Japan's longest-serving prime minister, Shinzo Abe, announced in a press conference Thursday that he is stepping down because of poor health.

Abe, 65, has been in office since 2012. He also served as prime minister for one year beginning in 2006, also citing health as the reason for his resignation. Abe's longevity is noteworthy in a country that sees frequent turnover in its leadership.

The prime minister has suffered bouts of ulcerative colitis, a debilitating inflammatory bowel disease, for years. Abe made two hospital visits in the past week leading to speculation he would step down.

Abe said his health began to decline last month and he was concerned his illness would affect his judgment.

Abe is considered a comparatively successful manager of relations with the U.S., and in particular with President Trump. Abe put his personal relationship with Trump on display during a presidential visit to Tokyo last year, feting him with steak, burgers, golf and a sumo wrestling match.

He was able to keep trade frictions with the U.S. from blowing up, as he put together a trade deal that largely gave Washington the treatment it would have received under the Trans-Pacific Partnership, an Obama-era trade agreement that Trump rejected.

Abe failed to achieve his most cherished political goal, and that of his ruling Liberal Democratic Party: to revise Japan's pacifist, post-World War II constitution. His proposed revisions would strengthen the government's emergency powers, while downplaying the role of human rights. Abe felt the political values imposed by the U.S.-imposed constitution were alien to some of Japan's traditions, such as reverence for the emperor.

Abe was, however, successful in passing legislation in 2015 that allows Japan's military to expand its operations overseas in support of allies, including the U.S.

Most Japanese have been dissatisfied with Abe's handling of the coronavirus pandemic, feeling he moved too slowly by waiting until April to impose a state of emergency mostly out of concerns about the economy. These sentiments lowered his approval rating to just under 30%.

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