1. Centers for Disease Control and Prevention TM Presenter name Presenter Title, SNS

2. Centers for Disease Control and Prevention TM SNS Program President Department of Health and Human Services (DHHS) Centers for Disease Control and Prevention (CDC) Coordinating Office of Terrorism Preparedness and Emergency Response (COTPER) Strategic National Stockpile (SNS) Program

3. Centers for Disease Control and Prevention TM Mission Deliver critical medical assets to the site of a national emergency

4. Centers for Disease Control and Prevention TM Vision The nation’s premiere medical materiel preparedness and response organization: we deliver the right assets where they are needed, when they are needed. Professionalism Reliability Service Stewardship Values

5. Centers for Disease Control and Prevention TM Evolution of Response and Preparedness $50 million FY99FY00FY01 FOCUS  Push Packages  Bulk  SLEP  Start up Costs $645 million $400 million FY03FY04 9/11Anthrax FY02 FOCUS  Push Packages  VMI/SMI  Vaccines  Unit of Use  SLEP  Rotation  BT Grants  Alert Levels  Public Health Emergencies  OCONUS  CRI FY05 FOCUS  Distribution Network  BioShield  Strategic Planning

6. Centers for Disease Control and Prevention TM Management Approach SNS Program serves as managing partner** – Purchase support  VA  Pharmaceutical manufacturers  Equipment manufacturers – Material storage and maintenance  Commercial distributors  DoD – Rapid movement of people, materiel, equipment  Commercial carriers Materiel coordination with DoD and VA

7. Centers for Disease Control and Prevention TM Organizational Structure

8. Centers for Disease Control and Prevention TM Program Structure Program Planning and Evaluation Science Logistics Operations Program Preparedness Administrative Services Security

9. Centers for Disease Control and Prevention TM Program Planning and Evaluation

10. Centers for Disease Control and Prevention TM Program Planning and Evaluation Strategic Planning Business Planning Current Good Manufacturing Practices (cGMP)

11. Centers for Disease Control and Prevention TM Science

12. Centers for Disease Control and Prevention TM Science Drives the SNS Program Formulary Contents Pharmaceuticals Medical Supplies Medical Equipment Vaccines Botulinum Antitoxin

13. Centers for Disease Control and Prevention TM Science Drives the SNS Program Formulary Development Based on Category A Threat Agents ­ Smallpox, anthrax, botulism, viral hemorrhagic fevers, plague & tularemia ­ Chemical nerve agents Recommended by Subject Matter Experts ­ Government and non-government representation ­ Experts in:  Biological, chemical, and radiological threats  Other medical specialties PUBLIC HEALTH EMERGENCY

14. Centers for Disease Control and Prevention TM Logistics

15. Centers for Disease Control and Prevention TM Logistics Challenge 199 lines –$1 billion inventory –600 tons Products – Pharmaceuticals – Medical Supplies – Medical Equipment – Vaccines, Antitoxins, Antidotes Distribution network: multiple sites ~ 500,000 sq. ft. warehouse space

16. Centers for Disease Control and Prevention TM Operations

17. Centers for Disease Control and Prevention TM Operational Response Planning Technical Advisory Response Unit (TARU) Training SNS Program Exercises State Exercise Participation Operations Center Training Operations Center Management SNS Basic Course Operational Responsibilities

18. Centers for Disease Control and Prevention TM 9/11 NYC – Advisors on the ground - 5 hrs – First materiel - 7 hours – 100,000 N95 masks purchased/delivered for ground zero workers - 24 hrs Fall 2001 anthrax attacks – First materiel in Florida - 8 hrs – Multiple shipments to 10 states Operational Response Track Record

19. Centers for Disease Control and Prevention TM Operational Response Track Record Smallpox Phase 1 (Jan-Feb 03) DHS Orange Alert (Dec 03-Jan 04) Olympics (Aug 04) National Security Special Events (04-05) International Support – Guam – Jan 04 – Haiti – Sep 04

20. Centers for Disease Control and Prevention TM Program Preparedness

21. Centers for Disease Control and Prevention TM State/Local Support and Evaluation Assistance to state and local authorities in 62 projects –50 states –4 cities (Chicago, DC, LA, NYC) –Puerto Rico & Virgin Islands –Pacific Basin Jurisdictions (Guam, American Samoa, Commonwealth of the Northern Mariana Islands, Federated States of Micronesia, the Marshall Islands, and the Republic of Palau)

22. Centers for Disease Control and Prevention TM State/Local Support and Evaluation Assistance includes: –$65 million to develop infrastructure and plans –Assignment of primary and secondary consultants –Site visits to provide technical assistance and to evaluate readiness –Tools & Training –Exercise Support

23. Centers for Disease Control and Prevention TM Security

24. Centers for Disease Control and Prevention TM Security Physical Security Asset Protection Area Assessments United States Marshal Service (USMS)

25. Centers for Disease Control and Prevention TM Response Concept

26. Centers for Disease Control and Prevention TM Emergency Response Concept Provide rapid delivery of a broad spectrum of support for an ill-defined threat in the early hours of an event Provide large shipments of specific materiel when a threat is known Provide technical assistance to receive and distribute Program materiel during an event

27. Centers for Disease Control and Prevention TM Emergency Response Options Broad Spectrum Support: ­12-Hour Push Packages Specific Item Support: ­Types of Inventory  Vendor Managed Inventory  Stockpile Managed Inventory ­Vaccines ­Buying Power/Surge Capacity

28. Centers for Disease Control and Prevention TM Broad Spectrum Support: 12-Hour Push Packages Pre-packed and configured materiel in transport- ready containers Pre-positioned in secure facilities near major transportation hubs Delivered rapidly by our world class transport partners Color coded and numbered containers for rapid identification by state and local authorities

29. Centers for Disease Control and Prevention TM 12-Hour Push Packages

30. Centers for Disease Control and Prevention TM External Support

31. Centers for Disease Control and Prevention TM Partnerships Federal ­ Purchasing support from the VA ­ Collaboration with the Federal Medical Materiel Coordination Group with DoD, VA, DHS and DoJ Private Sector ­ Materiel storage and maintenance by commercial vendors ­ Rapid movement to an event by commercial carriers ­ Pharmaceutical manufacturers ­ Medical supply and equipment manufacturers

32. Centers for Disease Control and Prevention TM BioShield $6.5 Billion Timeframe – 10 years New BS II Legislation Proposal New Frontiers – Devices – Drugs  Treatment  Prevention

33. Centers for Disease Control and Prevention TM Questions?