Not so long ago, India was sending coronavirus vaccines to other countries. Prime Minister Narendra Modi dubbed India the “pharmacy to the world”. His administration said the pandemic was at its final stages in India. Now, in a second wave of contagion, the world’s second-biggest population is at the epicentre. Unprecedented numbers of new cases are overwhelming hospitals. People are dying on the streets outside while awaiting admission to overcrowded, oxygen-starved wards. Deaths are overwhelming graveyards and cremation services. Other countries have imposed travel curbs and flight bans. It is India that now desperately needs aid such as oxygen, vaccines and basic medical supplies. China has led the response – an offer that met some resistance in India, but this is no time for politicisation. The crisis is a horrific example of the dangers of relaxing anti-contagion measures too soon. It is not as if New Delhi had any excuse to have been taken by surprise. Simple observation of second waves of contagion in other parts of the world should have alerted it to the need to stockpile medicines and prepare to confront a new surge. There is a wider lesson for the rest of the world. People tend to assume that once their country has a vaccine and a mass inoculation programme Covid-19 is going to go away. But unless vaccine coverage is swift and comprehensive, it is in danger of being overwhelmed by the virus. India’s vaccination centres are running out of doses. And if countries lagging behind do not catch up, no one is safe unless everyone is vaccinated or borders are closed. Given its population size, India is a vulnerable example. It offers an ideal environment for the virus to jump from host to host and mutate. As a result, it has added to new strains of the virus causing global concern. India is also paying the price for underinvestment in public health. Unless the situation is brought under control, not only is it bad for India but it also increases the danger that the virus will defeat the current vaccines and force research and development laboratories back to square one. It is therefore the international community’s public health responsibility, as well as a humanitarian issue. All the major rich countries need to get behind India and give it support. Modi has rightly appealed to people to get vaccinated and not “get swayed by any rumour about the vaccines”. But he has hardly set a good example by allowing Hindu festivals and attending huge election rallies that could have accelerated contagion. A request to Twitter to censor more than 50 tweets critical of officials’ handling of Covid-19 does not inspire confidence in accountability. Having claimed the government was in control after the first wave and taken the credit, Modi now risks being blamed for the second wave.