Social Agenda for the COVID Era and Beyond: Toward a Platinum Society

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Social Agenda for the COVID Era and Beyond: Toward a Platinum Society

What has the COVID-19 pandemic taught us about the long-term challenges facing human society and the kind of governance needed to tackle them?

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In January 2020, the world was alerted to a public health crisis in the form of a newly emerging infectious disease, now known as COVID-19. The novel coronavirus responsible for the disease spread rapidly around the world, and as of this writing (October 29, 2020), the pandemic shows no signs of abating.

The human and economic toll from this previously unknown pathogen has been compounded by long-standing societal ills, suggesting that action to mitigate social problems could also reduce the impact of the crisis. Meanwhile, the pandemic, having forced individuals and businesses to alter their behavior so as to stem the contagion, may actually have provided us with a unique opportunity to modify our conduct with a view to overcoming society’s many challenges.

What, specifically, are the social issues that the pandemic has exposed and exacerbated? What have we learned thus far, and how can those lessons inform our vision for the future? Hiroshi Komiyama, who chairs the Foundation’s CSR Committee, spent much of 2020 grappling with these questions. The following is a summation of his thoughts, drawn primarily from his May 2020 keynote address to the opening seminar of the Nikkei SDGs Festival (Komiyama 2020a) and his paper submitted to the Japan Medical Association COVID-19 Medical Expert Meeting the same month (Komiyama 2020b).

Setbacks in the Fight Against Poverty and Inequality

COVID-19 spread rapidly around the world after China reported a major outbreak in January 2020. By October 23, 2020, the total number of infections confirmed globally had reached 41.6 million[1]—approximately 0.5% of the world’s population, or about 5 out of every 1,000 people. Deaths have continued to mount, especially in Europe, the United States, Brazil, and India, passing the 1 million mark in October 2020.

In the absence of an effective treatment for this disease, governments were obliged to place tough mandatory or voluntary restrictions on movement in an effort to stem its spread. People were asked to stay home, shops and restaurants closed their doors, travel was severely restricted, and economic activity inevitably plummeted as a result. In October, the International Monetary Fund was forecasting a 4.4% drop in global economic output for 2020 (IMF 2020).

The pandemic’s impacts have fallen on the world’s populations unequally, highlighting and exacerbating pre-existing disparities. In developing countries, inadequate access to healthcare has driven up the death count.[2] The pandemic has also greatly exacerbated the endemic ills of hunger and poverty. Within many developed countries, low-income communities have suffered disproportionately, recording higher rates of hospitalization and death. In the United States, racial disparities have been particularly striking: The rate of hospitalization among African Americans has been 4.7 times that of white Americans and their death rate has been 2.1 times higher. Low-income households have been the hardest hit by the economic slowdown.[3]

Meanwhile, travel restrictions and social distancing have greatly hindered aid programs and other initiatives to address these problems. Figure 1 lists some of the pandemic’s reported impacts on key UN Sustainable Development Goals (the 17 goals embraced by the UN member states under the 2030 Agenda for Sustainable Development).

Figure 1. Examples of the Pandemic’s Impact on the Importance of Governance

Zero hunger (Goal 2)

The United Nations World Food Programme warned that by the end of 2020, starvation could be facing 270 million people worldwide, an increase of 82% from pre-pandemic levels. The impact was most severe in low-income urban communities in Central and South American, where the number of people requiring food assistance tripled.

Good health and well-being (Goal 3)

The World Health Organization and UNICEF reported that severe disruption of routine immunizations in at least 68 countries was likely to affect at least 80 million children   under the age of 1 living in those countries.

Decent work and economic growth (Goal 8)

The International Labor Organization estimated that working hours in the third quarter of 2020 would be down 12.1% from the same period of the previous year. Labor income during the first three quarters of 2020   was estimated to be down 10.7% from the corresponding period in 2019. Labor income losses were estimated at 15.1% in lower-middle-income countries.

No poverty (Goal 1)

Oxfam warned that the pandemic could push an additional 500 million people into poverty.

Quality education (Goal 4)

UNESCO reported that on April 24, 2020, school closures and other disruptions, including 165 country-wide closures, were impacting the education of 1,465,679,660 learners (preschool through tertiary levels  ), or 83.7% of the total.

The COVID-19 pandemic has also served to underscore the critical role of organizational governance. One early Japanese study, for example, found that even among the many countries where the virus spread rapidly during the first wave, some were much more successful than others in preventing a rapid rise in fatalities (Taniguchi et al. 2020). The authors suggest that a major factor may have been the ability of hospitals to provide all patients with optimal treatment—which, in turn, depended on how quickly administrators were able to boost the capacity of the local healthcare delivery system to cope with the epidemic. In areas that did not respond nimbly enough, hospitals were overwhelmed, and the case fatality rate rose. In other words, the disparities in outcomes may have been partly a result of differences in healthcare administration and governance (Komiyama 2020b).

