The 71-year-old head of the ruling Liberal Democratic Party (LDP) replaces outgoing leader Shinzo Abe, Japan’s longest-serving Prime Minister, who announced his intention to resign in August due to health problems related to colitis — a non-curable inflammatory bowel disease that he was able to manage for most of his tenure.
Suga was elected LDP leader on Monday with about 70% of the votes, but he still required the backing of the country’s national legislature, the Diet, before he could officially become Prime Minister.
He won the Diet vote with 314 out of 465 votes in the lower house and 142 out of 240 votes in the upper chamber.
Shortly after his confirmation, the new Prime Minister announced his cabinet line up, which included a large number of former Abe appointees, likely to promote the impression of stability and continuity between the two leaders.
Foreign Minister Toshimitsu Motegi and Finance Minister Aso Taro will continue in their roles, while Abe’s Health Minister Motonobu Kato was promoted to the important post of chief cabinet secretary — a combination of chief of staff and press secretary.
Former Prime Minister’s Abe’s brother Nobuo Kishi will take the role of Defense Minister under Suga. In total, there are only two women in the cabinet.
Suga is expected to be sworn in by Emperor Naruhito at the Imperial Palace in Tokyo on Wednesday afternoon.
The appointment of Suga as Abe’s replacement isn’t surprising. Suga was the former Japanese leader’s right-hand man during Abe’s almost eight years in office throughout his second term, holding the position of chief cabinet secretary in his government
Suga is known as a successful political operator, who can get things done, and worked hand-in-hand with the former leader to implement “Abenomics” — a series of economic policies designed to boost Japan’s flagging economy.
In fact, Suga is so closely tied to the former Prime Minister that Kazuto Suzuki, a vice dean and professor of international politics at Hokkaido University, described him as an “Abe substitute.”
Freshly installed in Japan’s top job, Suga is already facing several significant challenges. Although a second wave of coronavirus infections in the country has been mostly brought under control, the disease is still causing major disruptions to the local and global economy.
In August, Japan reported its worst GDP fall on record amid the global pandemic, with the economy shrinking 7.8% in the second quarter of 2020.
Tokyo is still scheduled to hold the delayed 2020 Summer Olympics in 2021, although questions remain around whether or not the global pandemic will have been brought under control in time.
Japan is also facing major long-term economic and social issues, such as massive government debt and an aging population. Despite Abe’s public calls for reforms for gender equality in the workplace, critics say not enough progress was made during his time in government.
Suga will also face a referendum on his new government sooner than he may have liked. The Prime Minister must hold another general election by October 2021, although Defense Minister Taro Kono said Wednesday that snap elections could be called as early as next month.
CNN’s Emiko Jozuka, Joshua Berlinger and Will Ripley contributed to this article.
Yoshihide Suga was formally elected Wednesday as Japan’s new prime minister in a parliamentary vote.
The 71-year-old is replacing Shinzo Abe, who resigned because of ill health. Suga had been chosen as the new head of the governing Liberal Democratic Party on Monday, virtually assuring his succession.
Suga, who was chief Cabinet secretary and long seen as Abe’s right-hand man, is to launch his own Cabinet later on Wednesday.
He has stressed his background as the son of a strawberry grower and a self-made politician, in promising to serve the interests of ordinary people and rural communities.
The new prime minister has vowed to pursue Abe’s unfinished policies, adding that his top priorities will be fighting the coronavirus and turning around an economy battered by the pandemic.
Abe, Japan’s longest-serving prime minister, announced last month that he was stepping down because of health problems.
“I devoted my body and soul for the economic recovery and diplomacy to protect Japan’s national interest every single day since we returned to power,” he said, adding that his health was improving thanks to treatment.
Suga has been a loyal supporter of Abe since the former leader’s first stint as prime minister from 2006 to 2007. Abe’s tenure ended abruptly because of illness, and Suga helped him return as prime minister in 2012.
The new prime minister says he is a reformer who will break down vested interests and rules that hamper reforms. He has vowed to set up a new government agency to speed up Japan’s lagging digital transformation.
