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In launching the Ayushman Bharat Digital Mission prime minister Modi says it "has th potential of bringing a revolutionary change in India's health facilities."  Following the launch of Arogya Setu app and the 900 million vaccine doses given under Co-Win for the free vaccine campaign this is the next step.  To take healthcare facilities to a new level and integrate it with technology prime minister Modi noted the 1.25 billion remote consultations under telemedicine that have taken place since March 2021 under e-Sanjeevani. Using this people in all parts of India are able to connect with doctors of large hospitals in cities. Ayushman Digital will connect digital solutions of hospitals across India to each other. This would make process simplified and enhance ease of living. Under this plan every citizen would now get a digital health ID and health records digitally protected. The overall model is for preventive healthcare and in event of disease easy, affordable, accessible healthcare.  Part of the plan is to build the facilities and resources to be able to handle needs. For doctors and para medical manpower a comprehensive network of AIIMS and modern health institutions is being setup, and one medical college is being setup for every 3 Lok Sabha parliamentary constituencies. In villages and rural areas primary health care network is being strengthened. Over 80,000 centers of this type have been operationalized.    ...

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Lloyd Webber in this BBC News video says it is not normal that one would say I would like a drink and like to drive home tonight. Its completely wrong he says, and compares this drunk driving behaviour to vaccine refusers who endanger the lives of others who can get infected in the process of one individual's misconceived exercizing of his rights. Completely ignoring in the process his responsibilities in society. 

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The Labour party's support for not withdrawing from the European Medicines Agency is the subject of an argument after Prime Minister's Questions in the British parliament. Labour leader Keir Starmer confronts prime minister Boris Johnson in parliament after Johnson reminds Labour that it had on repeated occasions called for the UK not to withdraw from the European Medicines Agency.  The UK vaccination drive is far ahead of the vaccination drive in European Union countries including France and Germany, because of British initiative in boldly betting money on vaccine supplies with pharmaceutical companies, and earlier approval by the UK health regulatory authority. Here is the comment in the House of Commons by Boris Johnson- "If we had listened to (Starmer), we would still be at the starting blocks because he wanted to stay in the European Medicines Agency and said so four times from that dispatch box." Starmer disputes the statement. The Times cites Hansard, the official record of the House of Commons. It records that Starmer questioned why Britain would want to withdraw from the Medicines Agency in Jan. 2017. In 2018 Labour party supported an Amendment to the Trade Bill that called for the UK to seek participation in the European Medicines Agency. Germany, Spain and France are hit hard by the second wave of the coronavirus and the lack of adequate vaccine supplies is causing grief in European Union. The EU president Von der Leyen, another European Union style bureaucrat, seen as having bungled the handling of vaccine supply. ...

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In his farewell speech Boris Johnson, with true British resilient spirit,  says "I will be giving fervent support to Liz Truss and her government every step of the way." Johnson likened his transfer of power to Ms Truss to a relay race. "The baton will be handed over," saying it "unexpectedly turned into a relay race, they changed the rules halfway through." But he expressed no feelings of regret, having come to terms with the arrangement in his own way. More likely Johnson is without saying it still determining the policies and direction of the government, perhaps more so now with Liz Truss and his loyalists the only persons in the cabinet and running the British government. Johnson addressed people's fears about the energy price increases- "the UK would continue to have the strength to give people cash they need to get through this energy crisis that is caused by Putin's vicious war."  He listed his government's achievements- the response to Covid. Some of this is forgotten as the UK not the EU leadership was first to move forward with vaccination plans. Johnson put his government's faith in the vaccine invented at Oxford University and committed early while the EU languished under Merkel and her protege Ursula Von der Leyen. The EU fell behind in providing vaccine leadership as Britain forged ahead early, giving hope to the rest of the world's population including India that adopted the Oxford vaccine. Johnson likened his role to the missions to the planets- "Let me say I am now like one of those booster rockets that has fulfilled its function and I will be re-entering the atmosphere and splashing down invisibly into some remote and obscure corner of the Pacific." Johnson has taken the situation in a truly British way without any rancor and gracefully. With Liz Truss in charge he even gets a break after the difficult period handling the once in a century pandemic, handing over to a younger member of his group, and yet deciding on many of the policies and guiding the government for the term it was elected for to 2024. History will look at him favorably for his handling of the pandemic and vaccination, and for his instincts about the Ukraine war and Britain's unwavering support, and now in guiding Truss to provide Britain with strong support for the cost of living crisis caused by the war. His failings stem partly from his exuberance and optimistic spirit, but nowhere near detract from these achievements. ...

