The search for supply chain efficiencies has made our health care system leaner and more global. But this efficiency has come at the cost of resilience, with hospitals and health care providers now dependent on fragile global supply chains vulnerable to disruptions from “black swan” events like Covid-19. The pandemic demonstrated the devastating human and economic costs of this fragility: soaring prices and widespread shortages of critical medical supplies and personal protective equipment (PPE), and health care facilities struggling to protect staff and patients. The shortages also unleashed a homegrown resource that helped us cope: the tens of thousands of domestic manufacturers and community groups who stepped up to produce PPE and other critical supplies when existing supply chains failed.