Strategic National Stockpile

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• Strategic National Stockpile

Todd Piester Branch Chief Division of Strategic
National Stockpile Coordinating Office for
Terrorism Preparedness and Emergency
Response Centers for Disease Control and
Prevention July 1, 2008
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Strategic National Stockpile Mission Deliver
critical medical assets to the site of a national
emergency

• Work within the HHS PHEMCE requirements process
  to assure we have the most appropriate
  countermeasures.
• Create pathways to move the materiel to the area
  of need in the timeframe that is clinically
  relevant.
• As medical response is local, assure integration
  with local planning.
• Provide technical assistance to assure that
  state/local partners who receive SNS assets are
  ready to effectively use them.
• Maintain materiel in a manner that assures
  viability.

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Background

• Program created in 1999.
• SNS valued at 3.5 billion and contains
  antibiotics, medical supplies, antidotes,
  antitoxins, antiviral drugs, vaccines and other
  pharmaceuticals.
• Annual budget of nearly 600 million.
• Designed to supplement and re-supply state and
  local medical materiel responses.
• Transferred to DHS by Homeland Security Act of
  2002. Returned to HHS by Project BioShield Act
  of 2004.

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Putting it Together
ACQUISITION
SCIENCE
DEPLOYMENT
PRODUCT INTO PEOPLE
STORAGE
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Federal Partnerships

• Receive acquisition support from Veterans
  Affairs.
• Collaborate with Defense, Justice, Homeland
  Security and FDA.
• Work with USDA and the National Veterinary
  Stockpile.

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Commercial Partnerships

• Contract with vendors to store and maintain SNS
  materiel.
• Utilize commercial transport carriers for rapid
  deployment of medical countermeasures.
• Seek assistance from outside sources to assist
  with efficiency.

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Other Partnerships

• National Association of County and City Health
  Officials (NACCHO)
• Association of State and Territorial Health
  Officials (ASTHO)
• Business Executives for National Security (BENS)

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Formulary Framework

• Based on Category A Threat Agents
• Biological - smallpox, anthrax, botulism, viral
  hemorrhagic fevers, plague tularemia
• Chemical - nerve agents
• Radiological
• Non BT
• Pandemic influenza

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REASON - Acquisition Considerations

• R rotation - can drugs be rotated?
• E effectiveness of drugs for a particular
  disease
• A availability of items
• S storage considerations
• O other - such as IND, cost, more than one use
• N need for ancillary supplies

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Project BioShield Act

• Enacted by President Bush.
• Purpose is to accelerate the research,
  development and acquisition of medical
  countermeasures for the SNS.
• Legislation authorized 5.6 billion over 10
  years.
• Established the emergency use authorization
  to provide access to medical countermeasures
  after a public health emergency declaration.
• Department of Homeland Security makes threat
  determinations.

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BioShield Procurements

• Products in the SNS to date
• Anthrax Immune Globulin
• Calcium and Zinc Diethylene Triamine Pentaacetic
  Acid (DTPA)
• Liquid Potassium Iodide
• Heptavalent Botulinum Antitoxin
• Anthrax Vaccine Adsorbed

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Biomedical Advanced Research and Development
Authority (BARDA)

• Established by the Pandemic and All-Hazards
  Preparedness Act (PAHPA).
• Responsible for the procurement of
  countermeasures against chemical, biological,
  radiological and nuclear threats.
• Charged with acquiring medical countermeasures
  not commercially available or in the
  research/development pipeline.
• Authorized 1.07 billion between 2006 and 2008.

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Emergency Response Concepts

• Provide rapid delivery of a broad spectrum of
  support for an ill-defined threat in the early
  hours of an event.
• Provide large shipments of specific materiel
  when a threat is known.
• Provide technical assistance to receive and
  distribute SNS materiel during an event.

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Emergency Response Options

• Broad Spectrum Support
• - 12-hour Push Packages
• Specific Materiel Support
• - Types of inventory
• - Vaccines
• - Buying Power/Surge Capacity

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12-hour Push Packages

• Prepackaged and configured materiel in
  transport-ready containers.
• Pre-positioned in secure facilities near major
  transportation hubs.
• Delivered rapidly by world-class transportation
  partners.
• Color-coded and numbered containers for easy
  identification by state and local authorities.

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12-hour Push Packages
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Specific Item Support

• Managed Inventory
• Vaccines
• Chemical Packs (CHEMPACK)
• Federal Medical Stations
• Buying Power/Surge Capacity

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Two Types of Inventory

• Vendor-Managed Inventory (VMI)
• Strategic National Stockpile-Managed Inventory
  (SMI)

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Stockpile-Managed Inventory
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Vaccine Management

• Key Inventory
• Anthrax Vaccine
• Smallpox Vaccine/with Ancillary Supplies
• Immune Globulin Plasma
• Botulinum Antitoxin

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Forward Placed CachesCHEMPACK

• Nationwide joint venture program
• Forward placement of nerve agent antidotes
• Integrated into local hazardous materiel response
• Containerized storage
• Uniform formulary
• Two configurations

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Federal Medical Stations

• Department of Health and Human Services
  assets.
• Managed and deployed by DSNS.
• Provides non-acute and special needs care to
  250 patients over three days.
• Increasable in 50-bed increments.
• Contains supplies for housekeeping, first aid
  equipment and pharmaceuticals.

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Buying Power/Surge Capacity

• Utilize buying power of Veterans Affairs to
  ensure best prices.
• Utilize prime-vendor contracts and emergency
  spending protocols to replenish depleted SNS
  supplies during an event.

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Technical Advisory Response Unit(TARU)
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TARU Primary Missions

• Receive SNS materiel at designated location.
• Facilitate transfer of SNS materiel to
  state/local authorities.

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TARU Secondary Missions

• Assist with breakdown of materiel.
• Assist with dispensing and distribution issues.
• Advise state/local authorities on needs and
  requests.
• Advise on storage and transportation issues.
• Manage SNS materiel not released to state/local
  authorities.

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Technical Assistance for Countermeasure Dispensing

• Version 10.02 Receiving, Distributing and
  Dispensing SNS Assets
• Technical assistance to 62 project areas
• State and local exercise support and evaluations
• Classroom instruction
• Satellite broadcasts

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Putting it Together
ACQUISITION
SCIENCE
DEPLOYMENT
PRODUCT INTO PEOPLE
STORAGE
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• Questions?

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