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Dr. Michiaki Takahashi of Osaka, Japan, who developed the chickenpox vaccine in 1972. He decided to do research on a vaccine for chicken pox after his son contracted chickenpox in 1964 and barely survived. At the time he was at Baylor Medical College in Houston. The U.S. alone has about 4 million chickenpox cases a year. This vaccine is now used all over the world.

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Speaking for the Biden administration Anthony Blinken says that "on the current trajectory, if we don't do more, if the entire world doesn't do more, the entire world won't be vaccinated until 2024." What is needed he said is to "speed this up, and get that done, I think, in a much shorter time." Experts say the immediate impact of the Biden decision to give waivers on transfer of patents technologies is to get drug companies to cooperate with each other and for them to voluntarily join in the manufacture of vaccines globally. This would be done through global manufacturing alliances in major pharmaceutical manufacturing nations such as France, India and other countries that can quickly ramp up manufacturing if they have access to the technologies involved and the knowhow itself. The Biden decision is then the first of many decisions that would lead to voluntary action by pharmaceutical companies cooperating say Novartis and Sanofi in France and Switzerland with a Pfizer or Moderna in increasing manufacturing capacity or a Serum Institute or Reddy Labs in India working with Pfizer and Moderna or Novavax. These companies already have the basic structures to ramp up. This would take months yet the process has to start immediately. Today many companies such as Glaxo Smith Kline in UK and US are in a position to get involved in manufacturing but need access to the technologies and knowhow. Leadership by the US plays a huge part in making that happen.  ...

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Israel remains a laboratory for the rest of the world in tackling coronavirus. During the beginning of 2021 Israel was the first country to push ahead with Pfizer vaccines for the over 18 population in a country of 10 million people. As winter approaches Israel has given a third booster shot to 50% of the population and is able to conduct normal life with a green pass system and the use of masks indoors. Each time a major surge has been prevented. The green pass in Israel is now for people who have had a third shot or booster shot. By thinking one step ahead, making decisions rapidly, and coordinating action early between the government and other organizations to vaccinate everyone, Israel provides lessons for the rest of the world. Not that there are no unvaccinated -about 700,000 people do not believe in vaccination and are unvaccinated. They are a vocal group but only about 8% of the population, and the vast majority of Israelis are in favor of vaccination and the green pass system. ...

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Daily coronavirus cases dropped to the lowest level since March 30, 2021. Cases on June 19 were at 58,000 and deaths at 1154 for India's population of 1.2 billion people. The only state with cases over 10,000 was Kerala, and close to 9000 was Tamilnadu. Karnataka and Andhra Pradesh were at over 5000. All these states are in southern India. Only Maharashtra with about 9000 cases was in northern India. The positivity rate in Maharashtra state was 3% and in Mumbai 2%.  The Indian government has a clear vaccine policy and it is for vaccine supplies and vaccination drive to be under the federal government. This puts responsibility in one place and makes it possible to achieve the target of vaccinating 1.2 billion people by December 31, 2021, with the federal government putting all the resources it can muster into the effort. The economy is also linked to how the vaccination supply effort and vaccination drive progresses in the next 6 months, so that the goal of vaccination is closely linked to economic recovery and progress for India as a whole. A good monsoon rainy season would also help the rural economy recovery. ...

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British prime minister Boris Johnson will visit India in January at the invitation of Indian prime minister Modi. It is the first bilateral visit of Mr. Johnson since taking office. Johnson says he really looks forward to the trip and delivering on the quantum leap to create jobs and growth for the two countries. He has invited Modi to the G7 Summit in London as a guest nation along with Australia and South Korea. Mr. Johnson will also host a climate change summit. This is the first visit to India by a British prime minister since John Major. Because of the historical relationship and the British Commonwealth of nations, and as leaders in the English speaking world, both countries have a lot in common. The parliamentary system India adopted comes from Britain. India's role in the Indian ocean as a maritime power alongside Britain and Australia also comes from the period when Britain was the preeminent maritime power in the world. Indian companies in UK have $41 billion pounds in sales and half a million British jobs come from Indian companies. India also is UK's biggest partner in pharmaceuticals, making 50% of the world's vaccines. ...

