- The United States maintains stockpiles of medical equipment, petroleum, and other materials that the federal and state governments can draw on amid supply disruptions.
- These stockpiles are intended to enhance U.S. national security and safeguard the independence of U.S. foreign policy.
- The COVID-19 pandemic and 2022 mpox outbreak focused attention on the Strategic National Stockpile, which some have criticized as understocked for a major disease outbreak.
The United States maintains several strategic stockpiles that the states and the federal government can draw from when supply shocks occur. Among the most prominent is the Strategic National Stockpile (SNS), a reserve of essential medical supplies. Alongside other stockpiles, such as the Strategic Petroleum Reserve (SPR), the SNS is intended to strengthen national security and protect U.S. foreign policy prerogatives during times of crisis. Yet as the COVID-19 pandemic and a concurrent outbreak of mpox refocused attention on health-care supplies, the SNS drew criticism for being underfunded and inadequately supplied.
What is the Strategic National Stockpile?
The SNS grew out of an earlier program, the National Pharmaceutical Stockpile, which Congress created in 1999 to serve as an emergency supply of drugs and vaccines in the wake of a terrorist attack or other crisis affecting public health. It was overseen by the Centers for Disease Control and Prevention (CDC). In 2003, amid a sweeping government reorganization prompted by the 9/11 terrorist attacks, it became the SNS, and in 2018 was placed under the authority of another body within the Department of Health and Human Services (HHS).
The SNS contains a slew of medical supplies and equipment, including antibiotics, antivirals, vaccines, ventilators, and beds, stored in secret locations across the country to supplement state and local resources. Some of the materials are organized into “twelve-hour push packages”—each contains fifty tons of medical supplies that can be rapidly deployed to another part of the country. The exact contents of the stockpile are kept secret for security reasons, but it holds over $8 billion worth of inventory, according to Greg Burel, who directed the SNS for more than twelve years. The composition of the stockpile is determined by a special interagency body that includes experts from the CDC, the Food and Drug Administration, and the National Institutes of Health.
Governors can request supplies from the SNS to respond to a health emergency in their state. The federal government can also deploy SNS resources at the discretion of executive branch leaders.
The SNS has been used to respond to a range of crises since its inception, including the 9/11 terrorist attacks; Hurricane Katrina; and outbreaks of Zika, Ebola, H1N1, COVID-19, and, most recently, mpox, the smallpox relative formerly known as monkeypox. But because the SNS was initially designed and funded to handle chemical, biological, radiological, and nuclear (CBRN) events, experts, including Burel, say it has not received the necessary funding for pandemic preparedness.
Robert Kadlec, the Donald Trump administration’s official in charge of public health preparedness, acknowledged that his focus coming into his role in 2017 was readying the country for a bioterrorist attack involving smallpox, anthrax, or other deadly pathogens.
What else does the U.S. stockpile?
Perhaps the most well-known stockpile is the Strategic Petroleum Reserve, an extensive oil storage system created in response to a 1973 oil embargo by the Organization of the Petroleum Exporting Countries (OPEC). The SPR is able to hold more than seven hundred million barrels of oil in a network of underground caverns that runs through Texas and Louisiana. In 2022, the Joe Biden administration made historic withdrawals from the reserve in response to the Russian invasion of Ukraine and subsequent oil price inflation.
The United States also maintains a few lesser-known stockpiles. The Northeast Home Heating Oil Reserve is a stockpile of one million barrels of diesel fuel kept in Connecticut, New Jersey, and Massachusetts to supply the northeastern United States, where the majority of heating oil is used. The federal government used to maintain a stockpile of helium near Amarillo, Texas, but Congress ordered the reserve to be shut by 2021, and the government transitioned it to private-sector use. While it was initially hoarded for use in military blimps, helium today is used in rockets and in superconductors. Additionally, the Defense Department reportedly stockpiles rare earth minerals, which are used to manufacture advanced weaponry, and lithium, a critical input for advanced batteries, to curb its reliance on Chinese sources. The Pentagon also maintains a National Defense Stockpile of about $1.5 billion worth of various metals.
