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When President Biden addressed Congress this week, he didn’t have much to say about healthcare reform. The one exception was the President offering a vague proposal to grant Medicare negotiating power regarding prescription drugs prices: “Let’s give Medicare the power to save hundreds of billions of dollars by negotiating lower prices for prescription drugs.” Details were left to the imagination. Would this be through some version of H.R. 3, the bill co-sponsored by Speaker of the House, Pelosi, which would introduce price controls through international reference pricing for certain drugs? Or, would it simply mean giving Medicare the ability to negotiate drug prices as a single entity? The President went on to say that the “money we save [from lower drug prices] can go to strengthen the Affordable Care Act and expand Medicare coverage and benefits.” Once more, Biden provided no further elaboration on what is implied by “expansion of Medicare coverage.” Perhaps lowering the age of eligibility? Maybe. But we don’t know.

What we do know, however, from the Biden Administration’s actions in recent months is that the push to expand Medicaid is in full swing, particularly in the 12 states that have not yet added to their rolls. And it’s not just one-off pronouncements. Under the Affordable Care Act (ACA), the federal government already covers 90% of states’ costs of Medicaid expansion. Additionally, the American Rescue Plan Act, enacted in March, substantially sweetened the deal by providing a supplemental financial incentive for the 12 states that hitherto have not expanded Medicaid Specifically, states would become eligible for a five percentage point increase in the federal government’s match rate – the percentage of costs of the state’s Medicaid program that the federal government incurs – for the next two years if they implement expansion.

Here, the Biden Administration is attempting to reduce the levels of uninsured by offering lucrative incentives to the 12 states that have resisted expanding Medicaid. Across these 12 states, 2.2 million uninsured people with incomes below poverty lack affordable healthcare options. They earn too much income to be eligible for Medicaid in their state, but not enough to qualify for financial subsidies to purchase ACA exchange health insurance.

In April, the Biden Administration rescinded approval of a 10-year extension of a Texas Medicaid demonstration project involving so-called “uncompensated care pools.” After enactment of the ACA, the Centers for Medicare and Medicaid Services had approved uncompensated care pools, but sought to phase them out, favoring Medicaid expansion instead. The Trump administration reversed course and allowed uncompensated care pool funding to substitute for coverage.

During its final weeks in power, the Trump administration approved 10-year extensions of Section 1115 Medicaid waivers for demonstration projects in Florida, Tennessee, and Texas — three states that have not expanded Medicaid under the ACA. These waivers have been used to allow states to draw down Medicaid funds to pay hospitals for care provided to the uninsured. The uncompensated care pools can play a meaningful role in defraying costs associated with treating people who lack access to affordable coverage.

The renewed Section 1115 waivers were approved on January 15, 2021, for an unprecedented 10 years, as opposed to five, which had been the convention. The Trump administration even ignored public notice requirements to approve the Texas waiver extension.

In revoking the Texas waivers, the Biden Administration appears to be signaling that the demonstration project strayed too far from Medicaid’s original purpose of providing comprehensive access to the Medicaid-eligible with the full range of healthcare benefits.

In the case of Texas, if the state were to expand Medicaid, the federal government would increase its matching rate reimbursement from 62% to 67% of all Medicaid expenditures. Furthermore, the federal government would pay 95% of the costs for the estimated 1.4 million adults who would become newly eligible for the Medicaid program.

The uncompensated care pool programs are relatively inefficient mechanisms of access. The programs’ narrow focus on hospital cost coverage in lieu of a broad set of healthcare services disregards the role of preventive and maintenance care. Indeed, comprehensive Medicaid coverage could have helped avoid costly emergency room visits and inpatient admissions in the first place. For this reason, among others, hospitals have continued to press for Medicaid expansion.

In the end, paying for an emergency room visit or inpatient care is no substitute for coverage that provides access to the full array of healthcare benefits, including primary and specialty care, diagnostic tests, prescription drugs, and other healthcare services to treat and manage acute and chronic illnesses and conditions.

It appears politics, not public opinion, explains why the 12 holdout states aren’t budging. Most voters in the 12 states want Medicaid expansion. But because Medicaid expansion is a key provision in the ACA, opposition endures. Ostensibly, a number of Republicans leaders balk at the cost of Medicaid expansion. However, given the latest inducements offered through the federal stimulus package that argument doesn’t stand up, at least not in the short term.