Suga has said he will appoint “reform-minded, hard-working people” to the new Cabinet.
Editor’s note:Since this article was published, Abe Shinzo has announced his resignation because of ill health
FOR ABE SHINZO August 24th was supposed to be a celebration. It was his 2,799th straight day as Japan’s prime minister, making him the longest-serving in the country’s history, surpassing a record set by his great-uncle, Sato Eisaku. Instead, Mr Abe spent the afternoon at Keio University Hospital in Tokyo undergoing medical checks and denying reports that he was about to step down.
Ill health has long dogged Mr Abe. His first stint as prime minister came to an abrupt end in 2007, after a turbulent year marred by, among other things, a flare-up of ulcerative colitis, a chronic intestinal disease. A new drug has helped Mr Abe manage the symptoms since he took up the job again in 2012. Yet as he has receded from public view in recent months, rumours about his health have proliferated. Japanese media have taken to analysing footage of his gait to see if it has slowed. It now takes him 21 seconds to walk down the corridor outside his office, compared with 18 seconds in April, reports TBS, a television station. The visit to the hospital on the 24th was his second in as many weeks. On August 28th Mr Abe plans a press conference to clarify the state of his health.
Aides admit that the stress of leading the country through the pandemic has taken a toll on Mr Abe, but they balk at the idea that he is too ill to carry on. His third and, by the party’s regulations, final term as leader of the ruling Liberal Democratic Party (LDP) lasts until September next year. A general election is due around the same time. On August 26th Suga Yoshihide, the chief cabinet secretary, declared that it was “premature to talk about ‘post-Abe’”. Nonetheless, the prime minister’s perceived frailty has fuelled exactly that kind of talk. Within the LDP, “many are sniffing blood,” says one of Mr Abe’s advisers.
The succession could play out in three ways. If Mr Abe is hospitalised or temporarily incapacitated, the deputy prime minister, Aso Taro, would become the interim leader. Mr Abe could step down early, allowing the LDP to elect a replacement to complete the duration of his current term. The party’s rules allow an emergency election at a meeting of its MPs, bypassing the normal party-wide vote. Or Mr Abe could stay on until the end of his term, reshuffling his cabinet or even calling an election to reassert control.
Mr Abe’s stamina is just one of many uncertainties. Two opposition parties, the Constitutional Democratic Party and the Democratic Party for the People, announced a merger earlier this month. Their support remains too shallow to challenge the LDP’s hold on power, but the LDP might favour an early election to deprive them of the chance to organise and make their mark. The Tokyo Olympic Games remain in limbo because of covid-19. Mr Abe seems to have thought of them as his swansong—but they may not happen at all.
Then again, if Donald Trump triumphs in November, calls for Mr Abe to stay on might increase, given his skill at buttering up the mercurial American president. Moreover, covid-19 has sent Japan’s economy into a tailspin, and Mr Abe’s poll numbers along with it: GDP shrank by a record 7.8% in the second quarter of this year compared with the first. Approval of Mr Abe’s government sits at 34%, the lowest since the start of his long second term. He might prefer to try to regain popularity in order to leave his successor on solid electoral footing—and to have bigger say in choosing that successor, his adviser notes.
Kishida Fumio, the LDP’s head of policy, is believed to be Mr Abe’s favourite. Voters see him as competent, moderate and thoroughly uninspiring. Ishiba Shigeru, a former defence and agriculture minister, staked out a rare position as an Abe critic. He has broad support among the party’s rank and file, but few backers among its MPs. (Mr Abe may resign early to avoid a party-wide vote and thus block Mr Ishiba’s rise, argues Toshikawa Takao, editor of Tokyo Insideline, a political newsletter.) Mr Suga is a master at managing the bureaucracy, but has little foreign-policy experience. Kono Taro, the current defence minister, and Motegi Toshimitsu, the foreign minister, both have aspirations for higher office, though their candidacies are seen as long shots.