The government has in the past stockpiled food, but these programs were mainly to support farmers hurt by low prices. For example, in the late 1970s and early 1980s, the Department of Agriculture (USDA) bought surplus dairy products, which it distributed to Americans via various welfare programs. Food stockpiling has been a point of debate in negotiations at the World Trade Organization because some critics say it distorts trade flows.
Today, the USDA still buys various commodities for both domestic and international food aid programs. It also maintains a vault in Fort Collins, Colorado, that houses thousands of plant species and genetic material of livestock in the event of a disaster.
The SNS does not contain food reserves, but the Federal Emergency Management Agency (FEMA) stockpiles food, water, generators, and other resources across eight distribution centers located in the United States and its territories.
Are there global stockpiles?
There aren’t many. The United States is a member of the Paris-based International Energy Agency (IEA), which was created around the same time as the SPR following the oil crisis. IEA member countries pledge to hold at least ninety days worth of net oil imports, which can be collectively released during supply shortages. All of the United States’ emergency SPR drawdowns have been part of coordinated IEA actions.
The Svalbard Global Seed Vault safeguards the world’s flora in the event of a major disaster. The vault holds nearly one million seed samples inside a mountain on a remote Norwegian island in the Arctic.
Are strategic stockpiles common in other countries?
The COVID-19 pandemic overwhelmed the medical systems of many European Union members and led the bloc to announce plans to stockpile essential medicines and medical equipment. But those plans didn’t move forward, and in January 2023, a surge in winter illnesses caused another medicine shortage, revitalizing calls for a permanent stockpile. However, the pandemic did prompt the bloc to create a stockpile of disaster-management equipment, dubbed RescEU, that includes some medical items.
China requires local governments [PDF] to “reserve medicines, medical devices and other supplies for the prevention and treatment of infectious diseases.” Beijing also maintains some other stockpiles, including a strategic pork reserve that occasionally deploys thousands of tons of meat into the market. The exact quantity of pork in reserve is a state secret.
What are the debates over the Strategic National Stockpile?
The SNS has been criticized for being underfunded and ill-prepared to handle recent disease outbreaks, particularly the COVID-19 pandemic.
Shortly after taking office in 2021, President Biden released his national strategy for responding to pandemics, which called for “revitalizing” the SNS. A subsequent report from the administration, on the U.S. pharmaceutical supply chain, reaffirmed the SNS’s mandate to secure the country’s access to medicines and critical drug ingredients. Later that year, the head of the SNS told Congress that the stockpile is far better equipped with masks and other protective equipment than before the pandemic.
Despite recent efforts to refill the stockpile, the SNS has also been blamed for shortcomings in its handling of mpox, a less lethal relative of smallpox that can be treated with the same vaccine. As an outbreak of the virus spread across the United States and the world in 2022, reports emerged that U.S. health officials knew for years that the SNS did not hold enough doses of that vaccine to ward off an outbreak. Critics have said a lack of funding prevented the stockpile from amassing the doses necessary to effectively mitigate the crisis.
CFR’s Tom Frieden, who led the CDC during the Barack Obama presidency (2009–2017), when the agency was responsible for the SNS, suggests returning oversight of the stockpile to the CDC. Frieden says that the CDC was better able to coordinate with state and local officials to deploy the stockpile. He also urges greater transparency in how the SNS is managed, including the costs of different stockpiled products. “It is absolutely essential that these life-and-death decisions be insulated from any commercial or political pressures that could lead to purchases that don’t maximize saving lives,” he says. The Biden administration announced that it would conduct an audit of the SNS after the New York Times reported that stockpile purchases disproportionately benefited a company that focused on bioterrorism threats.
This Backgrounder explains how the U.S. government uses the Strategic Petroleum Reserve.
Researchers at Harvard University’s Belfer Center for Science and International Affairs offer recommendations for the SNS in this report.
This New York Times investigation examines how a handful of biotech companies profited from government purchases for the SNS.
Testifying before the Senate Committee on Homeland Security and Governmental Affairs, the RAND Corporation’s Daniel M. Gerstein argues for [PDF] increased SNS funding.
The Government Accountability Office finds that the SNS failed to provide enough resources [PDF] for the country to manage the COVID-19 pandemic.
This Congressional Research Service report outlines the issues [PDF] facing the SNS in 2023.