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American-Made Medical Supplies for Veterans' Care

The COVID-19 pandemic revealed, much to the surprise of many, the reliance within the United States medical supply chain on foreign-made goods. Suddenly struggling to fulfill a basic need left many in the health care industry flat footed. Determined to be better prepared in the future, the United States Legislature took action.

The Infrastructure Investment and Jobs Act (also referred to as the Bipartisan Infrastructure Law or BIL) signed into law in November 2021 contained a subsection, The Make PPE in America Act, aimed at resolving this now-acknowledged gap in domestic manufacturing. It defined Personal Protective Equipment (PPE) as items used to prevent or reduce the transmission of disease, including but not limited to masks, respirators, face shields, gowns, eyewear, gloves, etc. By requiring the Department of Homeland Security (DHS), the Department of Health and Human Services (DHHS), and the Department of Veterans Affairs (VA) to procure these items from made in America manufacturers, the commercial/industrial base will expand and ultimately provide a domestic source for these critical medical items and strengthen this nation’s self-reliance.

Highlighting the challenges in compliance with The Make PPE in America Act, the VA was initially forced to seek a waiver for nitrile gloves in full due to the lack of domestic manufacturers. Foreign sources had, essentially, displaced almost all American-based manufacturers of this product. In December 2023, the VA finally secured robust market research supporting sufficient Infrastructure Investment and Jobs Act and the Make Personal Protective Equipment in America compliant manufacturers existed for the 4 MIL and 5 MIL gloves and a proper competition could occur. The VA is still seeking compliant 6 MIL gloves as insufficient made-in-America quantities do not currently exist. The VA is committed to this process and has stated it will fully exhaust domestically-made products before utilizing foreign-sourced products; however, another hiccup was soon revealed. While the purchased gloves are now mostly procured from made-in America sources, the VA was forced to seek another waiver in April 2024 concerning the raw materials for the nitrile gloves. Currently, raw materials for these gloves, the nitrile butadiene rubber (NBR), is not produced domestically and only partially-compliant products are available in the commercial marketplace. The VA is confident the raw materials issue will eventually be resolved by 2025, which is its publicly stated goal for 100% transition to fully compliant nitrile gloves.

Through its large purchasing power and self-imposed rules, the Federal Government has the ability to expand the commercial made-in-America industrial base. It is a complex balancing act for all agencies given the importance of procuring cost effective products, but one the VA has proven it will succeed in accomplishing.


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