Photo: T.J. KIRKPATRICK/POOL/AFP/Getty Images
The Centers for Disease Control and Prevention (CDC) is officially opening on February 5 an East Asia and Pacific regional office, based in Tokyo, Japan. Heading the office is Dr. Michelle McConnell, a highly accomplished career public health diplomat, epidemiologist, and pediatrician, with exceptional Asia credentials. Tokyo is now the sixth regional CDC platform created in recent years, following: Tbilisi, Georgia; Brasília, Brazil; Muscat, Oman; Hanoi, Vietnam; and Panama City, Panama.
CDC’s new East Asia and Pacific office will unquestionably advance U.S. national interests. It will strengthen preparedness against future dangerous outbreaks and improve the health status of the region’s citizens while contributing to U.S. foreign policy and geopolitical goals. It will accomplish those goals principally through enlarged health diplomacy, new partnerships, and deepened alliances backed by CDC’s wide technical expertise.
But first, why Japan? On its face, creating a CDC footprint in Tokyo might seem odd, given that Japan is the world’s third-largest economy and hardly needs CDC funding, or even technical assistance, to protect its citizens against dangerous infectious disease outbreaks or to support its work in other key areas such as aging. The decision was first taken during the Trump administration, and subsequently carried forward by the Biden administration. When it is understood in the larger health security and strategic context, it is indeed a smart and timely decision for two primary reasons.
First, this choice grows out of the recognition that the 70-year U.S.-Japan treaty alliance is now at a historic peak, amid rising geopolitical competition with China. That creates the opportunity, the need, and the political will—shared by both the Japanese and U.S. governments—to build innovative health collaborations that can bring wide benefits across the region. Japan’s leadership on health during its G7 presidency in 2023 drew systematically upon its close alignment with the United States.
Second is the recognition, reinforced profoundly by the Covid-19 pandemic, that health and security are inextricably linked, and that a U.S. health security diplomacy that drives new regional health partnerships will advance U.S. national interests. That U.S. leadership will strengthen alliances with the Japanese and other Asian partners—most importantly, longstanding treaty allies as South Korea, Australia, the Philippines, and increasingly also, India—that advance the health and well-being of Asia’s citizens.
What special value will the Tokyo regional office deliver? It will deliver a new diplomatic instrument. The CDC has minimal presence in the countries of the East Asia regional office: Japan, South Korea, Mongolia, Papua New Guinea, and the Pacific. The CDC Tokyo office provides a regional platform that can redress, regional gaps up close, and stir collaborations with these pivotal partner countries that stand keen to enlarge their regional and global reach, both programmatically and diplomatically.
It delivers a new capability to address inequity. During the worst of the pandemic, many low- and middle-income countries in Asia (and elsewhere in the world) faced gross inequities and delays in timely and affordable access to vaccines, therapies, tests, protective gear and oxygen, as the most wealthy and powerful countries pursued a narrowly nationalistic approach to satisfying their sovereign needs. Countries of the Global South suffered disproportionately and are now intently looking for proof that the most powerful and wealthy countries are changing their ways to invest at a higher level in regional capabilities. A CDC regional office, working with partner countries in the region, can begin to speak systematically to that tough question.
It is a diplomatic tool, with visibility and reach, that can deliver a strategic coherence to the CDC’s work across the region and can forge new health security partnerships under the auspices of such bodies as the QUAD, the security grouping of Japan, India, Australia, and the United States that has already driven forward an initiative on regional vaccine production and conducted health security exercises. ASEAN is an increasingly influential regional body that is developing a regional hub for public health emergencies (know by the acronym ACPHEED). Japan is playing a strong role in standing up this entity, and the CDC and Japan can work together to ensure its success.
A regional on-the-ground presence—versus operating from the CDC’s headquarters in Atlanta—will greatly enhance local knowledge, enrich relationships, and embed U.S. experts in regional networks. In an area with very few CDC country offices, it can build trust and collaboration.
Lastly, the office can deliver important specialized expertise that meet the evolving demands emerging from within the region. There are critical unmet needs in workforce development, data systems, laboratories, and communications, including combatting disinformation and misinformation.
What will it take to succeed? Success requires strong leadership—an impressive leader, Dr. McConnell, is already in place. It needs to be empowered by Washington to play an active and innovative diplomatic role, free of micromanagement. It needs the nimbleness to pivot as it discovers new region-wide priorities. And it needs ample and flexible core operating resources that provide stability and predictability that reach beyond the fixed timeline of programmatic funding. In the coming months, members of Congress focused on restoring trust and confidence in CDC and improving its performance should rally behind ensuring these conditions of success.
Global health security is national security. The Tokyo regional office should not be seen as a development activity, but as health security collaboration with influential global partners. It is an office that relies on a lean and efficient structure, focused on relationships and collaborations, with the ability to tap the exceptional depth of expertise at CDC headquarters in Atlanta. It is the sort of innovation that is so sorely needed in U.S. leadership in global health, demonstrating resolve and adaptation to changing circumstances.
February 5 is a moment of opportunity. U.S.-Japan ties have never been stronger, and the United States is actively building its relations across the region. This geopolitical reality creates a bounce, the opening to do far more in health security and other key health areas. The CDC regional office, if adequately supported, will advance U.S. national interests, benefit the health of the region’s citizens, and bring credit and prominence to CDC as the United States’ premier national public health institution.
J. Stephen Morrison is senior vice president and director of the Global Health Policy Center at the Center for Strategic and International Studies (CSIS) in Washington, D.C. Mitchell Wolfe is a senior associate (non-resident) at the Global Health Policy Center at CSIS.
