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U.S. Department of Health and Human Services

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The Evolution of the Strategic National Stockpile

Author: Greg Burel, Director, Strategic National Stockpile, and Denise Williams, Technical Writer-Editor, Strategic National Stockpile
Published Date: 8/21/2019 10:02:00 AM
Category: Response & Recovery; Medical Countermeasures; Public Health Preparedness;

Twenty Years of Stockpiling Critical Medical Products and Training Professionals to Respond to 21st Century Health Threats


Twenty years ago, Congress established the Strategic National Stockpile (SNS), originally named the National Pharmaceutical Stockpile, with a $51 million appropriation and a handful of staff quietly housed in CDC’s National Center for Environmental Health. Today, the SNS is part of the HHS Assistant Secretary for Preparedness and Response and holds a $7 billion inventory as well as vast experience in preparing for and responding to a variety of public health threats. Over time, the SNS has strengthened the federal government’s response capabilities so that the country is more prepared than ever to help protect the health and safety of the American people.

For the last two decades, experts at the SNS have worked to stockpile lifesaving products and build partnerships so we are ready to respond when disaster strikes. As a result, today’s SNS has the capacity to get the right medicines, supplies and devices to the right people at the right time.

SNS 20 Year History

One of our first collaborative efforts was working with the New York City Department of Emergency Operations responsible for medical countermeasure planning and the Federal Aviation Administration. On Sept. 11, 2001, one month after the three organizations staged their first full-scale exercise, an early morning attack on the World Trade Center and the Pentagon shocked the nation and the world. The stockpile was called into action as part of the government’s immediate response to the deadliest terrorist attack on U.S. soil and delivered medicines and supplies within 12 hours of the request.

On the heels of that incident came the 2001 anthrax attacks, which served as a wake-up call for the United States and the western world on the realities of bioterrorism. Scientists in laboratories and doctors in hospitals became acutely aware of the dangers of bioterrorism and voiced concern about their ability to identify such illnesses and treat patients to save lives.

Identification of bioterrorism-related diseases is not as straightforward as one might think. Illnesses caused by bioterrorism often mimic the symptoms of other, more common maladies. In the wake of the anthrax attacks, treatment options were extremely limited. In addition, even after a healthcare provider identifies a cause, treatment is not always readily available. For twenty years, we have worked with our public and private partners to expand the treatment options that are stockpiled in the SNS and to build the partnerships and protocols to respond on a moment’s notice.

The crises of 2001 led to a cultural shift in how public health, emergency management, and medical experts think about national security. These potential threats resulted in public health becoming an important component in the national security framework and changed the way state and local health departments worked and interacted with other agencies and sectors. Health departments became accepted as important partners by traditional emergency management and first responders, including law enforcement, fire departments and emergency medical services. The nation’s ability to respond to disasters strengthened with each area of government working together.

Since 1999, the stockpile responded to more than 60 public health emergencies, including natural disasters and disease outbreaks with the potential to threaten public health. The SNS deployed medicines, supplies, equipment and expertise for multiple major natural disasters, including Hurricanes Katrina, Sandy, Harvey and Maria, as well as flooding in North Dakota. When the SNS responds to an emergency, it fills major gaps, providing medicines, medical supplies, equipment, personnel and more.

The SNS also has deployed medical countermeasures rapidly and efficiently in the wake of disease outbreaks. During the 2009 H1N1 influenza pandemic, the SNS demonstrated its ability to deploy antiviral drugs and personal protective equipment nationwide for an influenza emergency. The SNS shipped 25 percent of its total supply of influenza antiviral medications to 62 areas in just 7 days.

In emergencies, the SNS works with public and private sector partners to find and close gaps. For example, during the 2014 Ebola response, the SNS coordinated with supply chain partners to identify gaps in the commercial supply of personal protective equipment (PPE) to healthcare facilities. Requests for PPE in hospitals were prioritized, and the SNS established a small supply of Ebola-specific PPE to better prepare for future outbreaks.

Emergencies can overwhelm state and local medical resources even with the best preparation. To help in those situations, the SNS has evolved to become the nation’s largest supply of life-saving pharmaceuticals and medical supplies for use in a public health emergency. Staff at the SNS are honored to serve our country in this unique capacity.

Whether you work for a hospital, a healthcare facility, or public health department, learning about the SNS can help you enhance your organization’s preparedness and national health security. Discover our in-person and online training opportunities to increase your understanding of the assets available from the SNS and teach you how to receive, stage, and use the products during emergencies, and more. For more information, see the Strategic National Stockpile Course Listing.


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