In Japan, the number of cases and deaths per 100,000 has been quite low compared with the United States and other Western countries. However, Japan does not compare favorably with its neighbors in East Asia. Failings related to healthcare administration and governance were conspicuous from the start. For example, since the early days of the pandemic, Japan has conducted very little PCR (polymerase chain reaction) testing for the coronavirus compared with other countries, and from March to May 2020, the capacity of many hospitals was severely strained despite the relatively low numbers of confirmed cases.[4]

Chairman Komiyama zeroed in on Japanese governance issues in his JMA paper. “PCR testing is a standard technique of genome research,” he noted. “Japan is surely the equal of other countries in terms of equipment, personnel, and technology [for PCR testing]. As for healthcare delivery resources, such as hospital beds available for COVID patients, it seems unthinkable that Japan suffers from a material shortage. Where we fall short is in creating systems conducive to the efficient utilization of those resources” (Komiyama 2020b).

One widely acknowledged key to good governance is ongoing dialogue and collaboration among stakeholders and participants at various levels to ensure continuous improvement and a nimble response to changing circumstances on the ground. In Japan, however, people are reluctant to question direction from on high. (For example, under the state of emergency declared on April 7. 2020, most citizens and businesses complied with government requests to strictly limit their movement, social contacts, and business activity, even though there were no penalties for noncompliance.) This one-way relationship between “a bureaucracy that wields excessive authority and a people resigned to that state of affairs” is unconducive to flexible, responsive policymaking that incorporates the input of people on the front lines (Komiyama 2020b).

Hints for improving governance in an emergency situation can be gleaned from the independent actions of certain local governments and hospitals. In response to the threat of COVID-19, a number of local entities, including the prefectural governments of Wakayama, Hokkaido, and Osaka and the municipal governments of Chiba, Kawasaki, and Shinjuku ward (Tokyo), took the initiative and set their own policies, in some cases moving more quickly than the central government. Frustrated with the slow pace of centralized testing, some hospitals began conducting their own PCR and antibody tests. A decentralized, collaborative system of governance, in which local communities and businesses are empowered to respond autonomously and cooperatively to local circumstances, might yield better outcomes (Komiyama 2020b).

Figure 2. Recommendations for Preventing a Breakdown of the Healthcare Delivery System and Minimizing the Impact on Economic Activity

1. Consolidate healthcare facilities by means of specialization and collaboration to make the most efficient possible use of healthcare resources.

2. Utilize the capacity of clinics and small hospitals nationwide to lighten the burden on large hospitals and public health centers to speed testing and enhance safety and peace of mind.

3. Provide generous, targeted fiscal assistance to strengthen the capacity of the healthcare delivery system to cope with COVID-19.

4. Bolster the nation’s testing regime and achieve rapid turnaround.

5. Prioritize protection of high-risk individuals.

6. Provide detailed and accurate information about varying infection and risk levels and establish rational, targeted social-distancing and business-activity guidelines based on that information. At the same time, work at all levels of society to eliminate prejudice, discrimination, and shaming.

Source: Study Group on Problems in the Healthcare Delivery System and Hospital Management during the COVID-19 Pandemic (2020).

Challenges for Post-Pandemic Society

The COVID-19 pandemic has forced individuals and businesses alike to rethink the way they function on a daily basis. As suggested earlier, some of these changes could open the way for long-term shifts in behavior that would help make the world a better place.

For most of human history, economies grew at a very slow pace. With the Industrial Revolution, labor productivity began to rise sharply, leading to a rapid improvement in living standards during the twentieth century (today is seven to eight times higher than in 1900). At the same time, average global life expectancy soared from 31 years in 1900 to 72 today. As a result, the population has ballooned as the pace, range, and impact of economic activity have surged. From a relative standpoint, the earth has gotten much smaller.

Such dramatic changes, occurring within a relatively short time frame, have strained the fabric of human society, even while accelerating economic development worldwide. One area in which the strain is manifested is human rights. For example, there are many countries that still cannot guarantee universal access to clean water or school education. Another casualty is the global environment. Economic development and growth have been accompanied by ever-rising emissions of carbon dioxide and other greenhouse gases, which are fueling climate change and other serious environmental impacts. The SDGs—the core of the 2030 agenda formally adopted by the UN Sustainable Development Summit in September 2015—seek to resolve or at least mitigate these problems, while “leaving no one behind.”

The developed world is facing its own challenges, including demographic aging and stagnant demand. As industrial societies mature and reach a certain level of affluence, the birthrate tends to decline, and lifespans to lengthen. Meanwhile, factors like the rise of automation and digital technology and the availability of inexpensive imports from less developed countries have contributed to chronically lackluster aggregate demand, which translates into economic stagnation.