The differences among them all are more of tone and tactics than of ideology. Finding differences on policy requires a microscope. Mr Kishida would carry Mr Abe’s flag, though he hails from a more centrist wing of the LDP, less wedded to Mr Abe’s priorities, such as revising the constitution. Mr Ishiba may favour more orthodox fiscal and monetary policy, but his room for manoeuvre would be limited after the pandemic. Mr Suga might devolve more power to local governments. Mr Kono casts himself as a maverick, having taken stances at odds with the party in opposition to nuclear energy and in favour of allowing the sons of female royals—or even (gasp!) the female royals themselves—to inherit the throne. Ultimately, the decision will come down to personalities and factional arithmetic. “The selection process is not really a policy choice,” says Sone Yasunori of Keio University.
Whoever replaces Mr Abe will inherit immense problems: gargantuan public debt, a shrinking population and an economy that has been limping along for decades. But he will also wield great authority. During his long reign, Mr Abe has centralised decision-making, establishing a national security council and shifting power away from the bureaucracy. “To navigate a turbulent world, you need a strong prime minister—that pattern is embedded,” says Tobias Harris of Teneo, a consultancy. “The institutional power will be there for a prime minister who manages to keep the LDP in his grip.” For now, however, the question is whether Mr Abe himself, not his as-yet-unknown successor, can maintain his grip on the party. ■
This article appeared in the Asia section of the print edition under the headline “After Abe”
TOKYO — Japan’s next prime minister is to be elected in a special session of parliament to be held as early as Sept. 17, according to plans within the ruling Liberal Democratic Party.
Following Shinzo Abe’s decision to step down, the LDP has begun preparations to vote for its next leader by Sept. 15. The party’s General Council will meet Tuesday to decide how and when the process will take place.
Chief Cabinet Secretary Yoshihide Suga, Abe’s right-hand man, has decided to seek the top spot, Nikkei has learned. The party’s powerful factions are starting to throw their support behind him. Members of parliament who support his bid will gather today for a meeting.
Though Suga trails in voter polls behind such other likely candidates as Abe rival Shigeru Ishiba and Defense Minister Taro Kono, Suga is seen as a steady hand who can maintain policymaking continuity and spare Japan from another succession of short-lived governments like those before Abe.
Suga told aides Sunday that he wants to focus on “tackling the coronavirus and the economy.”
LDP Secretary-General Toshihiro Nikai said over the weekend that he would support Suga in the party leadership race. A senior member of the Hosoda faction, the largest grouping in the LDP, described Suga as “a leading candidate.”
The chief cabinet secretary, as the head of the cabinet secretariat, sits atop Japan’s powerful Kasumigaseki bureaucracy. All of the current career bureaucrats leading the ministries have been installed by the Abe-Suga team, and the influence Suga enjoys is unrivaled by the other candidates.
Winning support from party factions will be crucial for Suga, who does not belong to one himself.
Takeo Kawamura, a high-ranking member of Nikai’s faction, said after a meeting of senior faction officials Sunday that there is a “growing atmosphere” of support for Suga, seen as a solid choice who can “carry on the work of the current administration.”
Support for Suga is broadening within the Takeshita faction as well, while lawmakers unaffiliated with a faction who back Suga will meet Monday to affirm their support. Contenders for LDP leadership are expected to announce their intentions early next month.
But voters appear to favor other candidates.
A Nikkei/TV Tokyo poll conducted over the weekend put Ishiba, a former defense minister, in the lead at 28%, followed by Kono at 15% and Environment Minister Shinjiro Koizumi — son of former Prime Minister Junichiro Koizumi — at 14%. Suga came in fourth at 11%, followed by former Foreign Minister Fumio Kishida at 6%.
Looking at just LDP supporters, the top two remained the same, but Suga led Koizumi 16% to 13%.
Asked to assess Abe’s nearly eight years in office, 74% approved of how he handled the job, triple the 24% who disapproved.
Though Ishiba has expressed interest in running, he told reporters after a speech Sunday that he will wait to see how the party intends to conduct the vote before making a decision.
LDP elections normally are held at the end of a party leader’s three-year term, and the voting involves lawmakers in parliament as well as rank-and-file party members, with both groups having an equal number of votes.
But for an emergency election following a resignation like Abe’s, the party can limit the voting to just lawmakers and a much smaller set of prefectural representatives.
