1/ I've been helplessly watching the humanitarian crisis unfold in India. Friends' anxiety has turned to distress. Distress has turned to panic. Smart people in the US govt are working behind the scenes to help. But it's time for private deliberation to turn into public action.

2/ I'm no expert on public health or humanitarian crises, but I think there are at least four key elements of a response. First, we need to see senior U.S. leadership express solidarity with the Indian people. To Indians and Indian Americans, empathy will be welcome.

3/ Second, the US has the capacity to provide oxygen, ventilators, medication & emergency supplies. The public sector can galvanize private support. If the optics of the US Defense Dept delivering relief is problematic, there are other workarounds, including via 3rd countries.

4/ Third, access to essential vaccine materials. The DPA issue is real but hardly black & white. GOI, USG, Serum Institute -- their stories don't match up. Here's the good news: GOI has finally delivered a list of what it needs. Now USG can work the problem. It's messy but doable

5/ The goal of addressing India's DPA (& related) concerns should be to ensure that future vaccine production in India (for India and for the world) is not adversely impacted in any way. From the outside, it appears that both sides agree on this.

6/ Finally, vaccines. US is pivoting from domestic to international provision. The crisis may demand an interim arrangement for India. The supposed AZ stocks are shrouded in mystery. While these should be looked at, it seems to me the one-shot, easy storage J&J is even better.

7/ Diplomatic support and emergency response in the short-run. Then onto raw materials and vaccines. Let's be clear: the US is not the source of today's crisis. But it can and should be part of tomorrow's solution. But this is a five-alarm fire and the clock is ticking.