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Strategic National Stockpile (SNS)


Who authorized the SNS program?


  • In 1998, Congress appropriated funds for the CDC to acquire a pharmaceutical and vaccine stockpile to counter potential biological and chemical threats and threats from widespread diseases that could affect large numbers of persons in the civilian population.
  • The program was originally called the National Pharmaceutical Stockpile (NPS) program, but it has since been extended to involve much more than just drugs.
  • On March 1, 2003, the NPS became the Strategic National Stockpile (SNS) program managed jointly by DHS and HHS.
  • With the signing of the BioShield legislation, the SNS program was returned to HHS for oversight and guidance.
  • Effective Oct. 1, 2018, the Strategic National Stockpile is managed by the Office of the Assistant Secretary for Preparedness and Response (ASPR) in the U.S. Department of Health and Human Services.
  • The SNS is designed to supplement and resupply state and local public health agencies in the event of a national emergency anywhere and at anytime within the United States or its territories.

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What is in the SNS?


  • The SNS is a national repository of antibiotics, chemical antidotes, antitoxins, life-support medications, IV administration, airway maintenance supplies, and medical/surgical items.

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Who manages the SNS program?


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When would the stockpile be used?


  • The plan is to deliver critical medical resources to the site of a national emergency when local public health resources would likely be or have already been overwhelmed by the magnitude of the medical emergency.
  • Examples might be emergencies resulting from a major earthquake, pandemic flu, a smallpox event, and terrorist events of chemical, biological, radiological/nuclear, or explosive incidents.
  • Pre-event requests for SNS resources might include
    • Actionable intelligence indicating an impending chemical, biological, radiological/nuclear, or large explosive attack or overwhelming public health disaster
    • Analysis of data derived from syndromic or epidemiologic surveillance
    • A sentinel event, such as a single case of smallpox

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Who can request assets of the SNS?


  • State departments of health, usually in conjunction with the state governor
  • National agencies e.g., FEMA, FBI in certain circumstances
  • To receive SNS assets, the affected state's governor's office would directly request the deployment of the SNS assets from HHS.

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Whose decision is it to release assets from the SNS?


  • HHS, and other federal agencies will evaluate the request, the situation, and determine a prompt course of action, releasing those assets that are most appropriate.

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What kinds of things are in the stockpile?


  • 12-Hour Push Packs (less than 5% of the SNS inventory)
    • Broad-spectrum oral and intravenous antibiotics
    • Other medicines for emergency conditions
    • IV fluids and fluid administration kits
    • Airway equipment, such as ET tubes, stylettes, oropharyngeal airways, Ambu-Bags, and CO2 detectors
    • Bandages
  • Managed inventories maintained by specific vendors or manufacturers, or the SNS
    • Vaccines
    • Antitoxins (e.g., Botulinum)
    • Ventilators
    • Additional quantities of 12-Hour Push Pack items

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Where are the SNS assets stored?


  • This is not public information
  • The SNS maintains ownership of the inventory and is responsible for storing, monitoring, and maintaining the inventory, which is located in secure, environmentally controlled areas throughout the United States.

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How fast can the SNS assets be deployed?


  • The SNS program is committed to having 12-Hour Push Packs delivered anywhere in the United States or its territories within 12 hours of a federal decision to deploy.
  • The 12-Hour Push Packs have been configured to be immediately loaded onto either trucks or commercial cargo aircraft for the most rapid transportation.
  • At the same time assets from the SNS are deployed, the SNS program will deploy its Technical Advisory Response Unit (TARU) to coordinate with state and local officials so the SNS assets can be efficiently received and distributed on arrival at the site.

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Are there specific agents available in the SNS for chemical emergencies?


  • Yes, the SNS is in the process of forward deploying "CHEMPACK" to the states. The CHEMPACK contain nerve agent antidotes that can be used in the event of a nerve agent attack that overwhelms locally available resources.
  • The SNS also contains nerve agent antidotes at this time.

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References

  1. Need JT, Mothershead JL, Strategic National Stockpile Program: Implications for Military Medicine. Military Medicine 2006, 171:698-702
  2. Strategic National Stockpile (HHS/ASPR)