymptomatic.However, the important features for studying the countermeasures were also known. While the new coronavirus often infects the surroundings very little, it has spread from a specific person to many people. In other words, if you control the "cluster (group of infected people)", the new coronavirus could end. Thus, he devised a "cluster measure."Nishiura has published a paper on concrete measures for cluster measures (Nishiura H et al. "Closed environments facilitate secondary transmission of coronavirus disease 2019 <COVID-19>). However, it is different from the corona countermeasures based on the existing SARS and new flu measures, which have been adopted in many countries. The cluster countermeasure is still a hypothesis.The serious problem is that the expert council cannot critically examine the "cluster countermeasures" proposed by Nishiura. Nishiura's specialty is "theoretical epidemiology" that theoretically studies the cause of disease, the epidemic state, and prevention in a group. At the Expert Meeting, Oshitani and Suzuki are "theoretical epidemiologists", but both are co-authors of Mr. Nishiura's paper on cluster measures. Therefore, they cannot be in a position to critically examine cluster measures.Others are Chairman Wakita (hepatitis C), Vice Chairman Omi (polio), Okabe (pediatrics), Kawaoka (Ebola virus), Kawana (Department of Respiratory Medicine), Tateda (Microbiology), Yoshida (Infectious disease control science). They are “prevention and treatment specialists” clinicians, not “theoretical epidemiology”.And the cluster measures were approved by the expert meeting. Only cluster measures were proposed to the government by the expert meeting. Prime Minister Abe has no choice but to accept it. Nishiura, who is not a member of the expert meeting, behaves like a "control tower" against coronaSince then, even though Nishiura is not a member of the expert council, he has behaved like the government's "control tower" for countering corona. On April 7, Prime Minister Abe declared a state of emergency to seven prefectures such as Tokyo and Osaka. At that time, regarding the number of infected people, the prime minister said, "If the infection spreads at this pace, it will be 10,000 in two weeks and more than 80,000 in one month" "If we can reduce contact between people by 70% to 80%, we can turn down the increase in the number of infected people in two weeks."This is based on Mr. Nishiura's trial calculation published in the Nihon Keizai Shimbun on April 3.This calculation was called "Nishiura model". On April 10, there was an event that gave Nishiura confidence. At the news conference, WHO praised the discovery of the cluster group that "clustered infections lead to large-scale infections, not all infected people spread the infection equally". WHO's praise has given authority to the "Nishiura Model".On April 15, Mr. Nishiura held a press conference and said, “if no measures were taken, the number of seriously ill patients in Japan would reach approximately 850,000, of which 49% (over 410,000 by simple calculation) would die.” He also said, “we ask the people to thoroughly reduce contact by 80%".Then, on April 16, Prime Minister Abe announced that he would extend the national emergency declaration to the whole country. Mr Nishiura also appeared at the press conference. He continued to use SNS to raise awareness to change the public's consciousness of "avoidance of three tights (closed, dense, close)", and frequently appeared on television. However, he is not a member of the Expert Meeting. Not verified between extension of emergency declaration and partial cancellationOn May 6, Prime Minister Abe announced that he would extend the deadline of the emergency declaration until the end of May. Although the number of new infections has fallen nationwide, Mr. Nishiura was cautious, saying that the spread of infection does not converge as expected, and that the spread of infection may further impose a burden on the healthcare system. The Expert Meeting advised the Prime Minister to extend the deadline.On May 14, Prime Minister Abe announced that he would cancel the emergency declaration in 39 prefectures. Also, he has indicated that for the remaining eight prefectures, state of emergency will be lifted before May 31, if the experts judge.However, the "Nishiura model" has not been verified yet. Nishiura's claim to "reduce 80% of human contact" could not be achieved, but the number of new infections has decreased. After all, it remains unclear whether the hypothesis of "cluster measures" was correct. In particular, the basis for the trial calculation of "more than 410,000 dead" remains unexplained. Why does the Liberal Democratic Party's lawmakers not raise the voice of the medical field to the official residence?There are many criticisms of the "Nishiura model" that have come from clinicians who treat new coronavirus, especially in the field. For example, Dr. Kami pointed out that the problem with the new coronavirus in Japan is "nosocomial infection", but "enforcing 80% reduction in human contact" is not effective against nosocomial infection.In summary of the story I heard from a member of the Liberal Democratic Party and a medical person, such voices of the field reached the LDP, but it was not been delivered to the Expert Meeting. There was almost no communication between the Prime Minister's office and the LDP regarding measures against the new coronavirus.On-site doctors create various communities through SNS and exchange information, and their representative traces the situation and requests of the site to the LDP members. However, the LDP members rarely pass them to the Prime Minister’s Office.The LDP seems to be using the government of Democratic Party of Japan (DPJ) at the time of the Great East Japan Earthquake and the Fukushima Daiichi Nuclear Power Plant accident in 2011 as a teacher. The members of DPJ had taken the voices of their supporters into the Prime Minister’s Office one after another and caused confusion. In particular, the poor response to disasters and accidents during the DPJ government is one of the reasons why Prime Minister Abe calls the DPJ administration a "nightmare." Thus, LDP members hesitate to pass voices of fields to Prime Minister Abe. LDP lawmakers were under stress. Their stresses may have exploded at the LDP's joint meeting of the Economic Growth Strategy Headquarters and the New Coronavirus-related Pneumonia Countermeasures Headquarters on May 7th. A large number of lawmakers were inundated at the conference, and the crowd was so conspicuous. It was criticized as a "Sanmitsu-kaigi (Three-Cs conrferrence)". The Abe administration's stray response to corona measures has the same roots as the Moritomo/Kakegakuen problemThe LDP accepted the voices of supporters and the medical field, but did not pass the them to Prime Minister Abe. Many requests have been conveyed to the Cabinet Office by using various personal connections to Abe. The reason behind the abrupt decisions to “close all schools at once”, to “Abenomask”, and to “consider September enrollment (fall enrollment)” is that various people have come to the Cabinet Office to voice their opinions to the Abe administration's top officials.Also, there has been a fierce debate among experts and the media to rage over whether to expand or curtail PCR testing. The statements of PM Abe and Health, Labor and Welfare Minister Katsunobu Kato seem to be going back and forth. The "expansionists" and "suppressionists" are appearing in the Cabinet Office one after the other and making their own speeches in front of Abe and Kato. Abe, in particular, has a tendency to be”happou-bijin (everybody’s friend). The Prime Minister does not deny what the other side says to his face. That character of the prime minister has confused the government's decision-making process. The unprofessional debate between "epidemiology vs. economics" could continue.On May 12, the government decided to add four economists, including Keiichiro Kobayashi, a senior researcher at the Policy Research Institute of the Tokyo Foundation, to the Advisory Committee on Basic Policy and Other Matters, which has been set up under the Special Measures Law to deal with the new coronavirus. Economists were added to the upper organizing body of the Expert Meeting. As a result, the influence of Nishiura and other experts will be reduced. From now on, the economy will probably take precedence over epidemiology.Mr. Kobayashi immediately began to speak out aggressively, saying, "We should provide a cash benefit of 100,000 yen per month to individuals who have faced declining incomes due to the coronavirus measure. However, Kobayashi's statement that "to avoid economic stagnation, we must continue our policy of fiscal expansion, while at the same time establishing the capacity to conduct testing on a large scale and quarantine those who test positive to relieve the anxiety of those who test negative," is irrelevant to his expertise. There are concerns about the continued unprofessional hesitation between epidemiology and economics. Japan's low number of people infected and killed by the new coronavirus has been called "Japan's miracle" and "Japan's mystery" by the world. Japan's quarantine system is not hailed as a "model for the world" like South Korea's. It is clear that the Abe administration's decision-making was in disarray. Japan's response to the new coronavirus is regarded as just being lucky. This article has examined in detail the problems with Japan's policymaking system, particularly its "contingency" system. Even if the number of people infected and killed by the new coronavirus is lower than in Europe and the United States, it is just good luck. When a highly virulent virus such as Ebola strikes, the current system will not be able to cope with it. The policy-making system needs to be overhauled.
出産・子育て
ファッション
美容・コスメ
健康・ダイエット
生活・インテリア
料理・食べ物
ドリンク・お酒
ペット
趣味・ゲーム
映画・ＴＶ
音楽
読書・コミック
旅行・海外情報
園芸
スポーツ
アウトドア・釣り
車・バイク
パソコン・家電
そのほか
すべてのジャンル
