- The HHS’ current management of the strategic national stockpile and its subsequent relaying of information to Congress is fractured and needs updates to ensure the country is prepared for future public health emergencies, according to a report from the Government Accountability Office.
- The GAO analysis ultimately found that current stockpiles hold most of the recommended medical supplies, but often not in the recommended quantities.
- The national stockpile is an arsenal of drugs and other medical supplies the federal government maintains in the event of a public health crisis or other emergencies.
The national stockpile is held in an undisclosed number of government warehouses, filled with pharmaceutical drugs and other medical supplies in case a public health emergency causes local supplies to run out. The warehouses, originally created by the federal government in 1999 to combat chemical or biological attacks, are strategically placed throughout the country.
The COVID-19 pandemic brought a heightened awareness to the national stockpile, as supply chain challenges caused shortages of ventilators, personal protective equipment and other resources across hospitals and health systems.
In fiscal years 2020 and 2021, $6.1 billion in COVID-19 relief funds was allocated for spending on stockpile supplies in the midst of the shortage, compared to nearly $5 billion allocated from 2015 to 2021 in total on non-coronavirus related supplies.
But the HHS stockpile reviews, which the agency employs to make inventory decisions, are insufficient and hampering its ability to ensure the stockpile has adequate resources and quantities to combat future public health emergencies, the GAO report found.
In 2019, the Administration for Strategic Preparedness and Response suspended its annual stockpile review process, which it uses to make inventory recommendations, for three years when an expert group used to assist the reviews went through a reorganization. Annual reviews were not completed to make inventory decisions for fiscal years 2020 through 2022, and the agency relied on past reviews and its own discretion to inform inventory decisions.
Although the HHS has now completed reviews to inform inventory decisions for fiscal years 2023 and 2024, the reviews didn’t meet most statutory requirements, because the agency did not update its procedures to account for changes enacted in 2019 under the Pandemic and All-Hazards Preparedness and Advancing Innovation Act, according to the report.
Until the HHS updates its procedures, it risks lapsing on statutory requirements that were designed to give Congress information about the supply inventory, the report said.
In order to better inform inventory decisions and funding allocations from Congress, the agency needs to develop and document an approach outlining how it regularly manages the risks associated with inventory level gaps and recommended quantities, while tracking progress and estimating resources needed, the report said.
The HHS concurred with the GAO’s recommendations.
Finding a balance between maintaining a stockpile of resources to combat low-probability, high-impact threats like anthrax while building up inventories of supplies to battle emerging infectious diseases, like COVID-19, was a challenge during the pandemic, the report said.
The pandemic was a catalyst for the GAO to reassess current stockpile procedures, according to the agency.
Beyond adding more ventilators and personal protective equipment, the HHS also added testing supplies including nasal swabs and transfer media, which it hadn’t stocked prior to the pandemic.
From 2015 through 2019, the HHS allocated about $33 million for ventilators, and allocated no more than $1 million for PPE for the stockpile. After the pandemic hit, it allocated about $5.5 billion for those supplies using relief funds.