Japan’s Global Health Diplomacy and the COVAX Facility
From the perspective of Japan’s global health diplomacy, its commitment to the COVID-19 Vaccines Global Access (COVAX) Facility has been of significance in the middle of the coronavirus pandemic. COVAX is a vaccines pillar of the Access to COVID-19 Tools (ACT) Accelerator, and co-led by the Coalition for Epidemic Preparedness Innovations (CEPI), Gavi, the Vaccine Alliance, the World Health Organization (WHO), and the United Nations Children’s Fund (UNICEF). As pointed out by Suzuki Kazuto, a professor at the graduate school of public policy of the University of Tokyo, Japan’s vaccine diplomacy is not that influenced by so-called “vaccine nationalism” which causes monopolization of vaccines in a country. Hence, the Japanese government contributed to the establishment of the COVAX Facility and has continued to strengthen the global vaccine distribution system during the pandemic period.
On April 8, 2022, the Gavi COVAX Advance Market Commitment (AMC) Summit was held under the leadership of co-hosts, the Governments of Germany (G7 Presidency), Ghana, Indonesia (G20 Presidency), Senegal (African Union Chair), as well as Gavi, the Vaccine Alliance. The summit was aimed to facilitate equitable access to safe, effective, and quality-assured coronavirus vaccines in both developed and developing countries in response to the COVID-19 pandemic. At the summit, Prime Minister Kishida Fumio stated that there is a “vaccine equity gap” in the world, and that Japan had already donated more than 43 million doses of vaccines to countries in need. Kishida pledged that Japan would contribute up to $500 million to COVAX on top of the previous contribution of $1 billion which was already disbursed. In a way, Japan’s global health diplomacy toward the COVAX Facility is consistent with Prime Minister Kishida’s “new capitalism” that values a redistribution of wealth and a virtuous cycle of growth on a global scale.
Japan’s Entry into the COVAX Facility: Domestic and External Aspects
Importantly, Japan became one of the first developed countries to participate in the COVAX Facility. On August 18, 2020, Komeito, a junior coalition partner of the Liberal Democratic Party (LDP), officially requested that the Japanese government should consider and decide on Japan’s early participation in the COVAX Facility. On August 27, Komeito’s Chief Representative Yamaguchi Natsuo reconfirmed the party’s request in order to secure necessary vaccines for Japan and provide vaccines for developing countries in need. On August 31, the Japanese government expressed its willingness to participate in the COVAX Facility, and took a cabinet decision on September 15, 2020, to spend 17.2 billion yen for Japan’s entry into the facility. Meanwhile, Seth Berkley as CEO of Gavi, the Vaccine Alliance commended Komeito for its role in facilitating Japan’s entry into the COVAX Facility.
Komeito moreover asked the Japanese government to encourage the US government to join the multilateral vaccine supply system. Previously, the Donald Trump administration declared that the United States would not participate in the COVAX Facility, whereas China decided to join the COVAX program backed by the WHO. During the Cabinet Committee of the Upper House on October 8, 2020, Takahashi Mitsuo, a lawmaker of Komeito, stated that Tokyo would need to encourage Washington to join the COVAX system regardless of the result of the presidential election scheduled the following month. In response, a government official responded that Japan would continue to explain the importance of the COVAX Facility to many countries, including the United States.
Likewise, Takeuchi Yuzuru of Komeito argued in the Budget Committee of the Lower House on November 2, 2020 that the Japanese government should encourage both the United States and Russia to join the COVAX Facility. In response, then-Prime Minister Suga Yoshihide promised that Japan would continue to call on the US to join the system. Although the role of the Japanese government in facilitating the increase of member-states of the COVAX Facility is not measurable, President Joe Biden announced on January 21, 2021, that the United States would join the multilateral vaccine distribution system. As a result of the strong urging by Komeito as a ruling party, Japan became one of the first developed countries to join the COVAX Facility and kept on urging Washington to participate in COVAX system.