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This WSJ podcast looks at the Fedspeak, the language, the use of specific words that telegraph the US central bank's carefully thought out message to markets. Th topic is inflation. Is it persistent or transitory? Fed chairman Powell's word for it was "transitory." Then transitory" but longer than we thought, because our Fed models did not include supplychain bottlenecks.  In reality every new variant brings new lockdowns and slows the rise or reverses the increase in gas and fuel prices that are a main driver of inflation. Wage increases are a good thing after decades of lack of leverage of workers and economic distortions from this, this may be termed constructive inflation.  Supplychain bottlenecks are likely to ease and not be permanent so that the Fed could be right on that point. A less noticed aspect of the Fed's decision to raise interests without careful thought is that this will impact the ability of poor and moderate income countries to afford medicine and food as exchange rates make their currencies worth less. At the time of variants this is both a practical and a human consideration. What are called emerging markets in finspeak (financial language) are really countries that Stephanie Nolan is writing about on the frontlines of the pandemic in the NYT- South Africa, Zambia. Then there are other poor or moderate income countries- Brazil, Mexico, Russia, India, Pakistan, Bangladesh, Indonesia, Philippines, Vietnam, Malaysia. Today the Fed needs to think about them also. How much vaccine, medicines, or food imports can they afford with weakening currencies as the Fed raises interest rates? At the same time some accomodations for inflation are necessary, but carefully thought, with a lot of thought given to the current state of the world with new variants and weakened economies and no stimulus payments in large parts of the world to offset weakness. ...

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Germany's national broadcaster DW.com looks into the details of the vaccination drive in countries around the world, including Germany, and finds that there is more to the story than meets the eye in headlines about safety in vaccinations. Many headlines do not tell the whole story carefully. DW revewed reports from Italy, Austria, South Korea, Germany, Spain, the USA, Norway, Belgium and Peru, and found that in most cases health authorites have not found causal links between the vaccination and deaths.  As of March 15 it says 360 million people have been vaccinated in 120 countries, or about 9.25 million a day.  DW.com cites the Pharmacovigilance Risk Assessment Committee (PRAC) of the European Medicines Agency (EMA) which states: 'there is no indication that vaccination has caused these conditions, which are not listed as side effects with this vaccine. Information available so far indicates that the number of thromboembolic events in vaccinated people is no higher than that seen in the general population." As of March 10, 2021 30 cases of blood clots are recorded for 5 million people vaccinated with Astra Zeneca vaccine in the European Economic Area.  The Paul Ehrlich Institute which is in charge of vaccination in Germany has looked into 113 reported deaths in 46 years to 100 years old patients in Germany. Of these 113 deaths PEI finds that 20 died of the Covid 19 infection as it takes 14 days after the second dose for full protection, and 43 died of pre-existing conditions or other infections. For the patient population it says "they were seriously ill patients with many underlying diseases." PEI says "based on the data we have we assume they died of their underlying disease- in a coincidental time with the vaccination." A virologist at the Technical University of Munich, says that the deaths after vaccination are below the expected number of deaths without the vaccination.  ...

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IMF chief economist, Gita Gopinath, says multispeed recoveries are in place in regions and across income groups, linked to the differences in vaccine rollout, and extent of economic policy support. 

All regions in the world are expected to grow faster than estimated in January 2021 by IMF. 

US - forecast raised to 6.4% from 5.1%, this follows contraction of 3.5% in 2020. Rapid vaccination drive and large economic support under president Biden accelerating growth. About $5 trillion in economic support in the US by April 2021.

Europe- forecasts raised for growth in UK and Italy.

Latin America- growth forecast raised to 4.6% from 4.1%.

Africa- growth forecast raised to 3.4% from 3.2%.

Emerging and developing economies including India as a whole- growth forecast raised to 6.7% from 6.3%.

 

 

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Saudi Arabian deputy defense minister Prince Khalid says polls show Saudis younger than 30 years old favor improved relations with Israel. As a first step Israeli planes would be allowed to fly over Saudi Arabia and control over two islands in the region would be handed over to the Saudis.  President Biden as a candidate had concerns about human rights in Saudi Arabia. Following the war with Ukraine and improving Saudi Israel relations it now appears likely that this will have an impact in improving US relations with the Saudis. Prince Khalid visited Washington and William Burns has also visited the Middle East for the Biden administration as it seeks to get Saudi Arabia to increase oil production following the EU oil embargo on Russian oil.  Saudis under Prince Salman who heads the administration are pushing to modernize Saudi Arabia and build ties for a broader relationship with the world than the traditional ties in the Middle East of Arab countries.The Saudis are improving relations with India and India was the first country to ship vaccines to Saudi Arabia. UAE and Qatar have also improved relations with the Modi administration in India. With China  engaged in trade and technology friction with the US after US investment and aid to China during the last 2 decades and the long period of aid to China during the Japanese invasion, the US is building new relationships in Asia, the Pacific and the Middle East. The new Saudi US relationship would be different from that of the old Saudi relationship as Saudi remains a monarchy but under the new administration and a younger generation of Saudis sees itself as a modernizing influence in the region. Biden sees these new factors as it looks to rebuild relationships in Asia.   ...

