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Despite post-COVID efforts, the U.S. is still undersupplied with domestic-made PPE

MARY LOUISE KELLY, HOST:

During the coronavirus pandemic, American hospitals struggled to get critical protective gear - things like masks, gloves, gowns. Almost all of these get made overseas. Well, to prevent similar shortages from happening in the next crisis, federal officials have been taking steps to boost production on U.S. soil. They have put more than a billion dollars into this effort. NPR's Nell Greenfieldboyce checked in to see how it's going by focusing on one key item - medical gloves.

NELL GREENFIELDBOYCE, BYLINE: We spent the whole pandemic talking about masks. So for a change, let's talk about gloves. The United States uses over a hundred billion medical exam gloves each year.

SCOTT MAIER: You know, I think most people are familiar with the blue nitrile or purple or whatever you see at your doctor's or dentist's office.

GREENFIELDBOYCE: Scott Maier is the CEO of a company called Blue Star NBR. He says almost all of those gloves come from Asia. To make gloves here, you'd first need some raw material, a kind of fake rubber that's called NBR. That's what his company wants to produce. He shows me a bottle full of it.

MAIER: Looks like thick milk. Yep. It's white, viscous.

GREENFIELDBOYCE: His company built a new facility to make this stuff using a $123 million grant from the federal government.

MAIER: This is the only facility in the U.S. that can make a medical-grade NBR.

GREENFIELDBOYCE: Actually, though, this facility isn't making anything. It's just sitting in southern Virginia, silent and idle, an 85-foot-tall, gray, windowless building surrounded by grassy fields and rolling mountains. Inside, there's eight stories full of shiny pipes and equipment to whiz chemicals together in a controlled way. We go up metal steps as Maier gives me the grand tour.

MAIER: To our right, we have our large mixing tanks.

GREENFIELDBOYCE: The tanks are empty. Nothing is being mixed. Maier says during the pandemic, government officials were scrambling to jumpstart a new U.S. manufacturing base for protective medical essentials. To support glove production, they ponied up the money to build this chemical plant. Maier's company also wanted to build a glove factory to turn the rubber into a finished product, but funding for that part of his plan never came through. So where he hoped to build a glove factory, there's just an empty lot.

MAIER: When our project was only half funded, we said, you know, we have some budget issues because there were shared costs here.

GREENFIELDBOYCE: Maier told officials that Blue Star needed more money.

MAIER: And they came back to us and said, well, your contract is only to build capacity. Your contract does not say you have to operate and bring the capacity online. We thought that was odd.

GREENFIELDBOYCE: He really wants to get this plant running, in part because the local community contributed millions of dollars in land and infrastructure because they thought the project would create new jobs. But even if Blue Star NBR somehow started producing this special rubber, who would buy it? Maier knows of only a few glove manufacturers in the United States. He says they make so few gloves, he wouldn't break even just selling to them. And while some government grants did go out to glove makers to get them to increase production...

MAIER: I don't think any of that capacity is up and running yet.

GREENFIELDBOYCE: You don't think any of it is.

MAIER: To my knowledge, no.

GREENFIELDBOYCE: I asked a spokesperson at the Department of Health and Human Services about that. This agency collaborated with the Department of Defense to make the grants. An email I got back said they expected to see expanded production - 2.5 billion extra gloves next year. The email said the agency recently did a thorough review of companies that got contracts during the pandemic for protective gear, that the agency was continuing to work with them and the rest of the government to try to increase the sustainability of domestic manufacturing. But that's tough, as I learned when I went to visit a company called United Safety Technology. Its CEO is Dan Izhaky. He wants to make medical gloves. He says he'd happily buy American-made rubber from that facility in Virginia.

DAN IZHAKY: What's the point of making gloves here if we're relying on imported raw material? Because if there's a supply chain disruption, we're still not going to be able to get what we need.

GREENFIELDBOYCE: Their new facility was created with nearly a hundred million dollars in government funding. It's just outside of Baltimore, in a giant building once owned by Bethlehem Steel.

IZHAKY: It's about 735,000 square feet.

GREENFIELDBOYCE: He says this place could produce 10 billion gloves a year. We walk around rows of truck-sized metal boxes. Izhaky says they're like a giant Lego set.

IZHAKY: What you're looking at right now are modules that have been assembled that are part of our production line. So these blue things are the ovens that actually, you know, cure and bake the gloves.

GREENFIELDBOYCE: No gloves are being baked. This factory isn't finished.

IZHAKY: Trying to stand up a facility like this in the middle of a pandemic was challenging.

GREENFIELDBOYCE: He says there's been unexpected expenses, inflation, plus the entire global glove market shifted. At the start of the pandemic, the U.S. bought most of its gloves from Malaysia, which had the lowest prices. But China started selling even cheaper gloves. It's rapidly taking over the U.S. market.

IZHAKY: Basically, they're selling it at what we believe to be an artificially low price. It's really hurting the whole global industry, other than the Chinese.

GREENFIELDBOYCE: During the pandemic, China was accused of covering up the extent of the outbreak in order to hoard medical supplies. Remember, the whole world ended up vying for masks and gloves and gowns. American doctors and nurses were making do or doing without. Izhaky says if there's not a decent amount of onshore manufacturing, it'll be deja vu in the next crisis.

IZHAKY: Listen, it could be a pandemic. It could be a geopolitical event. We don't know what it could be. But once global supply chains shut down, if we don't have some domestic capability to produce this, then it's shame on us - all of us.

GREENFIELDBOYCE: That's the case that he and other manufacturers are trying to make to the people who hold the purse strings. A bunch of executives just sent a letter to members of Congress pleading for help. They say the effort to foster American production of gloves, masks and gowns has stalled, that it's in danger of collapsing. They say some companies are facing imminent financial ruin. And instead of increasing production, they're laying off workers. Now, the government does stockpile some emergency supplies. Greg Burel used to run the Strategic National Stockpile. He says there would never be enough money to buy everything needed for a pandemic and just keep it on the shelf.

GREG BUREL: That'd mean we'd have to rely on going to the market during an event at some point.

GREENFIELDBOYCE: And in that market, the main day-to-day customers aren't government agencies. They're large hospital consortiums and health care distributors. Eric Toner is with the Johns Hopkins Center for Health Security. He says the big health care customers just want a product that works and is cheap.

ERIC TONER: You know, if they can get a glove for a penny versus a nickel, they're going to go for the penny.

GREENFIELDBOYCE: Toner says even though it makes some sense to prop up American production of items like medical gloves to help keep the nation prepared, measures like subsidies and incentives would cost real money.

TONER: I think in the current political environment, it would be a really hard sell.

GREENFIELDBOYCE: Because most of the time, these American-made products aren't needed. They're only really needed when there's a crisis.

Nell Greenfieldboyce, NPR News. Transcript provided by NPR, Copyright NPR.

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Nell Greenfieldboyce is a NPR science correspondent.