Trump, the Benevolent King of Ventilators

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We aren’t just the “King of Ventilators” -- we are benevolent medical monarchs looking to sell or give away for free our life-saving wares to the world. So says the president of the United States.

The honorific was self-anointed but not undeserved. President Trump announced at the height of the COVID-19 pandemic that the Arsenal of Democracy would be retrofitted, not for munitions, but this time for breathing machines.

The coronation was announced on March 27 at the White House with a promise to use the Defense Production Act. The United States typically produces 29,000 ventilators a year. Trump ordered 100,000 to be built within 100 days. General Motors, Philips, Medtronic, General Electric, Vyaire, Hamilton, Zoll, Hill-Rom and ResMed were to do the building.

And then they did. In the subsequent months, America has produced ventilators at such a clip that they have outstripped domestic demand. What to do with excess? Sell them. Give them away.

“Just spoke to my friend, President Joko Widodo of the Republic of Indonesia. Asking for Ventilators, which we will provide. Great cooperation between us,” Trump tweeted toward the end of April before going on a three-week tear of negotiating sales and gifts of the breathing devices.

But medicine, especially global medicine, still falls in the sphere of geopolitics. At a moment when China seeks to increase its influence around the world, dangling medical supplies in front of desperate nations, would the United States use the ventilators as a bargaining chip on the world stage? When RealClearPolitics put that question to the president during a recent cabinet meeting, Trump was unequivocal.

“No,” he said. “I’m looking to save lives. If we can save lives of another country, that’s a great thing. I’m only looking to save lives,” he added. Were there positive side effects? “Probably, that’s good diplomatically,” he added, “but I’m not looking at that.”

John Ullyot, a spokesman for the National Security Council, told RCP that nearly a thousand ventilators have already been shipped overseas to America’s partners and allies.

“President Trump and the administration have committed over 15,000 ventilators to over 40 countries, including NATO, through the end of July, through direct procurement, United States’ foreign assistance, or a combination of both,” Ullyot explained.

Capitol Hill has questions. A hospital-grade machine can cost from $25,000 to $50,000, a significant but necessary sum for a device the moves purified air in and out of the lungs of a patient.

“What mechanisms have the administration put in place to ensure that these ventilators are used effectively and appropriately? Who is responsible for determining where and in what parts of the country these ventilators are used? What plans are in place to monitor this assistance?” asked a senior congressional source monitoring international aid.

The White House gave a distended answer. A senior administration official told RCP that the government was working with recipient governments “to identify facilities that can safely and effectively deploy ventilators, using country- and facility-level assessments to determine the health system capacity of recipient countries and identify facilities best positioned to use ventilators safely and appropriately.”

At the end of the day though, the official explained, whether the ventilators are sold or gifted, “it is ultimately the responsibility of the host government to use the ventilators as it sees fit for the health and welfare of its people.”

The context for all of this is a medical cold war. China has launched a full-scale PR offensive to shift blame away from the Communist Party that fumbled its initial handling of the virus in the Wuhan province and spread disinformation about the origin of the disease. China then sent personal protective equipment around the globe (some of it defective). They have relentlessly advanced their initiative to become a counterweight to the United States, even during a pandemic.

This is not lost on the White House, though it creates a messaging dilemma for the president. Trump has long railed against foreign aid. Trump now promises to put all of that aside, to offer, at a discount or for free, medical aid. What will the United States get for it? Good will, presumably.

“The president has reached out to our partners and allies around the world to provide them with these life-saving machines,” Robert O’Brien, national security advisor, wrote in a Fox News op-ed.

“I have been with President Trump as he has spoken with leaders from countries on six continents,” he added, “including Brazil, Bolivia, Ecuador, France, India, Indonesia, Italy, Kenya, Pakistan, Paraguay, Philippines, South Africa, South Korea, Spain, the United Kingdom and many more.”

The generosity will be well marketed, a senior administration source told RCP. A likeness of the American flag will be on the boxes.

“The U.S. government is branding the packaging of the ventilators under the branding guidelines of the U.S. Agency for International Development (USAID) as aid from the American people,” the source said.  

“In addition, USAID is working with USAID missions overseas and U.S. embassies to publicize through embassy press releases, social media posts, and local media engagements that the ventilators are gifts from the American people to the people of the receiving country,” he continued.

Even benevolent kings of ventilators, it seems, want credit for their generosity.

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