The COVID-19 pandemic should be seen as a turning point in human history and an opportunity for decisive action to address these long-term structural problems.

Toward a “Platinum Society”

Komiyama (2020a) has used the term “platinum society” to describe a world in which these problems have been overcome, paving the way for “an affluent and sustainable society conducive to individual self-realization.” More specifically, a platinum society is characterized by (1) deep caring for ecosystems and the global environment, (2) long-term sufficiency of resources (including food and energy), (3) participation and inclusion, (4) ample employment opportunities, and (5) freedom of choice.

That may sound idealistic, but decentralized, collaborative initiatives all around Japan are showing that it can be done. One shining example is the alliance formed in Mishima, Shizuoka Prefecture, to restore the natural environment of the Genbei River while revitalizing the local economy. Since the 1960s, the Genbei River, which runs through the heart of Mishima, had fallen victim to industrial pollution and urban development, and the city’s beautiful waterfront had been spoiled. But a partnership of citizens, businesses, nonprofits, and local agencies has succeeded in restoring the area’s uniquely rich urban-riparian ecosystem. The environmental cleanup, paired with the construction of and other waterfront amenities, has helped power a four-fold increase in tourists over the past 25 years, creating jobs and other opportunities for people of all ages to participate in the local economy.

More and more often, local citizens, businesses, and administrators are taking action, voluntarily and collaboratively, instead of waiting for big government to step in and solve their problems. This kind of community collaboration and co-evolution may be the kind of governance we need to achieve a platinum society in the post-pandemic era.

 

References

International Monetary Fund (IMF). 2020. World Economic Outlook, October 2020. https://www.imf.org/en/Publications/WEO/Issues/2020/09/30/worldeconomic-outlook-october-2020.

Komiyama, Hiroshi. 2020a. “Purachina shakai ga ken’in suru SDGs” (Platinum Society and the SDGs). Keynote address, Nikkei SDGs Festival, May 11, 2020. https://channel.nikkei.co.jp/e/sdgsmirai0511.

Komiyama, Hiroshi. 2020b. “‘Korona-ka kara no dasshutsu’ no tame no chi no kozoka” (Structuring Knowledge to Escape the Coronavirus Crisis). Paper submitted to the Japan Medical Association COVID-19 Medical Expert Meeting, May 13, 2020. https://www.covid19-jma-medical-expert-meeting.jp/topic/1107.

Okubo, Toshihiro. 2020. “Expansion of Disparities During the COVID-19 Pandemic: The Income Gap and the Digitalization Gap.” NIRA Opinion Paper 53 (September 2020). https://english.nira.or.jp/papers/opinion_paper/2020/09/expansion-of-disparities-during-the-covid-19-pandemic--the-income-gap-and-the-digitalization-gap.html.

Study Group on Problems in the Healthcare Delivery System and Hospital Management during the COVID-19 Pandemic. 2020. “Six Emergency Recommendations for Preventing Breakdown of the Healthcare System and Minimizing Impact on Economic Activity.” September 2020. https://cigs.canon/uploads/2020/09/20200925_kobayashi_report.pdf.

Taniguchi, Takeaki, Sachiko Hirakawa, Koki Nakamura, and Toshihiro Hayashi. 2020. “Shingata koronawirusu kakkoku shisaku bunseki repoto 1: Kakkoku no kansenshasu to shiboshasu kara mita iryo teikyo taisei no jokyo” (Analysis of Measures Taken in Different Countries against the Novel Coronavirus, Report 1: The State of the Healthcare Delivery System as Seen in the Number of Infections and Fatalities). Mitsubishi Research Institute website, April 15, 2020. https://www.mri.co.jp/knowledge/column/20200415.html.

United Nations Development Programme (UNDP). 2020. “Coronavirus vs. Inequality.” UNDP website. https://feature.undp.org/coronavirus-vs-inequality/.

 

[1] Johns Hopkins University Center for Systems Science and Engineering, COVID-19 Dashboard, https://coronavirus.jhu.edu/map.html, October 23, 2020.

[2] According to the United Nations Development Programme(UNDP 2020), developed countries have on average of 55 hospital beds, more than 30 doctors, and 82 nurses per 10,000 population, while less developed countries average only 7 beds, 2.5 doctors, and 6 nurses.

[3] For example, in a survey carried out jointly by researchers at Keio University and the Nippon Institute for Research Advancement (Okubo 2020), the proportion of respondents indicating that their income had fallen between March and June 2020 was highest among low-income subjects.

[4] Experts at the Tokyo Foundation for Policy Research were among those who called attention to Japan’s inadequate testing regime early on. See “Addressing the Economic Fallout from the Coronavirus Crisis: Emergency Proposals by Economists in Japan,” April 18, 2020, https://www.tkfd.or.jp/en/research/detail.php?id=728.

Tokyo Foundation for Policy Research