In India, and beyond, a looming COVID catastrophe

India's infernal COVID catastrophe can be seen in what's abundant: record-setting (and likely dramatically undercounted) coronavirus cases and deaths.

And what's scarce: nearly everything to treat the afflicted and even handle the dead.

"Crematories are so full of bodies, it's as if a war just happened," Jeffrey Gettleman, the New York Times' New Delhi bureau chief, wrote in a searing firsthand account of the calamity. "Fires burn around the clock. Many places are holding mass cremations, dozens at a time, and at night, in certain areas of New Delhi, the sky glows."

The public health system, said Irfan Nooruddin, a Georgetown University professor of Indian politics who heads the Atlantic Council's South Asia Center, "is completely overwhelmed; the reports of patients turned away from hospitals, oxygen being unavailable, are rife across the country. The absence of a clear, centralized governance strategy has citizens having to scramble for themselves to find care for their loved ones" amid a disease the Times said was "spreading at such scale and speed."

The pandemic in the developing world — the topic of this month's Global Minnesota "Great Decisions" dialogue — represents the disease's third wave, after the initial outbreak in Wuhan and then the devastation in the developed world, including the U.S., Ian Bremmer, president and CEO of the Eurasia Group, a global political risk research and consulting firm, wrote in an analysis this week.

The developing world, Bremmer wrote, is "where most of the world's population lives and works, with weaker governance and both lower political tolerance and economic ability to lockdown, and with less health care capacity to respond to the virus."

Brazil — and ominously, now neighboring nations — have seen their own version of India's nightmare. COVID's impact on other developing countries in Asia and sub-Saharan Africa is not yet fully known, but in most cases the infrastructure is inferior to India's, so a similar wave could swamp those nations' nascent mitigation efforts, too. And when countries convulse from COVID, it may not happen sequentially, but simultaneously.

"India is on the front pages of newspapers, partly because of its size and scale," said Nooruddin, who explained that COVID "overwhelms the health system very, very quickly" and there is "exponential growth possible." Densely packed populations in other developing world cities are especially vulnerable, Nooruddin said, adding: "I suspect that this is not the last time we're going to see some really terrible images on the front pages of newspapers coming out of the developing world."

President Joe Biden likely hopes those headlines also tout the U.S. reasserting its global role as a force for good worldwide.

During his Address to a Joint Session of Congress (a rookie president's version of a State of the Union speech) on Wednesday, Biden assured that America's vaccine supply will suffice, and then the U.S. "will become an arsenal of vaccines for other countries, just as America was the arsenal of democracy for the world — and in consequence, influenced the world."

The opportunity is there, but Biden better catch up. He missed the opportunity to help India sooner, and that delay hurt the bilateral relationship, Bremmer said in an interview. And it also may have weakened the quadrilateral relationship involving India, the U.S., Australia and Japan (the so-called "Quad") that's designed to be a democratic bulwark against bullying by Beijing.

The bond between Washington and New Delhi "has always been strong," Nooruddin said, but "the fact of the matter is that the Biden administration probably missed a PR opportunity." Still, sending American aid now not only helps substantially, but also "is important symbolically, it's important from a humanitarian perspective that the United States is being seen to be helping in a crisis."

Nonetheless, "It's unfortunate that the United States has been so incredibly cautious about not only vaccines, but also just generally global aid," Bremmer said, while acknowledging the domestic dynamics that may have kept Biden from asserting the global leadership he claims "is back" with his administration.

"You want America to be back?" Bremmer asked rhetorically. "There needs to be true global leadership on vaccine deployment and on health care and on aid. And it's not something that's enormously popular in the United States. But it's not enormously unpopular, either."

In fact, Americans may miss the clarity of enduring global leadership even if they've forsaken the forever wars that sometimes were the result. Responding more completely, competently and compassionately to the developing world in their hours (or days or months or, yes, years) of need is in keeping with American can-do that the world witnessed in the Marshall Plan, and in the rapid response to the 2004 tsunami and the 2008 global financial crisis, among other instances.

The good news in such a bad-news situation is that the U.S. is better positioned than any nation to help lead the world out of the coronavirus crisis.

"We have the best vaccines in the world," Bremmer said, reflecting the efficacy of the three deployed domestically that experts say perform better than those developed in Europe, Russia and China. The U.S. also has the fastest deployment capabilities of any country, which Bremmer said "puts us in a position to be the global leader on vaccine diplomacy."

Playing that role would advance a broader Biden objective that all Americans can rally around: reminding an uncertain world about the benefits of the democratic form of government.

Referencing his diplomatic dialogues with Chinese President Xi Jinping, Biden said in his address, "He's deadly earnest about becoming the most significant, consequential nation in the world. He and others — autocrats — think that democracy can't compete in the 21st century with autocracies because it takes too long to get consensus."

Consensus can and must be formed around the urgent need to be the global leader on vaccine development, production and distribution. Debate on the methods will be critical, and must be quick; convincing arguments by economists, diplomats, humanitarians and others on loosening vaccine patents are passionately being made amid alternative suggestions on how to vastly expand vaccination access.

Whichever method is chosen, time is of the essence: The moral, medical (and yes, monetary) imperative is to rapidly vaccinate everyone, everywhere.

Fought with needles and not missiles, the pandemic, especially in the developing world, isn't an arms race, but a race for arms. The U.S. can and must win this race — for itself, and the world.

John Rash is a Star Tribune editorial writer and columnist. The Rash Report can be heard at 8:10 a.m. Fridays on WCCO Radio, 830-AM. On Twitter: @rashreport. Once a month, the theme of this column is determined by the "Great Decisions" dialogue on foreign policy, conducted in partnership with the nonprofit citizen engagement organization Global Minnesota. Want to join the conversation? Go to globalminnesota.org.