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Strategic National Stockpile (SNS)

Who authorized the SNS program?

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What is the SNS?

  • The SNS is the nation’s largest supply of life-saving pharmaceuticals and medical supplies for use in a public health emergency severe enough to cause state and local supplies to run out. When state, local, tribal, and territorial responders request federal assistance to support their public health response efforts, the SNS ensures that the right medicines and supplies get to those who need them most during an emergency.
  • The SNS is designed to supplement and resupply state and local public health agencies in the event of a national emergency anywhere and at any time within the United States or its territories.
  • Strategically stored in a network of warehouses across the country, stockpiled products are ready for rapid deployment to protect the U.S. population against 21st century health security threats, such as anthrax, botulism, smallpox, plague, tularemia and viral hemorrhagic fevers, as well as emerging infectious diseases, pandemic influenza, natural disasters, and other chemical, biological, radiological, and nuclear incidents.
  • The SNS contains enough supplies to respond to multiple large-scale emergencies, simultaneously.

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What is in the SNS?

  • HHS does not publicly release specific information about the contents in the SNS.
  • The SNS maintains medicines and medical supplies to address a wide range of threats, including category A agents. Products include antibiotics, antiviral drugs, antidotes, antitoxins, vaccines, personal protective equipment and various other medical supplies.
  • When a state or territory requests assistance to support their response efforts, the SNS stands ready to make available:
    • Inventory: Medicines, vaccines, and medical supplies to respond to any public health emergency in the U.S. in 12 hours or less
    • CHEMPACK: Pre-positioned containers strategically placed and maintained in approximately 1,340 U.S. locations to provide nerve-agent antidotes to over 90% of the U.S. population
    • Federal Medical Stations: Caches of beds, supplies, and medicines to provide care for 50-250 people with health-related needs
    • Personnel: Teams of stockpile experts who provide onsite logistics and operations support in an emergency

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Who manages the SNS program?

  • Effective October 1, 2018, the SNS is managed by the HHS Assistant Secretary for Preparedness and Response (ASPR).
  • Federal agencies, primarily ASPR, are responsible for maintenance and delivery of SNS assets, but all states and territories have established plans to receive SNS product and distribute it as quickly as possible to local jurisdictions, which then dispense to the local community.

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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, influenza pandemic, 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
  • Since its founding in 1999, the stockpile has been used to respond to multiple large-scale emergencies including floods, hurricanes, and influenza pandemics. It has also supported various small-scale deployments for the treatment of individuals with life-threatening infectious diseases like anthrax and botulism as well as adverse reactions to the smallpox vaccine. Learn more about stockpile responses.

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Who can request assets of the SNS?

  • Requests for SNS assets and assistance are generally made by the affected state’s governor or designee. A federal disaster declaration does not need to be in place in order to request SNS assets. To request assistance, health officials should contact the HHS Secretary’s Operations Center (SOC) at 202-619-7800 or the CDC Emergency Operations Center (EOC) at 770-488-7100. Both of these operations centers have staff on duty 24/7 to monitor incoming requests and emerging situations, and the two centers coordinate with each other on emergency responses.
  • In most incidents, local resources and local mutual aid and assistance agreements will provide the first line of emergency response and incident management. If the local jurisdiction is unable to sustain the response, it may request assistance from the state, interstate agreements, or the federal government. The request for assistance should accurately communicate any identified capability shortfalls, such as the depleted supplies of medical countermeasures, and the jurisdiction’s requirements. It is important to note that during the request process states should request a capability, not a specific resource. The federal government will then determine available resources for delivery to the affected area in the shortest timeframe.
  • Tribes are incorporated in state and local plans but may also request direct support and assistance from the SNS.
  • National agencies (e.g., FEMA, FBI) may request SNS assets in certain circumstances.

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Whose decision is it to release assets from the SNS?

  • HHS, in collaboration with other federal agencies, will review and evaluate the request for SNS assets, consider the situation, and determine a prompt course of action to release those assets that are most appropriate.

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Where are the SNS assets stored?

  • This is not public information.
  • In order to rapidly respond to state or local needs, SNS assets are stored in strategically located, secure, and environmentally controlled warehouses across the United States ready for deployment. The placement of SNS warehouses allows for optimum distribution of critical medicines and medical supplies to be rapidly moved to an area of need and integrated into a local public health response.
  • The SNS maintains ownership of the inventory and is responsible for storing, monitoring, and maintaining the inventory.

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How fast can the SNS assets be deployed?

  • In an emergency, the SNS can rapidly deliver medicines and supplies anywhere in the United States or its territories in less than 12 hours of a federal decision to deploy.
  • If a community experiences a large-scale public health incident in which the disease or agent is unknown, the first line of support from the SNS is to send a broad-range of pharmaceuticals and medical supplies (12-hour Push Package). Contents are pre-packed and configured in transport-ready containers to be immediately loaded onto either trucks or commercial cargo aircraft for the most rapid transportation.
  • At the same time SNS assets are deployed, the SNS program may also deploy teams of stockpile experts to coordinate with state and local officials and provide onsite technical assistance, logistics, and operations support in an emergency.
  • All states have plans to receive and distribute these SNS medical countermeasures quickly to local jurisdictions.

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

  • Yes, the SNS remains ready to respond to chemical or nerve agent incidents through its nationwide CHEMPACK program, which provides, monitors, and maintains pre-positioned CHEMPACK containers of chemical nerve agent antidotes and anticonvulsants in secure locations around the country.
  • Because nerve agent antidotes must be administered very soon after an exposure, the SNS maintains 1,960 CHEMPACK containers strategically placed in more than 1,340 locations in the United States. More than 90 percent of the U.S. population is within 1 hour of a CHEMPACK location.
  • Most CHEMPACK containers are located in hospitals or fire stations selected by local authorities to support a rapid hazmat response and can be accessed quickly if hospitals or first responders need them.

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  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)