There has never been a better argument for Universal Health Coverage (UHC) than the devastating global impact of the Covid-19 pandemic. As widespread infectious disease outbreaks are increasing in frequency and the number of people with chronic conditions continues to rise, we must find new ways to ensure that everyone is able to access and pay for the health services they need. As Covid-19 has demonstrated, no one is safe from health threats until the entire population is protected.        

WHO estimates that more than 100 million people around the world are pushed into poverty every year because of healthcare costs. In most countries, the process of paying for health coverage is not just costly, but complicated, stressful, and time consuming. If exorbitant prescription drug prices and out of pocket expenses were not already enough, healthcare consumers must also navigate payment systems known for their obscurity and susceptibility to error. We only need to look at the recent example of Americans who are being incorrectly billed by their insurers for Covid-19 vaccines that are meant to be free. An error that could have grave consequences if it deters someone from seeking out a vaccine. These systems not only overwhelm current users, but also discourages new users from finding the coverage that is right for them.

Fintech brings new and improved digital financial service models into the healthcare space. Fintech companies are leveraging powerful innovations such as blockchain, artificial intelligence, and machine learning to eliminate the inefficiencies and knowledge gaps that exist in our current systems. This is the topic of a new whitepaper, “Breaking the health-poverty trap: How fintech can improve access to healthcare in Asia” co-authored by ACCESS Health International initiative Fintech for Health and the MetLife Foundation.         

Fintech for Health represents a call to action to bring the financial and healthcare sectors together in service of meeting UHC goals. The population that is unbanked or underbanked is disproportionately low-income and is the same population that both financial inclusion and UHC policies seek to support. 

The development goals of UHC and universal financial access are essentially the same, to ensure that people are financially sound while pursuing both a better quality of life and health. The financial services sector has a direct and important role to play in creating financial solutions for healthcare.

The best solutions will be bundled, integrated, and comprehensive. Fintech can be used to deliver three types of solutions: information, healthcare services, and financing. Information may include health education, doctor appointment scheduling, and transparent pricing. Examples of healthcare services would be telehealth consultations and e-pharmacies. Financial products and services may include personalized insurance marketplaces, micro insurance plans, claims processing, digital savings and lending, and crowdfunding. Paying for healthcare out of pocket is one of the biggest drivers of exorbitant, unpredictable costs, almost any form of prepayment through a plan is preferable.

Fintech has and continues to make remarkable contributions toward increasing access and usage of financial services among low-income people. In just the past six years, 1.2 billion people worldwide have gained access to bank and mobile money accounts due to digital financial technology. Access to bank and mobile money accounts makes it easier for governments to distribute payments in a timely manner to pay for healthcare costs.            

Healthcare costs drive 65 mil people across Asia into extreme poverty every year. Bringing together Fintech and healthcare will make it easier to choose, save for, and pay for high-quality health services.

This past year has truly been like no other. The Covid-19 pandemic has disrupted every sector, including the entertainment industry: film studios were shut down; movie theatres were closed. Like most of you, I was watching movies at home, through streaming services like Netflix. While tonight’s 93rd Academy Awards broadcast will have a different feel – influenced by public health measures – I know it will showcase exceptional storytelling. What I noticed about many of the 2020 Oscar-nominated films is that they shared the same themes as the pandemic: the mental and physical toll of prolonged isolation; the impact of acute and chronic trauma; and our critical need for connection. Please note: this article will include spoilers!

Over the past 16 months, I have been living and breathing all things Covid-19. I constantly read coronavirus-related scientific articles discussing multi-organ damage and mask efficacy. Like many fellow physicians and health workers, I was also perplexed and infuriated by the lack of urgent, evidence-based responses by elected officials. Hospitals in New York where I see patients, followed by cities nationwide, were barraged with critically-ill patients who suffered without loved ones nearby, isolated and frightened. Doctors and nurses were exhausted, depressed, burned out and ignored by leadership at all levels.

Watching numerous colleagues and friends become infected with SARS-CoV-2 was very difficult. These emotions were intensified by the hardship experienced by the public, from ongoing unemployment and hunger to unstable housing and overwhelming loneliness. I felt a profound sense of isolation and hopelessness. My recourse during these difficult moments was movies. This year’s Oscar-nominated films, like most good stories, reminded me that art often imitates life, and that pain, trauma and resilience are universal. The themes below resonated with me. Remember, spoiler alert!

Isolation

During this ongoing pandemic, who hasn’t experienced isolation? Watching it unfold on the big screen – which I was finally able to do in New York – was moving and special. Isolation is associated with multiple health risks. According to the CDC, social isolation can increase one’s risk of dementia, stroke and premature death. Loneliness is also related to higher rates of depression, anxiety and suicide. In these three films, isolation manifests in different people in different ways.