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The World Vaccine Summit raises about $7 billion to immunize about 300 million children for polio, diphtheria and measles, over 5 years. Prime minister Boris Johnson who opened the summit called it "the greatest shared endeavour of our times." Bill Gates donated $1.6 billion and Britain pledged 1.65 billion pounds over 5 years, making Britain the largest donor. Mr. Trump also addressed the summit in virtual manner- "we will work hard, we will work strong... good luck, let's get the answer." Mr. Johnson called for renewing "the collective resolve."  Specifically he stated: " Just as we have great military alliances like NATO.... where countries collaborate on building their collective military defence, so we now need that sam spirit of collaboration and collective defense agains the common enemy of disease." Referring to failure of early warning systems for coronavirus with crucial weeks between Jan 6 to Feb 16 lost for the West with lack of international cooperation- "It will require a new international effort to cooperate on the surveillance and sharing of information- data is king- that can underpin a global alert system, so we can rapidly identify any future outbreak. And that will mean a rapid scale-up of our global capacity to respond."  ...

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Boosting vaccine production for the Indo-Pacific region that includes Bangladesh, Indonesia, Malaysia, Thailand, Philippines, Vietnam with production done through Biological E in Hyderabad will be discussed at the meeting with Biden. Japan will fund the project, and Australia will handle the distribution. This will be part of a followup to a March 12 virtual meeting of Quad leaders. This effort to meet the vaccine supplies challenge for the Asian region covering south east Asia and its population of 600 million will be one of the major outcomes of Quad countries collaboration, making it a peacetime collaboration that supports development in the region without burdening the financial position of any country.  The other part of US- Indian collaboration and Quad collaboration centers on two related themes after healthcare and pandemic. The immediate challenge is to tackle the breakdown in the supply chain for semiconductors. The US and Europe can no longer depend entirely on a supply chain based in Taiwan. The narrowest part of the Taiwan Straits which separates Taiwan from the Chinese mainland is only 81 miles wide, which makes continued dependence on chip production on Taiwan an unreliable option and the need to build a new supply chain for Japan, EU and US. Plans will be made to address this in the talks. The Biden administration has already taken action with Intel Corp making a U turn and bringing chip manufacturing back home to the US with $50 billion investment planned. India and other Asian countries may form additional options for semiconductor manufacturing. The third part of the Quad effort will center on US and Japan ramping up infrastructure building capabilities with India to build infrastructure across Asian countries and in Africa that will be financed in a way that will not have some of the liabilities of the Chinese initiative called Belt and Road. Loans given by Chinese state banks and contracts including manpower from Chinese contractors are now seen as not meeting the needs of Asian and African countries. These loans most of the time cannot be repaid as in Zambia, and other parts of Africa, and in Pakistan, leading to interest accumulating on debt and making future infrastructure development extremely difficult. The use of manpower from China also means no learning curve for infrastructure is formed for local companies and infrastructure comes without new jobs jobs being created.  For most of the period 1900 -1950 the British built Asian and African infrastructure. During the period 1950 onwards the US assumed a major role, as did the Soviets. This changed after belligerent Reagan administration policies and wars in the Middle East sapped the funds that could have gone to infrastructure building that would improved living standards in Asia and Africa. Mr Biden wants to see this change and this is what he meant when he said at the UN General Assembly today- " we want relentless diplomacy to take the place of relentless wars." He means every word of this and the diplomacy is between allies and also adversaries, but mostly with allies such as Japan, the EU and India to build a better world. That he has to do this quickly Biden is aware of that, which is why he said "the next 10 years will determine our future."   ...