Ishiba advocates the former option. The latter, which puts much more weight on parliamentarians, requires cobbling together a majority from among the party’s factions. Observers say this would hamper Ishiba given his weak base of support in parliament but stronger support among the party’s rank and file.
Asked whether he would run under a restricted vote, Ishiba said he “will not comment on hypothetical problems at this time.” The Abe rival has said he will clarify his stance after Tuesday’s General Council meeting.
The former minister called Suga the “backbone” of the administration and someone he trusts, noting that they worked together to return the LDP to power in 2012.
Kishida met here on Sunday with party heavyweights including Taro Aso, Abe’s deputy prime minister and leader of the LDP’s second-largest faction, to seek their support.
On the same day, Kono told reporters that he plans to consult with others and see which type of vote the LDP chooses before making a decision on running.
Whoever is ultimately chosen, the Nikkei poll indicated that voters prefer another stable leader to succeed Abe, Japan’s longest-serving prime minister.
A majority, 56%, said they want the next prime minister to serve at least four years, with 29% saying “as long as possible.” Just 19% hope for a caretaker who would stay only until the end of Abe’s unfinished term in September 2021. LDP leaders are elected for three-year terms.
Desired traits in the next prime minister include leadership, cited by 45% of respondents, as well as diplomatic skills and trustworthiness at 38% and 35%, respectively. Public popularity ranked last, chosen by just 9%.
Father: Shintaro Abe, former Secretary General of the LDP (Liberal Democratic Party)
Mother: Yoko Kishi
Marriage: Akie (Matsuzaki) Abe (1987-present)
Education: Seiki University, B.S. in Political Science, 1977. He also studied at the University of Southern California.
He was Japan’s first prime minister born after WWII.
His grandfather, Nobusuke Kishi, was Japan’s prime minister from 1957 to 1960.
Abe’s great uncle, Eisuke Sato, was prime minister from 1964 to 1972. Sato is also a Nobel Peace Prize recipient.
In early 2013, Abe launched a grand experiment designed to jolt Japan’s economy out of decades of stagnation. Known as “Abenomics,” it included three so-called arrows: massive monetary stimulus, increased government spending and significant economic reforms.
1977-1979 – Travels to the United States to study politics at the University of Southern California.
1993 – Abe is elected to Japan’s House of Representatives.
1999 – Becomes director of the Committee on Health and Welfare and also director of the LDP’s Social Affairs Division.
2000-2003 – Is the deputy chief cabinet secretary of the LDP.
2005-2006 – Chief cabinet secretary of the LDP.
September 26, 2006-September 25, 2007 – Prime minister of Japan.
March 1, 2007 – Abe sparks controversy by his claims that the foreign “comfort women” who staffed Japanese military brothels during World War II were not coerced into the work. He apologizes on March 26.
September 12, 2007 – Abe announces his resignation.
September 13, 2007 – Hospitalized at Keio University Hospital for gastrointestinal inflammation caused by exhaustion and stress.
September 25, 2007 – Abe dissolves his cabinet. Yasuo Fukuda becomes prime minister.
September 26, 2012 – Wins a run-off election for the leadership of the LDP.
December 16, 2012 – The Liberal Democratic Party wins a landslide victory in elections.
December 26, 2012 – Is elected prime minister by the Japanese parliament.
“I’m doing okay; I’m doing fine. I am running a bit on fumes, but as they say, the fumes are really thick,” Dr Fauci, 79, said in an interview with The Atlantic.
“It’s enough to keep me going.”
And Victoria’s Premier Dan Andrews was urged by some to take a break this month when he conducted his 50th consecutive daily coronavirus update.
“This has been going on for months, and probably will go on for a number of months so someone else is going to have a step up I think, so he can take a few days off,” his predecessor Jeff Kennett said on the Sunrise program.
The pandemic has forced Tokyo to delay the Olympics until at least next year — an event Abe was instrumental in winning and hoped would be his legacy.
More than 64,000 people in Japan have been infected with the virus.