Minari follows a Korean-American family’s journey from California to Arkansas in search of the American Dream. Right away, the audience senses the geographic isolation: a family of four, no friends or neighbors, settles on a desolate plot of land. The husband, played skillfully by Steven Yeun, toils away to create his dream farm. Meanwhile, his wife, portrayed by the talented Han Ye-Ri, labors at home, cooking and caring for the children, while missing her friends. Isolation leads to tension in the marriage and at work.

In Nomadland, Frances McDormand’s Fern is a woman in her 60s who embarks on a solo journey after losing her husband, her job and even her hometown. Driving alone in a beat-up van for thousands of miles with very little money is a frightening concept for many. But when you watch Fern, you understand her desire for simplicity, for self-preservation. Profound loss compelled her to go on the road. The isolation of the road led to surprising connections with fellow nomads.

The isolation in The Father is uniquely unsettling. The film follows Anthony, played brilliantly by Anthony Hopkins, who experiences progressive memory loss accompanied by audio- and visual hallucinations. The audience never really knows what’s real or fake. It’s not hard to empathize with his rollercoaster of emotions, from gleeful and confused to angry and tearful. The isolation of dementia is both painful and palpable. The sadness and seclusion of his daughter, played by the phenomenal, Olivia Colman, resonates with any caregiver of individuals experiencing cognitive decline.  

Trauma

The Covid-19 pandemic is distinct from other catastrophic events because of massive population exposure to ongoing trauma. People who’ve experienced traumatic events, according to Harvard researchers, may turn to unhealthy behaviors such as drinking or smoking as coping mechanisms. Trauma can also cause chronic stress and increased inflammation which has been linked to many illnesses including cardiovascular and autoimmune diseases.

In Pieces of a Woman, Martha Weiss, portrayed beautifully by Vanessa Kirby, experiences the devastating loss of her newborn baby. While her partner, her mother and sister are all physically available, they might as well be on Mars. Nobody was emotionally available to Martha. Each person in the film experiences the tragedy in a unique way. The father, played intensely by Shia LaBeouf, seeks litigation and sexual connection from Martha’s cousin. Martha retracts inward, avoiding family and quietly nurturing apple seeds which eventually sprout. Martha’s journey, in my opinion, reinforces the concept that people heal in different ways and at their own pace.

Promising Young Woman is perhaps the most captivating and disturbing film I’ve seen in a long time. Cassie, played by the gifted Carey Mulligan, may not have been sexually assaulted as her best friend had been, but she was no less traumatized. In addition to dropping out of medical school, she participated in deceptive, high-risk activities such as going home with strangers then confronting them just prior to being raped. Depressed, angry and fixated on revenge, Cassie’s methods are unconventional, to say the least. But I think most woman can empathize with her intent, with ‘cultural norms’ and the complicity of academic and legal systems that perpetuate gender discrimination, consistently giving men the benefit of the doubt.

Connection

A common saying in my field is, ‘The opposite of addiction isn’t sobriety, it’s connection.’ Among my patients with various substance use disorders, those with strong support systems (families, counselors, friends) have the best outcomes for recovery. This pandemic has demonstrated that we are social creatures; even the most introverted among us needs some social bonding. Studies show that people who feel more connected to others have higher self-esteem and experience lower rates of depression and anxiety.

Despite economic hardship and social isolation, the family in Minari was tight-knit. We never doubted the parents’ love for their children. The wife eventually forges connections at church, while the husband bonds with his farmhand and Korean War vet, adeptly played by Will Patton, who the family later invites for dinner. The little boy eventually bonds with his grandmother. These strong interpersonal connections played no small role in the family’s tenacity and survival.  

Connected by war-time political strife and shared passions in racial and social justice, students, writers and other activists build strong bonds in The Trial of the Chicago 7. The close friendship between Thomas Hayden, played by the talented Eddie Redmayne, and Rennie Davis triggered the former’s enraged speech after watching his friend’s bloodied skull crack open. Connectivity on individual and group levels strengthens the sense of self-worth and civic engagement.

*******

So many Oscar-nominated films skillfully incorporated themes of isolation, trauma and connection including Da 5 Bloods, The United States vs. Billie Holiday, Ma Rainey’s Black Bottom and yes, even Borat Subsequent Moviefilm! Cinema can be an escape from but also a mirror of society: its ills and triumphs. I hope you enjoy The 93rd Academy Awards – masked, distanced and vaccinated – I know I will!

