Large catastrophic events, or rare acute events, may cause situations in which a local jurisdictions medicines and medical supplies are not sufficient to provide care to the population it serves. In these cases of natural or engineered disasters, such as a terrorist attack, influenza pandemic, or earthquake, state or local authorities can request that the federal government provide assets from the Strategic National Stockpile to augment the state and local jurisdictions resources.The Centers for Disease Control and Preventions (CDCs) Strategic National Stockpile (SNS) is the nations repository of antibiotics, chemical antidotes, antitoxins, vaccines, antiviral drugs, and other medical materiel designed to supplement and resupply state and local public health agencies in the event of an emergency. The materiel is intended to support national health security and is managed by the Office of Public Health Preparedness and Responses (OPHPRs) Division of Strategic National Stockpile (DSNS). The stated mission of the SNS is to prepare and support partners and provide the right resources at the right time to secure the nations health.The National Academies of Sciences, Engineering, and Medicine organized a two-day public workshop to explore opportunities to improve the efficiency, effectiveness, and sustainable methods used by the CDCs SNS to distribute medical countermeasures and other supplies during disasters and other public health emergencies, especially those which result in disruption of physical infrastructure such as the electrical grid, central roadways, bridges, and tunnels within the impacted community. Participants explored relevant distribution lessons learned from other federal agency stockpiles and the private sector as well as opportunities to develop public-private collaborations in the purchase, warehousing, management, and distribution of medical countermeasures. This report summarizes the presentations and discussions from the workshop.

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Table of contents
- COVER PAGE
- TITLE PAGE
- COPYRIGHT PAGE
- TABLE OF CONTENTS
- ACRONYMS AND ABBREVIATIONS
- 1 INTRODUCTION, BACKGROUND, AND CONTEXT
- 2 THE STRATEGIC NATIONAL STOCKPILE: ORIGIN, POLICY FOUNDATIONS, AND FEDERAL CONTEXT
- 3 STUDIES AND REPORTS RELATED TO THE STRATEGIC NATIONAL STOCKPILE
- 4 POTENTIAL OPPORTUNITIES FOR RESTRUCTURING STRATEGIC NATIONAL STOCKPILE SCOPE, GOVERNANCE, AND DECISION MAKING
- 5 REACHING THE LAST MILE: POTENTIAL OPPORTUNITIES TO IMPROVE COORDINATION AND COMMUNICATION AMONG LOCAL, STATE, AND FEDERAL AGENCIES
- 6 POTENTIAL SUPPLY-CHAIN OPPORTUNITIES AND LESSONS FROM THE COMMERCIAL SECTOR AND GOVERNMENT PARTNERS
- 7 WRAP-UP
- REFERENCES
- APPENDIXES
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