While Japan has largely escaped the worst of the pandemic — especially compared to other countries like the UK and US — a series of missteps marred the early response and the government’s approval rating tanked.
The government distributed washable cloth face masks — but these were unpopular because they arrived too late and were seen to be too small.
Japan’s economy has also suffered greatly, shrinking at an annual rate of 27.8 per cent between April and June — the worst contraction on record.
The coronavirus-induced recession will be especially vexing to the man who coined the term “Abenomics” and the pandemic is sure to have dented his reputation as the man who helped pull Japan out of decades of economic stagnation.
Abe ‘most consequential’ Japanese PM on international front since WWII
Abenomics had mixed results in resuscitating the world’s third-largest economy. But Mr Abe’s legacy will go beyond his economic policies.
When he first took office in 2006, he became Japan’s youngest prime minister since World War II.
The grandson of former Japanese PM Nobusuke Kishi, he faced a huge amount of pressure in the role — including political scandals and voter outrage at lost pension records — before he quit citing ill health.
Five years later, he returned, leading his conservative Liberal Democratic Party (LDP) back to power.
“On the domestic front, he has a mixed record that will likely be seen as having accrued incremental economic gain in the large urban areas and with some structural reform, but not enough to change the long-term trajectory of Japan,” Dr Nagy said.
He kept his promises to boost spending on the military after years of declines and expanding its capacity to project power abroad.
And in a historic shift in 2014, his government reinterpreted the constitution to allow Japanese troops to fight abroad for the first time since World War II.
A year later, Japan adopted laws scrapping a ban on exercising the right to defend a friendly country under attack.
His work on the international stage has also set him apart from previous leaders, according to Dr Nagy.
Among his achievements include improving relations with China and South Korea and forging closer ties with the US under President Donald Trump, through frequent phone calls, meetings and the odd golf session.
Mr Abe has withstood a number of difficult periods in his time in power, but if this pandemic has reminded us of anything, it’s the importance of our health.
With infections on the way down in Japan, Abe decided now was the right time to step away — giving his successor the chance to prepare ahead of the winter flu season just months away.
TOKYO — Prime Minister Shinzo Abe of Japan said on Friday that he was resigning because of ill health, thrusting his country, during a global pandemic, into a new period of political uncertainty after a record-setting tenure that provided unaccustomed stability at the top.
Mr. Abe, 65, announced his decision to step down just four days after he had set a record for the longest uninterrupted run as Japanese leader — nearly eight years — but before he had achieved some of his most cherished ambitions.
Yet despite his long hold on power — it was his second stint as prime minister, having held the post from 2006 to 2007 — Mr. Abe fell short of his ultimate goal of revising the pacifist Constitution installed by the United States after World War II. He was also unable to secure the return of contested islands claimed by both Japan and Russia so that the two countries could sign a peace treaty to officially end the war.
And in an often emotional news conference Friday evening, Mr. Abe expressed regret for a third unfulfilled ambition: securing the return of Japanese citizens kidnapped by North Korea decades ago.
Explaining his decision to step aside, Mr. Abe told reporters that he had suffered a relapse of the bowel disease that led him to resign after just a year during his first stint in office.
He said that he wanted to make way for a new leader who could focus fully on tackling the coronavirus pandemic and other challenges, and that he felt the timing was right because Japan had seemed to have gotten its second wave under control.
“I don’t want to make mistakes in important political decisions” while undergoing treatment, Mr. Abe said. “I decided I shouldn’t continue sitting in this seat as long as I cannot respond to the mandate of the people with confidence.”
His conservative governing party, the Liberal Democratic Party, is expected to elect a leader within coming days or weeks, according to NHK, the public broadcaster. Mr. Abe’s term was set to expire in September 2021.
The leading candidates to replace Mr. Abe include Taro Aso, the long-serving deputy prime minister and a former prime minister; Yoshihide Suga, the chief cabinet secretary to Mr. Abe; Shigeru Ishiba, a former defense minister who once ran against Mr. Abe for party leader; and Fumio Kishida, a former foreign minister.
Mr. Abe declined to name a favorite, saying they were all “very promising.”