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About 600 US and European company brands are leaving Russia. This report in the WSJ shows how ordinary Russians are coping with jobs in limbo. Many of these companies are continuing to pay employees but jobs remain uncertain. This includes companies like Sweden's IKEA that are popular in Russia. As western sanctions make operating difficult companies future is uncertain. This is creating anti-Western sentiment particularly in the rural areas which use mostly Russian made products and which are Putin's main source of support. Even Russians who question the attacks on Ukraine are skeptical how the withdrawal of these companies helps find a solution for Ukraine. This is happening even as the errors made by 4 term German chancellor of increasing the dependence of Germany on Russian energy supplies from 36% during Putin's annexation of Crimea to 55% today are becoming abundantly clear.That makes an energy embargo on Russia difficult for Europe, with German business saying this would be "catastrophic" because it is unprepared even though this alone provides about $1 billion a day to Putin's Russia. Meanwhile EU and other western leaders call attention to India's drawing 1-2% of its energy supplies from Russia even though one month of Indian imports is equal to just one afternoon of European oil and gas imports from Russia. India has done more than Merkel's Germany to meet the need for humanitarian vaccine assistance for the poor countries of Asia and Africa, Middle East, and is now engaged in meeting the needs of the world for foodgrains after the fallout from an Ukraine crisis that is a result of emboldening of Russia from Merkel's policies.  ...

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The problems of vaccine access in Africa affect us all - this is the simple truth. Here the NYT gives letters from people on the frontlines, healthcare workers in Africa who in one situation in the Sudan had over 4000 people arrive some by canoe through floods and had only 545 vaccines. Africa Centers for CDC show 79% of people in Africa will take the vaccination. Vaccine access for Africa is something that should be on the top of the list for Biden in the US, Johnson in UK, Modi in India, Scholz in Germany, and for all world leaders.

 

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Novax vaccine could be a game changer for the poor countries in Africa, Asia and Latin America. Novax has 90% efficacy overall and 93% effectiveness against the UK, South Africa and Brazil variants. The Delta variant was not there during the trials. Novavax has signed an agreement to provide 1.1 billion doses to Covax, the organization which is designed to send vaccines to poor countries. India has contracted through Serum Institute of India to make 100 million doses. UK has ordered 60 million doses that may be sent to the developing world.

Novavax vaccine goes for regulatory approval in the third quarter of 2021.

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The Moderna vaccine can be more easily shipped and handled than the Pfizer vaccine making it easier to use at smaller hospitals and in rural areas. Moderna would add 20 million doses in December to that of Pfizer's 25 million doses for the U.S. Moderna vaccine is developed in Cambridge Massachusetts Labs and is manufactured in the U.S. and Switzerland.  Moderna vaccine can be stored in freezers does not require ultra low temperatures as Pfizer vaccine. Once thawed it can be stay refrigerated for 30 days compared to 5 days for Pfizer vaccine. Moderna ships in containers of 100 vaccine doses or larger, Pfizer minimum container size is for 975 doses. Both Pfizer and Moderna vaccines are in th 94-95% effectiveness range. Moderna can be injected as is, Pfizer's requires to be diluted in a separate solution. On Dec. 11 the U.S. ito double its purchase of Moderna vaccine to 200 million doses by end of June, Pfizer 's is still at 100 million doses. Moderna may get its approval from FDA in U.S. by Dec. 18. Both Moderna and Pfizer would require a second dose in 3 weeks, both use the same MrnA technology. J&J is developing a vaccine that requires only one dose. J&J finishes its trials in January and expects approval in February.  ...

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In speaking about Indian democracy and human freedom not mentioned was the unprecedented food security or freedom from hunger that was offered to one sixth of the world's population in India since March 2021, year of the pandemic. Not mentioned was the unprecedented health security or freedom from viral epidemic that was offered to the same people in that period with 900 million vaccine doses. Not mentioned was the freedom of expression in 15 Indian languages including freedom to write about the government at local, state and federal levels in the country with a wider spread of language and regional dialects than Europe for 75 years since independence. Not mentioned was the struggle within this democracy to give the younger generation of people under 30 who make up the biggest part of the population an opportunity for the first time in about one thousand years to take charge of their own future. All this one can see with open eyes and open mind. These are also the young people who have the most to gain or lose from the wrong actions at the wrong time, as they take up the challenges of modernization of a clean and vibrant infrastructure friendly India of the future.  ...