Japan’s Direct and Indirect Vaccine Donations and the FOIP Vision
Why is Japan eager to make financial contributions to the COVAX Facility? For one thing, human security is a core diplomatic pillar, but at the same time, it is also related to its Free and Open Indo-Pacific (FOIP) vision. On June 2, 2021, the Japanese government under the leadership of then-Prime Minister Suga Yoshihide pledged additional $800 million to the COVAX Facility during an online summit meeting. Suga also promised that Japan would provide 30 million domestically produced doses in the future. At the meeting, Suga stated that “We must not allow a country’s specific situation or economic power to determine its access to vaccines… Japan fully supports efforts to ensure equitable access to safe and effective vaccines for as many people as possible.” It was reported that Japan strengthened its vaccination support for developing countries to counter Beijing’s vaccine diplomacy, fearing political influence over recipient nations. Japan’s strategic vaccine diplomacy can be seen in a statement by then-Foreign Minister Motegi Toshimitsu who explained that “They are very important countries for our initiative to realize a free and open Indo-Pacific region.” Moreover, the Japanese government has reinforced its strategic partnership with the so-called Quad countries, such as Australia, India, and the United States. The Quad vaccine partnership represents Japan’s strategic commitment to the global health system.
According to a government document entitled “Japan’s COVID-19 vaccine-related support” announced by the Ministry of Foreign Affairs, Japan in May 2022, the Japanese government has already disbursed $1 billion to AMC of COVAX Facility, carried out so-called “last mile” support for capacity building of medical experts and cold chain system in 77 countries and areas with $18 billion through the Japan International Cooperation Agency (JICA) and the UNICEF, and conducted direct and indirect donations of coronavirus vaccines for approximately 44 million doses in total so far. Japan’s direct donations of COVID-19 vaccines amounted to 24.65 million doses, and vaccine recipient countries include Taiwan (4.2 million doses), Vietnam (7.35 million doses), Indonesia (6.88 million doses), Malaysia (1 million doses), the Philippines (3.08 million doses), Thailand (2.04 million doses), and Brunei (0.1 million doses) — all of which are strategically important countries in the Indo-Pacific area.
As for indirect donations through the COVAX Facility, Japan has made financial contributions to 19.38 million doses of COVID-19 vaccines. Recipient countries on the list in the government document are Cambodia (1.32 million doses), Laos (0.94 million doses), East Timor (0.17 million doses), Bangladesh (4.55 million doses), Maldives (0.11 million doses), Tajikistan (0.5 million doses), Uzbekistan (0.2 million doses), Nepal (1.61 million doses), Sri Lanka (1.46 million doses), Pacific Island Countries (0.34 million doses), Nicaragua (0.5 million doses), Iran (4.31 million doses), Syria (0.15 million doses), Egypt (0.7 million doses), Malawi (0.68 million doses), Nigeria (0.86 million doses), Cameroon (0.07 million doses), Ghana (0.31 million doses), Senegal (0.3 million doses), Kenya (0.2 million doses), and Sierra Leone (0.1 million doses). As these figures reflect, the Japanese government has made continuous contributions to the fair redistribution of coronavirus vaccines. Thus, it is critical to note that Japan has supported many countries of the Indo-Pacific region, and therefore, its vaccine diplomacy has been fundamentally influenced not only by its human security diplomacy but also by its FOIP vision.
Strategic Implications of Domestic Vaccine Development
Some COVID-19 vaccines under license contracts with Astra Zeneca or Novavax are domestically developed in Japan, and they have been supplied to other countries as part of the government’s direct vaccine donation program. This could be regarded as Japan’s international cooperation and global health diplomacy during the coronavirus pandemic. Nevertheless, there exists no domestically developed or original vaccines in Japan so far. Regarding this matter, Teshirogi Isao, President and CEO of Shionogi, representing the Federation of Pharmaceutical Manufacturers’ Associations of JAPAN (FPMAJ), pointed out that Japan had made financial contributions to the COVAX Facility, but the country was not able to make direct contributions to the facility in terms of the development of purely domestically developed COVID-19 vaccines. Teshirogi argued that domestic development of vaccines as a measure against the pandemic was a critical factor for Japan’s national security.
To contribute to the COVAX Facility in terms of vaccine development as well as financial contribution, it is imperative for the Kishida government to reinforce national pharmaceutical companies. It does not mean, however, that Japanese people should depend only on domestically produced vaccines, because such a measure might lead to vaccine nationalism. Still, it is important for Japanese pharmaceutical companies to develop and produce original vaccines, because it could be meaningful to the enhancement of the COVAX Facility as well as to current and future Japanese global health diplomacy in the pandemic and post-pandemic periods. In essence, Japan’s global health diplomacy toward the COVAX Facility is in line with Prime Minister Kishida’s new capitalism for redistribution of vaccines as opposed to vaccine nationalism.