The Japanese news media had been speculating about Mr. Abe’s health for weeks, particularly after he significantly dialed back public appearances as a new wave of coronavirus infections erupted in clusters throughout the country. When Mr. Abe visited a hospital twice in the span of a week, the rumor mill went into overdrive.
Earlier on Friday, Mr. Suga had reassured reporters that Mr. Abe intended to remain in office. “The prime minister himself has said he would like to work hard again from now on, and I’m seeing him every day,” he said, adding that the prime minister’s health “remains unchanged.”
But Mr. Abe said he had actually decided on Monday, after a visit to the hospital, that he should resign, although he said he would stay until a successor was chosen. “As I’m in the middle of treatment, I judged that this is the only timing that will not create a vacuum of political leadership,” he said.
When Mr. Abe, the grandson of a prime minister accused of war crimes and the son of a former foreign minister, resigned during his first term after a scandal-plagued year in office, he cited the debilitating effects of ulcerative colitis, which has no known cure.
At the news conference on Friday, Mr. Abe said he had been told by doctors a few months ago that they had found signs of a relapse of the disease. He said that he had since lost much of his strength, and that he would now step aside so he could receive treatment with a new drug that he called promising.
Mr. Abe, whose public approval ratings have plummeted into the 30s as the economy has faltered during the pandemic, said he would remain a member of the lower house of Japan’s Parliament and continue to help his party pursue its goals.
During his second period in office, beginning in late 2012, Mr. Abe survived several influence-peddling scandals and rode out numerous elections. In 2015, he pushed through contentious security legislation that permitted Japanese troops to engage in overseas combat missions alongside allied forces, as part of “collective self-defense.”
His political power peaked in 2017, when his party won a landslide victory that gave it, along with its coalition partners, two-thirds of the seats in Parliament. That was the supermajority required to push through a constitutional revision, but Mr. Abe never brought that nationalist dream to fruition, with public opposition to such a change remaining high.
Still, perhaps uniquely among world leaders, Mr. Abe developed a close personal relationship with Mr. Trump that many in Japan believe helped avert punishing trade deals or demands that Japan pay more to support close to 55,000 American troops on bases across the country.
He also held together a coalition of 11 countries around the Pacific Rim in a trade agreement, the Trans-Pacific Partnership, after the Trump administration pulled the United States out.
And before the pandemic and China’s increasingly authoritarian moves in Hong Kong and around the South China Sea, Mr. Abe had pursued warmer ties with China and its leader, Xi Jinping, reversing years of frosty relations.
“I think Abe’s biggest legacy for his successor is that he managed to stay in power in Japan longer than any other prime minister,” said Kristi Govella, an assistant professor of Asian studies at the University of Hawaii at Manoa. “He managed to really elevate Japan’s profile on the international stage and make substantial changes in policy across a number of issue areas, and in Japan that is something we have not seen very often.”
Mr. Abe also helped secure the 2020 Summer Olympics for Tokyo, but they have been postponed until 2021 because of the pandemic.
But by the time he decided to resign, Mr. Abe’s disapproval ratings had risen to their highest level since he began his second term.
“I want to celebrate his resignation,” one poster wrote on Twitter. “But he did whatever he wanted without consequences and people celebrated him for exceeding the record for longest consecutive days served in office. And now he just gets to escape, so I feel angry.”
But analysts said that the political opposition, divided and disorganized, was unlikely to be able to take advantage of Mr. Abe’s resignation.
“For the sake of Japanese democracy, they should try,” said Kunihiko Miyake, a former Japanese diplomat who is now teaching at Ritsumeikan University in Kyoto. “But I don’t think they can do it. They are not even united, and there is no discussion of policies.”
The public has been dissatisfied with Mr. Abe’s handling of the coronavirus, particularly its effects on the economy, which erased what achievements he could claim under his economic platform, known as “Abenomics.”
Under that program, Mr. Abe had administered a three-pronged plan of monetary easing, fiscal stimulation and corporate reform. Some of its promises — including efforts to empower women, reduce the influence of nepotism and change entrenched work culture — remained unfulfilled.
