Friday, December 26, 2014

Strategic Stockpiling After Ebola: Lessons Learned

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                                                  Photo By: 1st Lt. Rusty Ridley, Air National Guard

All NATO states and the EU have strategic national stockpiles (SNS). SNS comprise a nations repository of vaccines, anti-virals, anti-toxins and a range of critical care medical equipment and technologies to support mass casualty care in the event of an emergency involving bio-terrorism, pandemics or natural disaster. The US SNS has a response time of approximately 12 hours and is located in stockpiles throughout the United States. In contrast, NATO maintains a 'virtual' stockpile with nations designating available supplies should an outbreak, either deliberate of natural require the intervention of NATO medical sections associated with COMEDS. 
A vital aspect of NATO's SNS, which can also be conceived of as a real SNS as each Member State must stockpile anything it designates for contribution should a crisis aise is procurement and procurement based on risk analysis. The on-going Ebola outbreak in West Africa will no doubt teach us the finer points of critical care stockpiling. Several NATO states have sent military support to affected nations in West Africa. Not only must their health care workers and military personnel be potentially treated should they contract Ebola or other endemic diseases such as Malaria and Lassa, (to date around 10% of Ebola cases have been health care workers), but returning military personnel must be considered as well). NATO Member State SNS have pushed vital medical supplies to West Africa. Gaps in stockpiling and risk based audits must now be conducted to understand which technologies, anti-virals, antibiotics, diagnostic technologies, barrier products should be procured in greater quantities and which should be reduced from our stockpiles.

Over the course of this Ebola outbreak, procurment officers have no doubt had a sharp learning curve regarding which products, materials, technologies and therapeutics are key to containing not just an Ebola outbreak, but applicable to a range of infectious disease outbreaks and which are not. In a discussion with one of the highest ranking public health officers in the US last week, I was informed that it was highly likely the composition of the SNS will shift to take into account lessons learned from the worst outbreak of Ebola in history. Likewise NATO will no doubt refine its advice on SNS, with a more risk based approach applied over the coming years. Gaps which define inadequacies in our stockpiling are particularly relevant, such as availability of personal protective equipment, respirators, support therapies, drugs and diagnostic equipment as well as issues related to working in environments with little or no consistent energy supply. The cold-chain issue with vaccines is a case in point and offers an opportunity to develop technologies which overcome this issue, so vaccines and therapeutics are no longer dependant upon maintaining a cold-chain. Development of such technology includes a range of exciting innovative solutions.  

As the CEO of Warfare Technology Analytics, based in the Netherlands, it has been an intense time of reviewing technologies which should be promoted for inclusion in NATO Member State strategic stockpiles. A number of technologies have been presented to me, not purely related to anti-virals, therapeutics and medical counter-measures, but diagnostic tools which I am likely to promote in the near future as highly valuable for our SNS across NATO states. Diagnostics proved to be a critical issue in this outbreak and one which is often overlooked in the composition of SNS. Additionally one of the positives to emerge from this crisis has to be the rapid advancement of technologies to control outbreaks of highly pathogenic diseases. I am looking forward to working with a number of firms producing technologies to contain outbreaks not purely at the drug level. Although the mortality rate and continued public health crisis in West Africa is alarming, if we take anything positive away from this crisis it has to be the inspiring development of a range of technologies we would perhaps have spent years trying to acquire. I look forward to reviewing technologies for procurement over the next few years in our SNS and to ensuring we are prepared and our forces protected against both deliberate and naturally occurring disease. 

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