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WASHINGTON — The Trump administration is considering new rules that would limit how American humanitarian aid is used to buy masks, plastic gloves and other protective medical equipment to combat the coronavirus in some of the world’s neediest nations.
Instead, the administration is working to secure those supplies for Americans first as the pandemic sweeps around the world.
The internal debate is the latest example of a global race for limited medical gear that puts countries that are poor, are unstable or have deficient health systems at a deadly disadvantage.
Already, officials have told some nonprofit aid groups that they cannot use money from the United States Agency for International Development to buy personal protective equipment for needy nations while American health providers face dwindling supplies.
A draft presidential memorandum, described to The New York Times on Thursday, would allow funds to be used to buy only protective gear that was produced in the countries where it was needed.
The issue is still under debate, officials said, and could be broadened to prohibit the government from paying to provide equipment to foreign medical systems when it is needed in the United States.
“Where there is a critical shortfall in the United States, obviously, we can’t pay for donations of materials that we can’t actually procure,” Jim Richardson, the director of the State Department’s foreign assistance resources, told reporters on March 26.
Four international aid officials said humanitarian workers in vulnerable communities had been informally alerted to the funding shift before the official White House decision. The aid workers spoke on the condition of anonymity out of fears that the Trump administration would withhold funding to their humanitarian organizations if they publicly criticized the policy.
Michael Klosson, the vice president for public policy and humanitarian response at Save the Children, said he had heard of the new U.S.A.I.D. guidance but did not know if it would become policy.
“We want to make sure the front-line health workers, wherever they are, are protected,” said Mr. Klosson, whose organization receives funding from the U.S. aid agency and the State Department.
“We’ve seen what’s happened in developed countries, where very advanced health systems and social safety nets have been overwhelmed,” he added. “Just imagine the challenges as this thing kind of multiplies in sub-Saharan Africa and places like that, with countries with much weaker health systems and much weaker social safety nets.”
The U.S. aid agency has shipped about 150,000 N95 masks and thousands of scrubs, coveralls and face shields to health care workers in Oregon from its warehouse in Dubai, United Arab Emirates. Andrew Phelps, Oregon’s director of emergency management, said last week that it “will make a huge difference in Oregon’s ability to fight this outbreak.”
In March, the aid agency was sending personal protective equipment from its own stockpiles to nations in need.
That changed after a meeting later in the month. Officials who were gathered from across the government were surprised to hear that those shipments were continuing and told the agency to stop, according to a senior administration official who spoke on the condition of anonymity.
A representative from the aid agency who was at the meeting asked for a memo to formalize the shipment freeze, the senior administration official said. Within weeks, and faced with a projected shortage in the Strategic National Stockpile of medical supplies, President Trump invoked the Defense Production Act to prohibit the export of face masks to other countries.
The aid agency and the State Department have provided about $508 million to the United Nations and nonprofit humanitarian aid organizations to help confront the virus in 104 needy nations and the Palestinian territories. Announcing the funding on April 8, Secretary of State Mike Pompeo described it as an example of “the unmatched generosity of the American people.”
“The United States is the undisputed leader in the provision of health and humanitarian aid, around the world,” Mr. Pompeo said.
That money has largely paid for messaging campaigns to educate people on how to protect themselves from the virus, to provide water and sanitation services like hand-washing stations, and to offer health services to refugees, migrants and other homeless people. Some of the funds have been spent on what an agency fact sheet released Thursday described as “infection prevention and control.”
The agency did not answer questions about whether that included personal protective equipment, although the fact sheet said funding could be used for “health commodities that are not required for the U.S. domestic response” in Italy and Eswatini, also known as Swaziland. Masks and other gear were not listed on the document.
The fact sheet also omitted mention of millions of dollars in aid previously designated for the World Health Organization. On Tuesday, Mr. Trump announced that the United States would halt funding to the W.H.O., which he faulted for mismanaging the global response to the coronavirus.
Representatives from the aid agency and the State Department’s office of foreign assistance resources declined to comment when asked about the funding and whether it could be used to buy personal protective equipment.
It is not clear whether the funding limits, if enacted, would be lifted once the domestic demand for protective medical gear eased in the United States.
J. Stephen Morrison, the director of the Global Health Policy Center at the Center for Strategic and International Studies, said the guidelines were not surprising, given that the United States and other major donor countries confronting the virus have “turned inward and are adopting very narrow, nationalistic policies.”
But if the limits remain, he said, it raises the risk that “low-income countries are just left in a catastrophic condition, walled off without hope of not much containment or recovery.”
“They stand at risk of losing a generation of development progress,” said Mr. Morrison, who had also heard of the proposed guidance from a colleague based in Africa. “They stand at risk of having massive setbacks, demographically, in terms of health status. There’s a huge amount at risk.”
Mr. Klosson of Save the Children said that many aid groups, including his own, received donations from other governments and private contributors that could be used to buy the equipment for health workers in needy communities. The organization works overseas and in rural areas in the United States.
“We want to make sure that front-line health workers in the United States are protected as well — it’s not an either-or thing,” he said.
Zolan Kanno-Youngs contributed reporting.
