Endnotes: Evaluation of the National Emergency Stockpile System (NESS)

Endnotes

  • [A] The Public Health Agency, in collaboration with the Pan-Canadian Public Health Network Council (PHNC), has undertaken the development of a sustainable antiviral stockpile strategy.

    The first element of this strategy is a scientific review of the size and composition of national antiviral stockpiles. This review has been undertaken by the Antiviral Scientific Advisory Group (AVSAG) that reports to the Public Health Agency of Canada, made up of a pan-Canadian group of antiviral, influenza and public health experts, and has been informed by the best available scientific evidence post-H1N1, cost effectiveness analyses, as well as sophisticated mathematic modeling. The updated expert recommendations will be provided in a separate report, and will serve to inform decision making for size and composition of national antiviral stockpiles going forward.

    The second element of a sustainable antiviral stockpile strategy addresses the logistical aspects of procuring, maintaining and managing antiviral stockpiles. This work has been undertaken by the Sustainable Antiviral Stockpile Working Group (SASWG) that reports to the Public Health Agency of Canada, and will facilitate a long term strategy for sustainability of antiviral stockpiles through the identification of options for cost effective and innovative antiviral procurement and stockpile management.
  • [B] The National Antiviral Stockpile (NAS) was created in 2004 to ensure equitable access across Canada to a secure supply of antivirals for pandemic influenza. The Public Health Agency of Canada supports the provinces/territories by facilitating the acquisition of these antiviral drugs. The NAS is administered by the provinces/territories. These antiviral drugs are held across the country on a per capita basis in secure temperature-controlled facilities. The NESS also holds a smaller supply of antivirals that is separate from the NAS, which is intended to be surge capacity for the NAS.
  • [C] As part of the review of the Public Health Network governance structure, the Emergency Preparedness and Response Expert Group and subsequently the Council of Health Emergency Management Directors and the Council of Emergency Social Services Directors will cease to be active as of March 31, 2011.
  • [D] http://www.redcross.ca/article.asp?id=000318
  • [E] 2008 CRC Partnering to Build a Resilient Civil Society report
  • [F] Ibid.
  • [G] Ibid.
  • [H] 2008 CRC Partnering to Build a Resilient Civil Society report
  • [I] Interview, 14 January 2011
  • [J] Ibid.
  • [K] Much of the information for this section may be found at: http://www.bt.cdc.gov/stockpile/
  • [L] The name was changed from the National Pharmaceutical Stockpile to the Strategic National Stockpile, March 1, 2003. Also see, http://ww.ndu.edu/CTNSP/docUploaded/DTP3%SNS.pdf
  • [M] Presentation: http://www.blsmeetings.net/2009GHSImeetingsMCM/presentations/Plenary/Burel-DSNS.pdf
  • [N] Interviewees indicated that not all products have a 12 hour delivery timeframe. The 12-hour delivery guarantee is for the 12-hour Push Packages only; 130 containers (50 tons) of product have been developed specifically for rapid response.
  • [O] Presentation: http://www.blsmeetings.net/2009GHSImeetingsMCM/presentations/Plenary/Burel-DSNS.pdf
  • [P] Ibid.
  • [Q] Interviewees noted that the SNS also owns Vendor Managed Inventory (VMI) which is actual product on shelves at vendor locations. Over time, as the SNS requirements have grown, there have been fewer and fewer VMI opportunities. Today, SNS needs far surpass what vendors can rotate through commercial supply chains. As a result, VMI is a much smaller component of the SNS. Instead, the SNS includes far more managed inventory (MI) which is product purchased and stored by the SNS.
  • [R] Ibid.
  • [S] CDC Report (September 2010) (p.11) (cited above)
  • [T] Web site: http://www.bt.cdc.gov/stockpile/
  • [U] Interviewees indicated the value of the program is $4.5 billion, up from $3.5 billion in 1999. This Information is also provided in a Ppt presentation entitled: "Strategic National Stockpile: Overview", Division of Strategic National Stockpile, Coordinating Office for Terrorism Preparedness and Emergency Response, Centers for Disease Control and Prevention, November, 1999.
  • [V] Interview
  • [W] See: Homeland Security, National Response Framework January 2008. This document outlines the roles/responsibilities of various federal, state, local, private sector, NGO, etc., players in providing emergency responses and supplies. Overall coordination is under the purview of Homeland Security's Federal Emergency Management Agency (FEMA).
  • [X] SNS Web site