“Abe wanted to be a transformational prime minister,” said Tobias Harris, an expert on Japanese politics at Teneo Intelligence in Washington and the author of “The Iconoclast: Shinzo Abe and the New Japan.”
“But the most difficult, potentially transformative decisions about Japan’s place in the world will be made by his successor, because Abe ended up being a prime minister who prioritized stability over the risks of transformation.”
Makiko Inoue and Hikari Hida contributed reporting.
Ulcerative colitis, the gastrointestinal affliction that has debilitated Prime Minister Shinzo Abe of Japan so badly that he is resigning, is a chronic inflammatory bowel disease, which is suffered by millions and can flare up unpredictably.
It irritates and inflames the innermost lining of the large intestine and rectum, causing ulcers or sores. Symptoms can include uncontrolled diarrhea, rectal bleeding, weight loss, diminished appetite, abdominal pain and frequent need to use the bathroom.
The disease can strike at a young age and worsen over time, as appeared to happen to Mr. Abe, 65. Doctors say they have also seen it develop in people in their 50s and older who had not suffered symptoms at a young age.
Inflammatory bowel disease also includes Crohn’s disease, which can disrupt the entire gastrointestinal tract.
Dr. Ashwin N. Ananthakrishnan, a gastroenterologist at Massachusetts General Hospital who was the lead author of that article, said ulcerative colitis was first seen during the Civil War, and has dramatically increased since the 1940s in the United States and since the 1970s in Asia, including Japan.
He and other doctors attributed the growth in cases partly to changes in eating habits — notably a move away from fiber-rich diets — particularly in Asia. But the underlying causes and triggers of both Crohn’s and ulcerative colitis remain areas of intense research. Many treatments have been developed to ease the symptoms, but both diseases can recur without warning.
“It’s still associated with a lot of disruption,” Dr. Ananthakrishnan said in a phone interview. “People can have flare-ups that can last for a few days to a few weeks.”
Dr. Reezwana Chowdhury, an assistant professor at the Johns Hopkins University School of Medicine and a specialist in colitis and other intestinal disorders, said ulcerative colitis “can develop at any age” and that children who are diagnosed with it can suffer chronic recurrences. “It’s a lifelong disease,” Dr. Chowdhury said.
Removal of the large intestine is considered a cure for ulcerative colitis, but that creates other complications. Surgeons must use part of the small intestine to replace the large intestine or create an artificial opening in the abdominal wall for the discharge of bodily waste, an operation known as a colostomy.
Dr. Ananthakrishnan said advances in treatments had sharply reduced the need for surgery. Twenty years ago, he said, one in five patients needed surgery, compared with one in 10 now.
Nonetheless, he said, even people who have responded to treatments can suffer flare-ups, which appeared to be the case for Mr. Abe, and that can “take a toll on functioning for such a high-level person.”
TOKYO — Japanese Prime Minister Shinzo Abe announced his resignation on Friday, saying his declining health would make it difficult to carry on.
“I decided that I should not stay in the position of prime minister as I am no longer able to perform my duty confidently,” Abe told reporters.
The prime minister, who is a few weeks shy of his 66th birthday, reached the decision following two visits to a Tokyo hospital in quick succession. He said he made up his mind on Monday after the second of those visits.
“I made the decision by myself,” he said, adding that he would stay on as a lawmaker.
Before the late-afternoon news conference, Abe conveyed his intentions to members of his ruling Liberal Democratic Party, according to the LDP’s secretary general for the upper house, Hiroshige Seko. Seko quoted Abe as saying: “I have been suffering from ulcerative colitis again, and there is a risk the illness will deteriorate. Therefore, I have decided to resign.”
Abe’s cabinet will resign en masse as soon as the LDP elects a new president. The party is likely to hold the vote in September.
Word of Abe’s plan to quit sent the Nikkei Stock Average plunging in afternoon trading. The benchmark index dropped over 600 points, or 2.6%, at one point before rebounding to close down 1.4% on the day. The yen strengthened to 106.11 per dollar.