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India stands true to the principles of Mohandas Gandhi and joins Pope Francis in strongly condemning the killing of innocent civilians in the Russian invasion of Ukraine, as Gandhi would have done in his own way when he even paused the nonviolent struggle against the British after the burning of police stations in British India. Of no less significance is the danger of food insecurity caused by the war in Asia, Africa and Latin America which India is meeting. India is America's true partner in the free world in a way that even Germany, France, even Britain fail to be now that we know Merkel's policy "errors" and Macron's lofty ambitions for Europe, emboldened Russia in its invasion of Ukraine. American and German business integration of the American and German economies with China may also have emboldened Russia and China in their perceptions of world affairs that directly conflict with China's Buddhist history, Gandhi's view of the world, and India as the land of the Buddha.  Mr. Biden will talk with Modi about the invasion of Ukraine , the Indo-Pacific, and the building of strong India-US partnership. A major issue that has not been discussed at this level is the challenge India is facing and meeting of food security after the war in Ukraine. Pakistan, Sri Lanka and many developing countries are feeling the effects of the war with soaring food prices denying access to basic necessities in these countries. This extends to countries from Asia to Africa and Latin America affecting hundreds of millions of people.  India is providing food assistance following its effort to share vaccines in a remarkable effort that has not received the world's attention. Vaccination for over a billion people in India has taken place in one of the significant achievements during the pandemic. This was combined with food security assistance to hundreds of millions of people in India in India's population of 1.2 billion people. India is now in a position to meet some of the world's food needs with its own efforts in agricultural production. In this way the role played by the US since World War II for peace and security is being met by India as a significant partner in the free world, and in a way this is returning the kind of help the US offered India during the period of famine in the sixties. US president Biden understands this as he will discuss "mitigating the destabilising impact on global food supply and commodity markets" of the war in Ukraine. These are the hidden costs of the war that are not less painful than the gory war scenes unfolding today in the Russian invasion of Ukraine, and because they are about food they are of no less importance. ...

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PM Modi talks about the changes since 2014 and the difference in India now compared to before 2014, during his visit to Shimla, Himachal Pradesh, a place that is close to his heart. His visit is for the "Garib Kalyan Sammelan" for the many schemes launched by his government for the benefit of ordinary people. "Before 2014 there were headlines in the newspapers, debates were taking place on TV channels regarding loot corruption and scams. But time has changed, now the talk is about benefit of government schemes. The World Bank too talks about ease of doing business in India. The Government prior to 2014 regarded corruption as a necessary part of the system. That government succumbed to corruption instead of fighting it. The country then was watching money for schemes being looted instead of going to the needy." With the combination of Jan Dhan, Aadhar and Mobile Modi said money was directly reaching the beneficiary account. Previous governments had accepted that money would not reach the beneficiary and development would be looted. "We have taken the initiative to make 100% benefits reach 100% of the beneficiaries. The government has taken the pledge for reaching the saturation of beneficiaries. 100% empowerment means ending the discrimination, every poor person gets the full benefit of government schemes." "Earlier there was compulsion to suffer because of smoke from the kitchen, today there is the facility to get LPG cylinders from the Ujjwala scheme. Earlier there was the shame of open defecation, today the poor have dignity of toilets. Earlier there was helplessness to raise money for treatment and hospitalization, today the poor have the benefit of Ayushman Bharat." PM Modi talked about how the Northeast was alienated before 2014, and now it was connected by heart and by infrastructure. During the pandemic India sent medicine and vaccines to 150 countries. India stretched out its hand to help other nations. India, he said, has shown that it not only has the potential, it is also a performer. International organizations are accepting that poverty is coming down and there are more facilities for the people. ...

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Jenny Medina looks at America's Biden 10 months into his presidency. Biden compared his presidency to that of FDR in his first years in office in 1933 with America in the depths of the Great Depression.  This report says FDR was better able to communicate how the New Deal would help families and workers in the face of distrust. Biden needs this today. During the ten months of the presidency Biden has already taken the tough decisions that are needed. For the vaccination drive, for the vaccine mandate on the coronavirus pandemic. On Afghanistan Biden took a similar tough decision to step away after learning the lessons of that conflict. He has quietly moved forward to build the alliance with Europe. On the infrastructure plan he has made the tough decision to make certain the essential components of spending on healthcare, education, childcare, support for mothers and older Americans are put in place, so that one bill for infrastructure is not passed without the bill for healthcare, childcare, mothers, elderly and education. Only this can provide the needed credibility for Republicans in states such as Tennessee who support community college open to all to come behind the overall Biden families and workers plan, and for working families throughout the whole country to support further spending for renewal of America.  ...