A new report has predicted that colorectal cancer will become the leading cause of cancer death in people aged between 20 and 49 by the year 2040. Pancreatic cancer will also become the second leading cause of cancer death overall by 2030, overtaking colorectal cancer to lie behind lung cancer in first place.

The work published in the journal JAMA Network Open predicts that the incidence of certain cancer types and cause of cancer deaths in the United States will be very different in 2040 compared to the present day. By 2040, the report predicts a greater number of people with melanoma and more deaths from pancreatic cancer and liver cancer. In better news, the report predicts there will be a decline in people with prostate cancer and fewer deaths from breast cancer.

So how can these predictions be used to help prepare for the future of oncology and cancer care?

“We hope that these estimates bring attention and spur research efforts to multiple cancer types especially the deadlier cancers such as pancreatic, liver, and colorectal cancer in the younger cohort,” said Lola Rahib, PhD, lead author of the report and Director of Scientific and Clinical Affairs at Cancer Commons in Mountain View, California.

The predictions were calculated by combining population growth projections with cancer incidence and death trends in all racial and ethnic groups.

“Cancer incidence and mortality projections are enormously useful in guiding the oncology community in determining how to optimally deploy its resources to areas of greatest need,” said James M. Cleary, MD, PhD, oncologist at Dana-Farber Cancer Institute in Boston, Massachusetts. “These statistics help leaders in academia, industry, and funding agencies make decisions about allocation of resources and establishment of priorities for the years ahead,” added Cleary.

The report predicts more young people will die from colorectal cancer

One of the most concerning predictions in the new report is that of a rapid rise in colorectal cancer incidences and deaths in people between the ages of 20 and 49. Awareness about younger people with colorectal cancer has been steadily rising since the death of Black Panther actor Chadwick Boseman from the disease age 43 in 2020, but researchers still don’t know why the number of young people with the disease is increasing.

“These estimates are alarming, and we urge the cancer community to come together and work with advocates to increase awareness and research funding to ultimately make advancements in both therapeutics and screening programs for this younger cohort,” said Rahib.

The screening age for colorectal cancer has recently been reduced from from 50 to 45 years and Rahib hopes that this might mean that the actual numbers turn out to not be as bad as predicted.

“As this [earlier screening] is implemented in the next several years and with heightened attention from this study, we hope that our estimates for both diagnoses and deaths of colorectal cancer will trend less rapidly,” said Rahib.

“Consistent with other recent data, this report demonstrates an alarming rise in the incidence of young-onset colorectal cancer. These statistics project that colorectal cancer will be the leading cause of cancer death in patients aged 20 – 49 by 2040. The cause of the increasing cases of young-onset colorectal cancer is still very unclear and intensive large-scale research efforts are underway,” said Cleary.

Deaths from pancreatic and liver cancers will continue to increase

“A significant increase in deaths from pancreatic and liver cancers is estimated to continue in the next 2 decades. The increase in pancreatic cancer deaths arises from several factors: Pancreatic cancer is usually diagnosed at an advanced stage when surgery is not possible. There are no standard screening tools, and treatments are limited. Even when patients undergo surgery, pancreatic cancer often recurs,” said Rahib.

Pancreatic cancer survival rates have remained woefully low for several decades and even new immunotherapy drugs that have made significant differences in diseases such as melanoma, have yet to result in improvements in pancreatic cancer survival.

“Unfortunately, the vast majority of pancreatic and colorectal cancers are resistant to currently available immunotherapies. Because of this, developing effective immunotherapeutic strategies directed against “immunologically cold” malignancies, like pancreatic and colorectal cancer, is a widely considered one of the holy grails of modern oncology,” said Cleary.

Deaths from breast cancer will continue to decline despite it being the most common cancer type

The report predicts that breast cancer will still be the most common type of cancer with 364,000 cases diagnosed per year. However, it will decrease to the fifth most common cause of cancer death, with 30,000 deaths per year, down from 44,130 predicted to occur this year.

Survival from breast cancer overall has been increasing since 2007, but the prognosis for some people with breast cancer is still poor. This includes people who are diagnosed in the later stages of the disease and those with metastatic breast cancer, which has spread to other parts of the body. Black women with breast cancer also still have around a 10% less chance of survival than white women.

