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June 15, 2020
National Stockpiles: Background and Issues for Congress
The United States maintains several distinct stockpiles of
supplies, equipment, and raw materials that may be us ed for
a national emergency, military operation, or other natural
dis as ter or manmade event where commercial supply and
distribution are unavailable. Some of these stockpiles were
established by Congress in law, while others began as
policy-driven initiatives of federal departments and
agencies. In general, there are two types of stockpiles that
the U.S. government owns and manages: (1) those intended
to support a subset ofthegeneralpublic in an emergency
(i.e., public stockpiles) and (2) those intended to support the
national defense during a war or other type ofnmilitary
operation (i.e., defense stockpiles).
Typically, a single federal department (including military
departments) is responsible for managing each stockpile.
Within departments, stockpiles are often supportedby one
or more logistics organizations thatprovide procurement,
storage, transportation, disposal, and/or other technical
services to stockpile managers. The degree to which
stockpile managers store certain goods, instead of relying
on pre-negotiated or rapidly executed contracts to deliver
goods in an emergency, varies. Stockpile managers often
consider several factors when making a decision to
stockpile, including: statutory requirements, forecasted
commercial availability of a product/material, anticipated
los s of suppliers in a certain geographic area during an
emergency, forecasted demand during peacetime and
emergencies, the rareness or criticality of a material, and a
department's overall stockpiling strategy.
Federally owned public stockpiles are meant to be deployed
when a domes tic emergency overwhelms local or state
supplies. Additionally, they may contain specialized as sets,
such as smallpoxvaccines unlikely to be stockpiled locally.
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In 1999, the DepartmentofHealth and Human Services
(HHS) established a stockpile of vaccines and antidotes to
respond to biological or chemical agent attacks on the
United States. In 2002, Congress named this initiative the
Strategic National Stockpile and expandedits mis sionto
provide for the emergencyhealth security of the United
States ... in the event of a bioterrorist attackor other public
health emergency (seeTitle 42, U.S. Code [U.S.C.]
§ 247d-6b). According to HHS, the SNS contains
potentially life-saving pharmaceuticals and medical
supplies foruse in a public healthemergencyin which local
supplies have been oray be depleted.
The HHS As sis tant Secretary for Preparedness and
Response (HHS/ASPR) manages the SNS, including
procurement, storage, deployment, andreplenishment of
supplies (otherwise SNS assets). State and local authorities
request assets and are generally responsible for receiving,
staging, distributing, and dispensing assets. However, in the
current COVID-19 response, the Federal Emergency
Management Agency (FEMA) is coordinating allocation
and delivery of SNS assets. Examples of assets stockpiled
include: antibiotics, anti-bioterrorisimvaccines (e.g.,
smallpox and anthraxvaccines), personal protective
equipment (PPE), and ventilators. SNS storage sites are
geographically distributed across the United States to
enable the deliveryof initial as sets within 12hours of a
request (typically made by a state governor). HHS provides
SNS assets at no cost to receiving authorities.
Prior to the 2020 COVID-19 pandemic, the SNS contained
about $8 billion of medical as sets. Figure 1 shows SNS
funding and asset deployment history.
Figure I. SNS Funding and Deployments
In millions of FY2019 dollars
$900
$600
$600
$500
$300
$200,
s100
99 00 01 020 3 04 05COC0 07 U8 09 101 2 13 14 15 16 17 18 19 20 21
YEAR
Requested -Enacted
0 9/11 & Anthrax Attacks L. N. Dakota Flooding Q Ebo[a .COVID-19
Hurricanes Katrina & Rite , Hurricane Alex . Zika Pandemic
Hurricanes Gustav& Ike f.- Hurricane Irene Hurrices Ha
'cares Crustnev&Harve,
1 HzNJ. Pandemic Influenza C Hurricanes Isaac & Sandy Irma & Maria
-k N. Dakota Flooding : Botulsm & Ebala , Hurricane Dorian
Source: Departmentof Health and Human Services; CRS Graphics.
According to 42 U.S.C. §247d 6b, HHS is required to
provide Congress an annual threat-based assessment of the
sufficiency of stockpile contents.
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The Department of Veterans Affairs (VA) VHA maintains
its own stockpile (otherwise caches) of drugs and medical
supplies at VA medical facilities. Its contents are meant for
local VA facility Veterans and s taff during the initial 48
hours of a major catastrophic emergency. These caches
serve to bridge any gap between what might be available
on-hand at local VA medical facilities, and what other
resources such as the SNS could provide.
As established by VA policy, each cache (formally AHEC)
is considered both a federal and community asset. The VA
Under Secretary for Health decides which medical facilities
will have a cache-which consists of a standard supply of
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