Japan’s vaccine procurements achieved through personal connections

The Yomiuri Shimbun

This is the second installment of the series, “The Politics Behind Vaccination Program,” examining behind-the-scenes political moves concerning COVID-19 vaccines.

“Congratulations.”

On the morning of April 17, Prime Minister Yoshihide Suga spoke this message into a speakerphone in a conference room at Blair House, the U.S. president’s official guest house in Washington. Sunshine flooded the room through its many windows.

The man Suga spoke to over the speakerphone was Albert Bourla, chief executive officer of Pfizer Inc., a major U.S. drugmaker that has led the world in terms of COVID-19 vaccine development.

Suga expressed his congratulations on the prize that Bourla had received about one month before as an excellent businessperson from an influential U.S. foundation. Suga, who had learned of his winning the prize, sent Bourla a congratulatory message before speaking to him. Apparently, Suga’s preparation worked favorably, so the conversation started smoothly.

The Pfizer side was at first reluctant to accept the request of the Japanese government for the conference call with Bourla. However, the Suga side wanted to realize a conference by any means, even if only by telephone.

An aide to the prime minister said that Suga had an intention to “display his leadership” in his first visit to the United States, a visit that attracted a lot of interest.

During the teleconference, Suga told Bourla that he would appreciate his continued support, and Bourla replied that he would make the utmost effort to supply vaccines to Japan.

The Japanese government had already entered into a contract for 144 million doses of vaccine for 72 million people. Through the teleconference, it was officially decided that an additional 50 million doses would be supplied.

In spite of that, the Japanese government, which has not domestically produced vaccines and has to rely entirely on imports, has had difficulty procuring vaccines. It was in January this year that the moves for securing vaccines accelerated within the government.

When Hiroto Izumi, a special adviser to the prime minister, reported to Suga at the Prime Minister’s Office in early January that it would be in April at the earliest that the Pfizer-BioNTech vaccine would arrive in Japan, Suga told Izumi in anger: “No good. It’s too late.”

With global competition for vaccines intensifying, Suga delegated negotiations to secure vaccines to a team of the Health, Labor and Welfare Ministry, with Izumi playing a central role.

However, the negotiations were going nowhere. While Japan had asked Pfizer for an early supply of the vaccine, the drug firm did not yield on supplying the vaccine to Japan in April, insisting that the infection situation in Japan was not worse than in Europe.

Therefore, Suga ordered Shinsuke Sugiyama, who had been the Japanese ambassador to the United States, to arrange the negotiation with Bourla, whom diplomatic sources describe as “the busiest businessperson in the world.” Bourla at first did not accept calls from Sugiyama, whom he had not met before.

Sugiyama relied on former U.S. Health and Human Services Secretary Alex Azar, who held the office in the administration of former President Donald Trump, whom Sugiyma has known for a long time.

Azar warned Sugiyama that a drugmaker would not accept what a government said. But after Sugiyama telephoned Azar, Bourla finally accepted a call from Sugiyama.

In the telephone conversation, Sugiyama told Bourla that the number of infections in Japan may be fewer than that of Western countries, but as prime minister, Suga had a sense of urgency that serious matters could happen in the near future.

In response, Bourla asked Sugiyama many times whether Suga had really said these things. He continued, saying that Japan was a huge market and the company would make efforts in that respect. After that, health minister Norihisa Tamura also negotiated with Bourla over the telephone to seek an early supply of the vaccine.

Administrative and regulatory reform minister Taro Kono, who was put in charge of the nation’s vaccination program, took over the negotiations. He personally phoned a Pfizer official in charge of the vaccine to discuss the matter directly. He even sent the Pfizer official photos of cherry blossoms in and around Tokyo in late March as a way to enrich their interactions. As a result, Kono’s efforts led to an advance supply of the vaccine and the additional provision of 50 million doses.

Even though Pfizer had decided to provide its vaccine to Japan, there was another hurdle for Japan to overcome: vaccine export rules the European Union introduced at the end of January.

Pfizer has factories in Belgium. Unless the Belgian government allowed the exports, Japan could not obtain the vaccine.

Kono used bureaucrats who worked under him when he was the foreign minister. Yasushi Masaki, the Japanese ambassador to the European Union, and Makita Shimokawa, the Japanese ambassador to Belgium, asked the EU and the Belgian government every day to allow a smooth supply of the vaccine to Japan.

Kono himself used his personal connections to press those related to the EU, telling them that if the exports to Japan stopped, that could affect Japan-EU relations.

As a result, out of a total of about 178 million vaccine doses that the EU endorsed for export to 45 countries and regions as of May 3, about 40% will go to Japan.

Through various negotiations, the first arrival of Pfizer’s vaccine to Japan was advanced to Feb. 12. Although there were pros and cons as to Suga’s direct request to the top executives of a drugmaker, Japan could secure the additional doses.

In August 2020, the Japanese government reached an agreement with Britain’s AstraZeneca PLC for the drugmaker to provide 120 million doses of its vaccine, but the detailed handling has yet to be decided. This is because there have been reports that the vaccine has caused blood clots as a rare side effect.

At a press conference on May 7, asked about the future outlook on the vaccine supply for next year, Suga emphasized that the government has promoted negotiations with U.S. drug makers Moderna, Inc. and Novavax, Inc. to seek 200 million doses of their vaccines.

As for the Japanese government’s strategy to procure vaccines, a senior government official said that it would purchase all the vaccines from companies that would sell them and try to procure as many as possible by all means.

While having worried about various hurdles, government officials including Suga and Kono made desperate efforts to secure vaccines, but a source close to the government said that there was no denying that the government had lacked a strategy for that purpose.

With limited bargaining chips, the government had to rely on personal connections to acquire vaccines for Japan.

In the future, Japan will face other hurdles, including a shortage of people who can administer the vaccination shots in order to keep the inoculation drive in motion.