In late January 2020—when Covid-19, then known as 2019-nCoV, had yet to penetrate most national borders—a research paper was published in The Lancet medical journal detailing the symptoms of a cohort of 41 patients hospitalized in Wuhan, China. The study, though tiny in scale, went on to become the year’s most widely cited, and more importantly it established fever, cough, and fatigue as telltale signs of Covid-19. But it also mischaracterized one symptom as rare that we now know, in retrospect, to be common: diarrhea.

According to the study, only three percent of patients—that is, just one of the 41—reported diarrhea, while 98 percent reported fever. Personal safety guidelines released by the CDC and other public health agencies early on in the pandemic reflected back this pecking order, as did their testing policies. If someone suspected they had Covid-19 but, for example, had only diarrhea and no fever, they were refused a test. Thankfully these protocols have since been revised; as of June 2020, diarrhea, nausea, and vomiting—collectively referred to as gastrointestinal symptoms—were upgraded to the CDC’s official list of primary symptoms. In the popular imagination, however, Covid-19 is still thought of as a respiratory disease first and foremost, if not exclusively, while the pathology of the gut remains overlooked.

Understanding the full extent of how Covid-19 manifests in the human body is critical to understanding how to treat it, particularly in so-called long haulers who harbor the virus for months. Infection of the gut also has serious implications for transmission—a factor that demands consideration if we’re intent on controlling and eventually eliminating this disease once and for all.

By no strange coincidence does SARS-CoV-2, the virus that causes Covid-19, have an affinity for our ACE2 receptors. Tissues rich with ACE2 are dispersed across several of our bodily organs, from the epithelial cells lining our bronchial tubes and alveoli to the endothelial cells in our arteries and veins. Surprisingly, it isn’t in the lungs and nasopharynx where ACE2 is found in greatest abundance, but in the gut—our liver, kidneys, gallbladder, pancreas, and gastrointestinal (GI) tract.

Your skin isn’t the only part of the body exposed to the outside world. SARS-CoV-2 isn’t just breathable, but swallowable. Think of the GI tract as an elongated donut with two exterior points of entry, the mouth and anus. Stretching between them are the esophagus, stomach, and intestines. If the virus manages to get inside your mouth, it can then infect your saliva—which, like mucus and breath, SARS-CoV-2 will commandeer as a new mode of transportation, allowing it to travel deep inside the gut. With its expansive surface area and plethora of ACE2 receptors, the gut makes an ideal breeding ground not just for the virus, but other microbially inclined diseases, like inflammatory bowel disease and pneumonia.

Gut infection gives the virus more room to go forth, multiply, and shed itself through our feces. And since the early Wuhan study, many papers on gastrointestinal Covid-19 symptoms have been published that suggest as much. Two surveys released in April 2020—the first conducted in California, the second in Massachusetts—found that 32 percent and 61 percent of subjects, respectively, reported digestive symptoms. An even more reliable indicator of gut infection than presence of digestive symptoms—prevalence of viral RNA in stool—has also been observed in multiple studies. A meta-analysis of data collected around the world reported that nearly 50 percent of fecal samples taken from patients contained traces of SARS-CoV-2. For patients with severe Covid-19, the rate was nearly 70 percent. Adding to the pile of supportive evidence is a study that unleashed the virus upon intestinal organoids—experimental models of our digestive organs grown from stem cells—and found it able to colonize the epithelial tissues quite rapidly.

It might also be the case that gut infection prolongs the length of time SARS-CoV-2 remains in the body. According to one study involving about 200 Covid-19 patients with either digestive symptoms, respiratory symptoms, or a combination of the two, those who experienced gastrointestinal complications took seven to nine days longer to reach viral clearance than those who didn’t. Another study shows that in general, fecal samples taken from Covid-19 patients continue to test PCR-positive even after nasopharyngeal samples start testing negative, which is why China implemented an anal swab testing policy for incoming travelers. If the virus that lingers on in patient stool is live and infectious, that opens up fecal-oral or fecal-aerosol routes of transmission. As I’ve already discussed in a previous Forbes article, epidemiological evidence of this exists not just for SARS-CoV-2 but SARS-CoV as well, the most prominent case being an outbreak of more than 300 cases in a Hong Kong apartment complex that health officials traced back to one man’s infectious diarrhea and a defective drainage system.

More research on Covid-19 gut infection is needed to understand the full extent of its impact on the body and the pandemic at large. If we leave lesser known manifestations of this virus unaccounted for in the drugs we develop to treat it, patients will continue to slip through the cracks—just as they did in the early days of the pandemic when digestive symptoms weren’t given their due. Much as we’ve learned about SARS-CoV-2 since then, our knowledge is still nowhere near complete. The sooner we can fill these gaps in our collective understanding of the virus, the better.

