Global & Disaster Medicine

Stockpile Products in the Strategic National Stockpile



The majority of stockpile assets are held in storage and kept as managed inventory. Maintaining a supply of medications and medical supplies for specific health threats allows the stockpile to respond with the right product when a specific disease or agent is known.

Products in the stockpile may require an Emergency Use Authorization, which is granted by the U.S. Food and Drug Administration (FDA). The authorization allows for the emergency use of an unapproved medical product (e.g., drugs, vaccines, and devices) or unapproved use of an approved medical product to diagnose, treat, or prevent serious or life-threatening diseases or conditions for which no adequate, FDA-approved alternative is available.

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 stockpile is to send a broad-range of pharmaceuticals and medical supplies. Contents are pre-packed and configured in transport-ready containers for rapid delivery anywhere in the United States within 12 hours of the federal decision to deploy. Each package contains 50 tons of emergency medical resources.

The stockpile has medicines and supplies stored in strategically located warehouses throughout the country ready for deployment. Immediately shipping a variety of items to the affected state allows authorities to begin or sustain response efforts. All states have plans to receive and distribute these medical countermeasures quickly to local jurisdictions.

Image of responders unloading products after Hurricane Maria. In an emergency that causes supplies to run out, the stockpile can rapidly deploy its medical assets.


CHEMPACKs are containers of nerve agent antidotes placed in secure locations in local jurisdictions around the country to allow rapid response to a chemical incident. These medications treat the symptoms of nerve agent exposure and can be used even when the actual agent is unknown.

Because these antidotes must be administered quickly, the CHEMPACK team maintains 1,960 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 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.

Nerve Agent EUA Information

On April 11, 2017, the U.S. Food and Drug Administration (FDA) issued an Emergency Use Authorization (EUA) to permit the emergency use of the 2 mg atropine auto-injector, manufactured by Rafa Laboratories, Ltd. On May 23, 2017, FDA amended the EUA to also permit the emergency use of pediatric strengths (i.e., 0.5 mg and 1 mg) of this atropine auto-injector. On January 24, 2018, FDA granted another EUA amendment to permit auto-injector administration through clothing. These products are included in CHEMPACK containers located across the United States. This specific atropine auto-injector is authorized for the initial treatment of symptoms of known or suspected poisoning in individuals exposed to nerve agents or certain insecticides (organophosphorus and/or carbamate). The original letter of authorization describes the scope and conditions of EUA that apply to all three strengths (0.5 mg, 1 mg and 2 mg) of this atropine auto-injector; the amendment letters are addenda to the original letter of authorization. The amended fact sheets dated January 24, 2018 (version 3) for healthcare providers and patients and caregivers are the current versions and available through FDA’s EUA website.

Federal Medical Stations

Somewhere between a temporary shelter and temporary hospital, a Federal Medical Station is a non-emergency medical center set up during a natural disaster to care for displaced persons with special health needs—including those with chronic health conditions, limited mobility, or common mental health issues—that cannot be met in a shelter for the general population during an incident.

The modular and rapidly deployable reserve of beds, supplies, and medicines provides equipment to care for 50–250 people for 3 days before resupply is needed. Flexible and scalable, it can be tailored to meet the requirements of each incident and has the ability to increase local healthcare capabilities in mass casualty events or in response to potential public health threats.

Federal Medical Stations operate through the cooperation of federal, state, and local authorities and require pre-planning and pre-identification of potential locations, based on specific selection criteria. Prior to an emergency event, state, local, tribal, and territorial agencies collaborate with the U.S. Department of Health and Human Services Regional Emergency Coordinators to survey sites and identify any gaps that may need addressing during a response.

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