Some had called on Abe to step down as the country faces the dual challenges of preventing the spread of COVID-19 and revitalizing the economy. Although he is Japan’s longest-serving prime minister, he is set to leave office without achieving his key goal — revising the nation’s pacifist constitution.
“I cannot regret enough about leaving office without finishing off the projects I had embarked on, such as signing a peace treaty with Russia or making amendments to the nation’s constitution,” Abe said on Friday, acknowledging that his call for constitutional reform “didn’t gain traction among the public.” He also expressed sorrow over his inability to secure the return of Japanese nationals abducted by North Korea.
But at the same time, Abe said his government had created more than 4 million jobs, helped more women and seniors join the workforce, and strengthened Japan’s alliance with the U.S. He also said he was proud of how his active diplomacy led to the Trans-Pacific Partnership trade pact.
Now, he said, is the right time to hand over responsibility “in order to avoid a political vacuum amid the coronavirus crisis.”
He noted that the coronavirus resurgence that began in July has started to ease and his government has put together a new package of measures to deal with the pandemic ahead of the winter flu season. “We have responded to the crisis as we gained insights about the virus,” he said, stressing Japan’s numbers of deaths and serious cases are relatively low.
Japan has recorded about 65,000 infections with around 1,200 deaths.
Abe, who abruptly ended his first stint as prime minister due to the same battle with colitis in 2007, has led the government since December 2012. But the social and economic toll of the pandemic has made this year particularly challenging.
Abe decided to forego his annual summer vacation at his villa in the Yamanashi prefectural village of Narusawa. The prime minister reportedly complained to aides of fatigue, and members of the media noticed him walking with difficulty.
“My condition turned since the middle of last month, causing my body to be physically quite exhausted,” Abe explained at Friday’s briefing. Echoing what he told LDP members, he said, “Early this month, I was diagnosed with a relapse of ulcerative colitis.”
The LDP has already begun preparing to choose a new party president.
Former LDP Secretary General Shigeru Ishiba is likely to run, along with LDP Policy Research Council Chairman Fumio Kishida. Abe refrained from naming his preference to take the reins, saying, “It’s not something I should comment about.”
Typically, the party would hold a leadership vote among lawmakers and regular members. In the past, the campaign period has usually lasted seven to 12 days. Another option would be to hold an election involving lawmakers from both Diet chambers and representatives of Japan’s 47 prefectures.
The term of Abe’s successor will expire at the end of September 2021, when Abe’s term would have ended.
In the interim, there is a possibility that the government will recommend Chief Cabinet Secretary Yoshihide Suga or Deputy Prime Minister and Finance Minister Taro Aso to take over the current cabinet.
Japanese Prime Minister Shinzo Abe has stepped down, citing declining health.
The country’s longest serving leader announced his decision during a press conference this evening.
“I pull out all the stops for my job as a Prime Minister. I needed to fight against the disease and be treated and I was not really in a perfect state in terms of health condition and, still, I have to make political decisions, important ones,” Abe said.
“I cannot make any mistake in terms of the important position and decisions I make.”
Concerns about the 65-year-old’s chronic health issue intensified this month when he visited a Tokyo hospital two weeks in a row for unspecified health check-ups.
Abe confirmed in June a regular check-up showed a sign of the chronic bowel disease, ulcerative colitis. He had managed to control the disease for the last eight years.
However, his condition has worsened and he will now need to have continuous drug administration.
“I go through treatment and I would like to regain my health again so that I can stand behind a new administration as a politician,” he said.
“For the people in Japan, I appreciate your support for about eight years.”
Abe admitted to struggling with his decision but said he “cannot make any mistake” when it comes to the country’s political future.
“The most significant challenge for us is the countermeasures against coronavirus. We have to avoid any obstacles when it comes to fighting against coronavirus,” he said.
“For the last month that was the only focus I had. I really struggled to make a decision. I see the downward trend in infection after July and, also, towards winter.
“The necessary measures have been put together and, therefore, under the new leadership, the challenges should be addressed and this is the only timing where the leadership changes should be happening.”
He did not specify when he would leave office.
In 2007, Abe abruptly resigned from his first stint in office due to his health.