Joe Grogan, former senior official of the George W. Bush administration and the first Trump administration, operates an active consultancy, hosts a podcast, writes commentaries for USC Schaeffer Center, and is an active member of the CSIS Bipartisan Alliance for Global Health Security. Drug shortages remain a real problem, with the potential to scale and impose political costs. What to make of the Big Beautiful Bill? It might provoke a backlash. How to understand the rising vulnerability of the aging foundational programs—PEPFAR, Gavi, the Global Fund? And how to understand what happened during Covid-19? It was a “toxic brew.” We need to be “radically transparent.”