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U.S. Department of Health and Human Services

Strategic Planning

BARDA's Anthrax Medical Countermeasures Portfolio Overview

The potential for an anthrax attack is still a very real and serious threat. The Department of Homeland Security has declared that Bacillus anthracis, the causative agent of anthrax disease, and multi-drug resistant Bacillus anthracis threaten national security. 

As biological threats continue to evolve, so must our biodefense capabilities.  In the event of a large-scale anthrax attack, federal, state and local partners will need to work in concert with healthcare professionals to mount a rapid response to protect health and save lives in impacted communities.   As directed in the National Biodefense Strategy, the U.S. government is working to enhance preparedness to save lives with medical countermeasures.

The Public Health Emergency Medical Countermeasures Enterprise (PHEMCE), which coordinates Federal efforts to enhance chemical, biological, radiological and nuclear threats and emerging infectious diseases preparedness from a medical countermeasure perspective, has developed a multi-pronged strategy to prepare for an anthrax attack:

  • Anthrax Vaccines: Anthrax vaccines can provide both pre-exposure and post-exposure protection and they are a major component of the PHEMCE’s strategy to protect the American people from anthrax. Significant investments have been made in all classes of medical countermeasures, but the largest investment remains in the development and procurement of improved anthrax vaccines. A licensed vaccine has been procured and three next-generation vaccines are being developed with support from BARDA. 
  • Anthrax Antibiotics:   In the event of an anthrax attack, antibiotics are the first line of defense for infected individuals.  Antibiotics remove the bacterial infection from the body faster than a person’s immune system.  However, antibiotics alone are not sufficient to protect health and save lives. According to an analysis of the 2001 anthrax attacks, approximately a 50 percent mortality rate among infected individuals is expected when antibiotics alone are used.  BARDA supports four antibiotics to potentially treat anthrax infection.
  • Anthrax Antitoxins: Anthrax antibiotics can be used to provide post-exposure protection and treatment.  While antibiotics can be effective in treating bacteria like anthrax, anthrax antitoxins can be used to neutralize the toxins released by the anthrax bacteria.  BARDA supported the development of three anthrax antitoxin products to treat individuals who may not respond to antibiotic therapy.  All three products have been approved by FDA and have been purchased by ASPR.
  • Anthrax Diagnostics:  To save lives in an emergency, health care providers will need to be able to rapidly diagnose patients to inform triaging decisions and patient care.  BARDA is supporting the continued development of four anthrax diagnostic tests. Some of these tests could provide results in just minutes. 

The PHEMCE also considers the potential benefits of having more than one source of a particular product to enhance long-term preparedness and to generate healthy price competition among providers.  The PHEMCE has to balance these potential advantages against the increased costs of supporting multiple manufacturers for products that have limited to no commercial markets and the complications that having multiple products pose when developing plans for deployment and use.

The PHEMCE must now focus on sustaining its existing response capability, improving the usefulness of specific countermeasures, and, where possible, reducing the long-term carrying costs of the Strategic National Stockpile



  • This page last reviewed: March 29, 2019