With the cold and flu season rapidly approaching and the H1N1 influenza virus continuing to spread, it seems an appropriate time to review resources. Whether it is Tamiflu or nerve-agent antidotes, the Strategic National Stockpile (SNS) is ready to assist states and first responders.
The mission of the SNS, which is managed by the Centers for Disease Control and Prevention (CDC), is to supplement the medical resources possessed by state and local public health agencies by providing additional resources in times of crisis. Those “additional resources” include but are not limited to antibiotics, chemical antidotes, antitoxins, and life-support medications as well as airway maintenance supplies and a broad spectrum of other medical and surgical items. These and other supplies are quickly made available when there is a public-health emergency anywhere in the United States; the supplies are “free” in the sense that they are paid for by U.S. taxpayers, but there is no additional cost incurred by the state and local jurisdictions receiving the supplies. In addition, the SNS is committed to delivering the supplies within 12 hours of the decision to provide them.
SNS deployment is activated when state and federal authorities agree there is a need. In times of crisis – a terrorist attack or a weather disaster, for example – the state governor’s office would make a deployment request to the CDC and HHS. After both of those federal agencies review the request and confirm the need, “Push Packages” – the term used for pre-packaged collections of pharmaceuticals, antidotes, and general medical supplies – are sent. As the Push Packages are shipped out (usually via cargo aircraft or trucks) Technical Advisory Response Units (TARUs) also are being deployed to the disaster scene to work with state and local officials in dealing with the crisis. After the supplies arrive on-scene, they become the responsibility of the local authorities involved. The TARU staff personnel usually remain on the scene to help, but actual distribution of the supplies is handled by the state agencies and authorities.
The shipment of SNS assets also may be authorized when there is evidence of the release of a biological or chemical agent that could be harmful to the public. The Push Packages consist primarily of a variety of “general needs” materials, but the SNS program also has a number of more specialized VMI (vendor-managed inventory) supplies available. The VMI packages are tailored more to meet particular needs or provide special materials that have been specifically requested, and their delivery usually follows the Push Packages by 12-24 hours or so. However, if the cause of the emergency isentified and defined early enough, the VMI materials also can be immediately shipped as part of the SNS’s first-response actions.
Many states and local jurisdictions already have been planning, of course, for the possibility of an influenza pandemic; for that reason, and because of the current concern about the H1N1 virus, the SNS has already stocked up on Tamiflu and Relenza in order to meet state requests as soon as possible. (In any case, there really is little if any need to worry about the timing, because all SNS stocks are inspected, inventoried, and limited to their previously determined shelf life.)
The Agencies Have Changed; the Mission Has Not
The SNS originated as the National Pharmaceutical Stockpile (NPS) in 1999, when Congress ordered the U.S. Department of Health and Human Services (HHS) and the CDC to establish a cache of medical materials to re-supply states and local communities throughout the nation in future times of emergency. With the passage of the Homeland Security Act in 2002, the Department of Homeland Security (DHS) became responsible for the stockpile, the deployment of the NPS materials, and the goals of the program. In March 2003 the NPS officially became the Strategic National Stockpile; later, after passage of the BioShield Act of 2004 (designed to protect the nation from a bioterrorism attack), the program returned to HHS management.
Since 2001 the CDC has been working with state, local, and tribal agencies on distribution plans for SNS materials. Today, all 50 states have developed a wide variety of plans – which are reviewed annually by the CDC – to meet individual state needs. Considerable progress has been made in refining and improving those plans from year to year – but it should be noted that only 36 state plans were considered satisfactory in the 2006-07 CDC review. (The annual reviews cover, among other things: (a) state legal statutes related to the distribution process; (b) the coordination of public health departments with community partners; and (c) both the type and frequency of training as well as the evaluation of state response plans.)
The SNS program is also active even when there is no current crisis to attend to. The SNS program offers training to federal officials, governors’ offices, and a broad spectrum of state and local officials. The CDC and SNS also are working together to improve SNS asset-distribution plans and to inform the American people about the resources available. To achieve those goals the two agencies are working not only with HHS, emergency-response coordinators at all PHS (Public Health Service) regional offices, and numerous local health departments and emergency-management agencies but also with the Department of Defense, the Department of Veterans Affairs, and cities and states affiliated with the Metropolitan Medical Response System.
Additional information about the SNS is available online via the CDC’s Public Health Training Network, where webcasts focus on such specific issues as point-of-dispensing design and operations, the management of volunteer staff, engaging at-risk populations, and the Cities Readiness Initiative. Whether it is Tamiflu or training, the SNS is always ready to help, not only during an actual crisis but also during the planning process needed to deal more effectively with a future crisis.
Kate Rosenblatt is a writer based in the Washington, D.C., metropolitan area. She has a background in education reform, communications, and business development, and has written for a number of publications on a broad range of subjects ranging from finance to fashion to public safety and related topics.