Healthcare Response to Weapons of Mass Destruction: Biological, Chemical and Radiological

Strategic National Stockpile





An act of terrorism targeting the U.S. civilian population, or a large scale natural disaster will require rapid access to large quantities of pharmaceuticals and medical supplies. Such quantities may not be readily available unless special stockpiles are created. Anticipating a terrorist strike is difficult and few state or local governments have the resources to create sufficient stockpiles on their own.

In 1999 Congress charged the Department of Health and Human Services (HHS) and the Centers for Disease Control and Prevention (CDC) with the establishment of the National Pharmaceutical Stockpile (NPS). The mission was to provide a re-supply of large quantities of essential medical materiel to states and communities during an emergency within twelve hours of the federal decision to deploy.

The Strategic National Stockpile (SNS) is a national repository of large quantities or medical countermeasures, vaccines, and other medical supplies stored in strategic locations around the nation. These assets are designed to supplement state and local public health departments in the event of a large-scale public health emergency that causes local supplies to run out (CDC, 2017b).


Storage of medications at CDC. Photo courtesy of CDC.

Managing the procurement, storage, and transportation of supplies in the SNS involves monitoring the shelf-life of pharmaceuticals to ensure that they are kept within U.S. Food and Drug Administration potency limits; conducting quality assurance practices; and ensuring that all SNS materials are based on the latest scientific data, threat levels, and overall ability to deploy a public health emergency. SNS supplies include (CDC, 2017b):

  • 12-Hour Push Packages and Managed Inventory - Once federal and state authorities agree that SNS assets are needed, the 12-Hour Push Packages can be delivered to any state in the continental United States within 12 hours of the decision to deploy. Each package contains 50 tons of a broad spectrum of medical assets. If the incident requires additional or different supplies, they can be delivered within 24 to 36 hours from SNS’s managed inventory. All states have plans to receive SNS supplies and distribute them as quickly as possible to local jurisdictions, who then dispense them to their communities.
  • CHEMPACKs are containers of nerve-agent antidotes placed in secure locations at state and local levels to facilitate rapid response to an incident. More than 92% of the U.S. population is within a one-hour buffer of these supplies. Containers are located in more than1,300 sites in all states and the District of Columbia.
  • Federal Medical Stations - These modular and rapidly deployable stations provide a platform for the care of displaced persons who have non-acute health-related needs that cannot be met in a shelter for the general population during an incident. The stations are stocked with beds and supplies to care for up to 250 patients for up to three days.


Photo Courtesy of CDC.

The decision to deploy SNS assets may be based on evidence showing the overt release of an agent that might adversely affect public health. It is more likely, however, that subtle indicators, such as unusual morbidity and/or mortality identified through the nation's disease outbreak surveillance and epidemiology network, will alert health officials to the possibility (and confirmation) of a biological or chemical incident or a national emergency. To receive SNS assets, the affected state's governor's office will directly request the deployment of the SNS assets from CDC or HHS. HHS, CDC, and other federal officials will evaluate the situation and determine a prompt course of action (2017b).

Once Federal and local authorities agree that the SNS is needed, medicines will be delivered to any state in the U.S. in time for them to be effective. Each state has plans to receive and distribute SNS medicine and medical supplies to local communities as quickly as possible (2017ba).

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