The global battle for personal protective equipment turns ugly

Should PPE be distributed based on need or the market?
Photo: michael_swan / flickr
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The competition for personal protective equipment has taken an ugly turn.

Amid a global shortage of PPE, countries have been competing for what is available in the global market (even as some states, including Canada, had previously been sharing and donating PPE to countries dealing with severe outbreaks). Many countries are ramping up their production of masks, surgical gowns, face shields, and other equipment required by healthcare workers treating COVID-19 patients.

Then last week, the United States invoked the Defense Production Act, which allows it to compel domestic companies to produce and distribute emergency goods in specific ways. Two incidents related to that country’s moves to secure PPE have figured in public discourse.

The wellbeing of Canadians became simply another rhetorical flourish for Trump to trot out during his daily self-congratulation speeches and adoration rallies.

First, and most pressing for Canada, was President Trump’s decision to order the company 3M to not ship N95 masks or other PPE to Canada. Provincial-run healthcare systems have ongoing relationships with 3M and were relying on these shipments to shore up essential supplies for workers, which the Ontario provincial government had estimated could be depleted within a week.

In a second incident, the German government accused the U.S. of “piracy” in taking a shipment of masks in Bangkok that were in transit from China to Germany. The German government said the U.S. was using “wild west” methods to secure PPE in the global market.

America first and Trump’s pandering

The Canadian response to these American moves to secure PPE has ranged from anger to dismay to feelings of betrayal.

While the Canadian federal government has maintained an even tone and encouraged constructive discussions with U.S. government officials (as it has consistently done through numerous disputes over the last few years), provincial politicians opened fire.

Saskatchewan’s premier Scott Moe called Trump’s demand for 3M to not export PPE to Canada a betrayal. Ontario’s premier Doug Ford took aim at the U.S. president and vowed he would never again allow the province to be at the mercy of decisions made by the White House. And Newfoundland and Labrador’s premier Dwight Ball said he was infuriated with the order and felt betrayed, even invoking his province’s efforts to care for Americans stranded during 9/11.

How can that be squared with the increasing restrictions on the movement of goods and services that Canada has imposed during this crisis by closing its borders and protecting its own industries?

Some of the colourful language used by Canadians on social media suggests the public response was even more pointed. Trump’s decision was viewed as a stab in the back, an affront to a history of close ties and integration of Canada and the U.S.

And of course the majority of the Canadian public also knew instinctively that Trump’s order was as much about pandering to his base, a cynical ploy to curry favour and votes ahead of an election. This was as infuriating and hurtful for Canadians as the actual loss of PPE, since the wellbeing of Canadians became simply another rhetorical flourish for Trump to trot out during his daily self-congratulation speeches and adoration rallies.

‘Canada first’

It is difficult to separate what happens in the United States from the ongoing spectacle of Trump’s presidency. At times it can also be difficult to separate his odious antics or the crassness of U.S. politics generally from the American people themselves.

However, I am asking, if only for the sake of thinking through the issue, that readers might for the moment forget about Trump and try to put his narcissism in brackets. This is how we can move the discussion to ethics — and since Trump has none he needs to be subtracted from the equation.

Is there some reason that the United States does not deserve to have this PPE?

Now to be clear, I think that Canadian healthcare workers should absolutely have the equipment necessary to work in a safe environment. They are afraid and anxious right now as they go to their jobs, and that is wrong. Everything that can be done for Canadian healthcare workers must be done.

But I have not seen any evidence to suggest that Canada’s need for PPE is greater than the need for PPE in the United States. In fact, everything that I see in the media suggests that the United States is experiencing the pandemic in a far more acute way than Canada, and American healthcare workers are similarly experiencing shortages of PPE and facing unacceptable risks.

Systems of global trade and international relations do not operate in the spirit of justice and fairness

Can it be understood as justice and fairness that Americans get what might have been intended as Canadian PPE? If the United States is indeed facing a worse crisis and a worse shortage of PPE, is it not incumbent on Canada to give up its claim to these resources in the name of the greater good?

I do not know if this can be quantified, but as so much of what is considered sound decision-making is based on numbers and empirical data, it would be interesting to know if there is a way to measure whose need is greater, Canada or the United States.

In the absence of hard data, how else can we justify assertions that Canada should receive this PPE? Is it because we believe in a principle of free markets and unrestricted international movement of goods and services? And if so, how can that be squared with the increasing restrictions on the movement of goods and services that Canada has imposed during this crisis by closing its borders and protecting its own industries?

And what does it say, furthermore, that Canada does not protest on behalf of the other countries specifically singled out by Trump’s restrictions on 3M? Is the Canadian response of asking to be exempt from the U.S. emergency order really any different than the U.S. response itself, in the sense that Canada is advocating only for itself and not calling for all countries to be exempt or for the order to be rescinded?

Is it not simply a version of “Canada first”?

A global and international response

Obviously, we want what is best for our people and especially for our healthcare workers caring for patients with COVID-19. I don’t think anyone disagrees that the lack of PPE for Canadian workers is wholly unacceptable.

But we should also recognize that the entire world is facing the same issue. And unfortunately, systems of global trade and international relations do not operate in the spirit of justice and fairness, even if laudable values are supposedly the foundation of international politics and international institutions such as the United Nations and World Health Organization.

Quite the opposite — it is in many ways an international order in which might rules, a system that historically privileges wealthy and powerful countries ahead of others.

As the pandemic is a truly global and international threat, it calls for a response that is likewise global and international. And it calls for an ethics that takes into account more than national or provincial concerns.

What is unfolding in this pandemic is undoubtedly a massive tragedy of human loss and suffering. It affects every country in the world. But the tragedy is not equal.

Countries that were already the most vulnerable are more vulnerable still. And vulnerable communities and vulnerable groups within countries, even within rich countries, are more vulnerable still.

The issue of PPE is one example of the ethical dilemmas the pandemic asks us to confront. Inasmuch as Canadians may say they will remember the way the U.S. president treated our country during a moment of need, people around the world will equally remember those who acted for the greater good.

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