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U.S. Department of Health and Human Services

Medical Countermeasures and Non-pharmaceutical Interventions

National Health Security Strategy Strategic Objective 2

Countermeasures are used to protect communities from and limit the adverse health impacts of chemical, biological, radiological, and nuclear (CBRN) attacks, outbreaks of infectious diseases, and other incidents.  Medical countermeasures (MCMs) include medications and other pharmaceuticals as well as non-pharmaceutical medical devices and approaches, such as ventilators, diagnostics, personal protective equipment, and patient decontamination.  Non-pharmaceutical interventions (NPI) refer to community mitigation and infection control (e.g., hand hygiene) strategies that are used to prevent the spread of disease, contamination, or other adverse effects related to an incident.  The NHSS promotes a suite of countermeasures to include MCMs and NPIs to protect communities from and alleviate the effects of CBRN agents and infectious diseases, including pandemic influenza, emerging and re-emerging pathogens, and antimicrobial pathogens.

The nation has made progress in developing and preparing countermeasures through the active involvement of many agencies and organizations.  The Public Health Emergency Medical Countermeasures Enterprise (PHEMCE) facilitates and strengthens interaction among stakeholder communities.  It provides an integrated vision of the entire MCM enterprise to ensure the maximum health benefit and most-efficient use of public and private resources. The Department of Health and Human Services (HHS) and Departments of Defense (DoD), Homeland Security (DHS),  Veteran Affairs (VA), and Agriculture (USDA) maximize the nation’s ability to respond to CBRN threats and infectious diseases through coordination and  alignment of available MCM research and development and related infrastructure resources with PHEMCE public health emergency priorities.  For example, the Biomedical Advanced Research and Development Authority’s (BARDA) Centers for Innovation in Advanced Development and Manufacturing and Fill Finish Manufacturing Network and DoD’s Advanced Development and Manufacturing Capability play key roles in assisting companies in the advanced development and manufacture of MCMs during public emergencies.

The NHSS builds on recent progress by focusing on decision-making processes for prioritizing countermeasures that will be most critical during incidents; expanding non-federal stakeholder involvement in the PHEMCE process; promoting research and development on NPIs; and improving the national ability to effectively distribute and dispense MCMs in a public health emergency.

Priorities

Actions to support these priorities

Decision-Making Frameworks and Coordinated Processes

Federal partners will

  • Continue to work with state and local stakeholders to improve state and local readiness to make and implement decisions about use of MCMs and NPIs in responses
  • Develop communications plans to better communicate to non-federal stakeholders the risks and benefits of implementing different types of MCMs and NPIs during incidents
  • Create a strategy or approach to prioritize investments in MCM and NPI development and implementation 
  • Collaborate with academia and state/local public health departments to develop guidance to address gaps in healthcare worker and healthcare first responder MCM and NPI preparedness
  • Establish a mechanism to develop an overarching framework and capability to rapidly identify best MCM strategies and other options to control newly emerging pandemic infectious diseases

Additional actions partners can take

  • State governments can lead, with support from academia and local governments, the development of a coordinated approach to regional and federal planning that contributes information on implementation constraints, opportunities, and the social and economic benefits and costs of MCMs and NPIs

Non-Federal Stakeholder Engagement within PHEMCE Processes

Federal partners will

  • Work with appropriate General Counsel to identify the scope of, and mechanisms to maximize, non-federal engagement in the PHEMCE process
  • Identify ways for nonfederal partners to engage in th PHEMCE process for requirement-setting for MCM research and development
  • Work with state, local, tribal and territorial (SLTT) governments and organizations to implement the PHEMCE framework to engage non-federal partners in requirement setting for MCM research and development 
  • Work with non-federal PHEMCE stakeholders, such as SLTT governments and medical community/providers, to identify the highest-priority needs for non-federal stakeholder input into the PHEMCE process
  • Work with other PHEMCE stakeholders to improve and expand federal and non-federal communication on security-sensitive PHEMCE-related issues
  • Work with academies of clinical practice to develop and disseminate, as appropriate, the PHEMCE response planning portfolio for MCMs that are already in the stockpile 
  • Work with SLTT governments to improve the active engagement of end users, such as patient providers and public health officials, in MCM-oriented trainings and exercises
  • Engage non-federal stakeholders in a discussion of the prioritization of antimicrobial resistance measures and solution

Research and Translation on NPIs

Federal partners will

  • Expand work with the public health and medical sectors to test and evaluate the utility of federal guidance on NPI use to targeted audiences
  • Work with SLTT governments and professional societies to assess, develop, and improve strategies for implementing research findings related to NPs
  • Work with SLTT governments and professional societies to reduce the need for respirators and masks during incidents by developing and improving engineering and administrative strategies and other options
  • Collaborate with state and local health departments, community-based organizations, and academia to research and translate risks, costs, benefits, and expectations of use for NPIs
  • Work with academia to identify situations through research and evaluation where NPIs can be prioritized because of delay in MCM production or because MCMs are determined to be infeasible

National Capacity to Research, Develop, Manufacture, Obtain, Distribute, and Dispense MCMs

Federal partners will

  •  Develop a coordinated communications approach to share timely and accurate information on the challenges of MCM use
  • Draft guidance outlining the process for disseminating and prioritizing MCMs for first response personnel and their families
  • Work with SLTT governments and community-based organizations to develop user-friendly tools for communicating scientific guidance on use of MCMs and NPIs to policy-makers and the public
  • Collaborate with academia and the commercial industry to report on the multi-purpose use of the manufacturing infrastructure to allow scalable delivery of countermeasures
  • Explore funding opportunities that can help SLTT governments address gaps in MCM and NPI education, training, and guidance
  • Work with academia and the private sector to identify and assess novel strategies for sustaining the Strategic National Stockpile (SNS)
  • Draft guidance for non-federal stakeholders on how the private sector, SLTT governments, community-based organizations, academia and healthcare systems can contribute to distribution and dispensing strategies and operational requirements, increase the number of closed PODs, and participate in exercises and drills
  • Develop strategies for prioritizing basic research, applied research, advanced development, and procurement of MCMs that address public health and medical consequence of CBRN accidents, incidents, and attacks, as well as pandemic influence and emerging infectious diseases
  • Develop strategies to maintain advanced development pipline replete with MCMs and platforms to address unmet public health needs
  • Create or sustain overarching capabilities to rapidly mature promising candidate drugs, vaccines, therapeutics, and diagnostics using public-private ventures and other collaborative opportunities
  • Develop capability based to provide enabling core services to MCM innovators
  • Develop agile, robust, and sustainable U.S. manufacturing infrastructure capable of rapidly producing vaccines and other biologics against pandemic influenza and other emerging threats

Additional action partners can take

  • SLTT governments can promote field tests of supply chain readiness for distribution and dispensing in every state, taking into consideration the resources of private supply chain contractors and public employees. 

  • This page last reviewed: February 19, 2015