In India, more than 332,000 Covid-19 infections were reported today, along with approximately 2,250 deaths. Both figures shattered previous daily records for the country. India has a nearly vertical coronavirus case growth curve. Similarly, the daily reported deaths curve’s slope is practically vertical. The official daily death toll is probably a significant underestimate. Moreover, soaring test positivity suggests the case count is also vastly underestimated.

Maharashtra, India’s second most populous and wealthiest (per capita) state, tops the list of most affected states in the country.

A fragile and fragmented healthcare system is buckling. Hospitals have been overwhelmed and have had to turn away scores of patients. There aren’t enough beds. There is an acute need for all kinds of medical supplies. Hospitals in the Mumbai and Delhi regions are running short on oxygen. In a video that has gone viral, a Mumbai physician, Dr. Trupti Gilada, describes the severity of the current crisis, and provides fellow citizens guidance on how to prevent contracting coronavirus as well as advice on what to do in case one falls ill.

Until this latest surge, the prevailing thought was that given India’s high population density it had done a remarkable job curbing the spread of Covid-19 and keeping the death rate comparatively low. But as Professor Madhu Pai, Research Chair of Epidemiology and Global Health at McGill University, explains, India has become a Covid-19 cautionary tale for the whole world. Government officials declared victory over Covid-19 too soon. In mid February Prime Minister Narendra Modi asserted that India’s “successful fight against Covid-19 is inspiring the entire world.” Authorities lifted most lockdown restrictions designed to stem the spread of the virus. Poor public health messaging ensued and people dropped their guard, many becoming non-compliant with masking and social distancing protocols. Large mass gatherings took place, including election rallies and religious festivals.

Also, despite having a considerable capacity for vaccine output – the Serum Institute of India is after all the world’s biggest vaccine maker – India ranks far behind China, as well as almost all European nations and the U.S. in terms of Covid-19 vaccine doses administered per 100 people.

Antibody tests taken several months ago indicated that in certain areas of India, such as Delhi, as many as 50% of the population had been exposed to the novel coronavirus. Yet, one of the world’s worst Covid-19 spikes on record is currently taking place in precisely those areas.

How much of a role the new Covid-19 variants play is uncertain. Specifically, questions have been raised around the B.1.617 variant, which was first detected in India in October 2020. The B.1.617 variant carries two mutations; E484Q and L452R. Both mutations may help the virus evade antibodies in the immune system, and as a result become partially resistant to one or more vaccines. This said, it’s highly unlikely the mutations would make vaccines completely ineffective.

Genome sequencing data suggests evidence of the “double mutant” B.1.617 in more than 60% of samples in Maharashtra. However, it’s still not determined the degree to which this new variant is driving the current surge. Scientists have also not ascertained this variant’s virulence, and whether it makes people more vulnerable to reinfection, more infectious, and more resistant to vaccines. There simply hasn’t been enough data sampling. In lieu of more evidence, the B.1.617 variant retains its “variant of interest” denotation rather than “variant of concern.”

Thus far the world’s reaction to the catastrophe unfolding in India has been muted. A number of Western countries have instituted travel bans, barring flights from India. But, besides offering words to express concern, Western leaders haven’t put forward constructive plans to help address the Indian crisis at hand. Surely, in short order much can be done to deal with India’s acute needs. For one thing, the U.S. could lift the embargo of raw material exports that supply India’s vaccine manufacturers. In addition, the U.S. is currently hoarding vaccines. For example, it has an inventory of at least 35 million doses of Astra Zeneca vaccine which it will likely never use. And, the U.S. and other countries could airlift personal protective equipment, oxygen, ventilators, Covid-19 treatments, and even trained personnel to various hot spots.

The Covid-19 emergency in India isn’t merely a humanitarian crisis of potentially monumental proportions. It also has negative repercussions for global economic growth, international reopening plans, and supply chains for a wide variety of products, including vaccines. India is the world’s 6th largest economy; the second largest emerging market, behind China. It is one of the world’s leading manufacturers of Covid-19 vaccines. Yet now, it cannot export vaccines to other nations in need. India’s desperate circumstances consequently have a snowball effect on vaccination efforts in other nations.

Worldwide, the Covid-19 pandemic is in a rapidly ascendant phase in a number of countries, including India. Clearly, the pandemic is far from over. Given the world’s interdependence, the motto, no one is safe until we are all safe, applies.