  • [Y] http://www.news-medical.net/news/20091020/CDC-stockpiles-ventilators-for-use-during-public-health-emergency.aspx
  • [Z] SNS web site and interview (It was noted that FMS sets do not include any tentage or other portable structures and rely on being established in a "building of opportunity".)
  • [AA] Strategic National Stockpile Program (SNS), Office of Terrorism Prevention and Emergency Response (OTPER), Centers for Disease Control and Prevention (CDC), CHEMPACK PROJECT, Operational Protocol, June 14, 2004
  • [BB] Public Health Preparedness: Mobilizing State by State (http://www.bt.cdc.gov/publications/feb08phprep/section1/response.asp); and interview
  • [CC] Ibid and SNS web site
  • [DD] Ibid and SNS web site
  • [EE] Ibid.
  • [FF] http://www/ndu/edi/CTNSP/docUploaded/DTP3%SNS.pdf (p. 8)
  • [GG] Ibid.
  • [HH] http://www.ndu.edu/CTNSP/docUploaded/DTP3%20SNS.pdf (p.4)
  • [II] Ibid.
  • [JJ] SNS Web site and interview
  • [KK] SNS web site
  • [LL] Ibid.
  • [MM] The webcast is available for download at: http://www.aarc.org/headlines/09/09/webcast_training.cfm
  • [NN] SNS web site
  • [OO] SNS Web page
  • [PP] Centers for Disease Control and Prevention, Coordinating Office for Terrorism Preparedness and Emergency Response, Division of Strategic National Stockpile Program Preparedness Branch, State Technical Assistance Review Tool Users Guide, December 2009.
  • [QQ] It should be noted that DSNS staff provides technical assistance to both state and local SNS programs with planning, exercising, evaluating and training in order to achieve and maintain overall readiness in these critical preparedness functions. See: State Technical Assistance Review Tool Users Guide, revised June 2010
  • [RR] http://pdm.medicine.wisc.edu/Volume_18/issue_4/koenig.pdf (p.330)
  • [SS] Ibid. and interview
  • [TT] Australian Government, Department of Health and Ageing, Annual Report 2009-10, Biosecurity and Emergency Response, p. 329.
  • [UU] Interview notes
  • [VV] Australian Government, Department of Health and Ageing, Annual Report 2009-10, Biosecurity and Emergency Response, p. 329.
  • [WW] http://www.health.gov.au/internet/main/publishing.nsf/Content/php-about.htm
  • [XX] Australian Government, Department of Health and Ageing, Annual Report 2009-10, Biosecurity and Emergency Response, p. 328.
  • [YY] DHA, Annual Report 2009-10, p. 330
  • [ZZ] Interview notes
  • [AAA] Australian Government, Department of Health and Ageing, Australian Health Protection Committee, National Health Disaster Management Capability Audit 2008, Health Emergency Management Branch, Office of Health Protection, 23 March 2010.
  • [BBB] http://www.ema.gov.au (Emergency Management Australia (EMA) is an Australian Federal Government Agency tasked with coordinating governmental responses to emergency incidents. EMA currently sits within the Federal Attorney General's Department.)
  • [CCC] National Health Disaster Management Capability Audit 2008, p. 5.
  • [DDD] Interview notes
  • [EEE] Information was gathered from several documents including the NOREPS web site: http://www.noreps.com
  • [FFF] Ibid.
  • [GGG] Innovation Norway is a state-owned company. As of 1 January 2004 the new state owned company replaced the following organizations: The Norwegian Tourist Board, the Norwegian Trade Council, The Norwegian Industrial and Regional Development Fund, SND and The Government Consultative Office for Inventors, SVO. http://www.innovasjonnorge.no/Om-oss/Innovation-Norway/
  • [HHH] Nordic Consulting Group and Channel Research, Evaluation of the Norwegian Emergency Preparedness System (NOREPS), January 2008, p. 17
  • [III] Ibid., p. 11
  • [JJJ] Ibid., p. 48
  • [KKK] Ibid., p. 59
  • [LLL] Ibid., p. 35
  • [MMM] Ibid., p.16
  • [NNN] Ibid., pp.49-51
  • [OOO] Ibid. p. 35
  • [PPP] Ibid., p.34
  • [QQQ] Ibid., p.39

  1. Public Health Agency of Canada, Audit Services. (2010). Audit of Emergency Preparedness and Response. p. 3.
  2. Library and Archives Canada. (1952). Cabinet conclusions, Civil defence – stockpiling of medical supplies. Retrieved on February 4, 2011, from
    http://www.collectionscanada.gc.ca/databases/conclusions/001039-119.01-e.php?&sisn_id_nbr=11597&
    page_sequence_nbr=1&interval=20&&PHPSESSID=oddebcluq2gcte65jj1smcj5s1
  3. Library and Archives Canada. (1965). Cabinet conclusions, Use of Emergency Health and Emergency Welfare Regional Stockpiles in Peacetime Disasters. Retrieved on February 4, 2011, from
    http://www.collectionscanada.gc.ca/databases/conclusions/001039-119.01-e.php?&sisn_id_nbr=26565&
    page_sequence_nbr=1&interval=20&&page_id_nbr=41546&&PHPSESSID=dger0arudut9n0ahdpitkocs51
  4. Public Health Agency of Canada, Audit Services. (2010). Audit of Emergency Preparedness and Response. p. 3.
  5. Public Safety Canada (2011-02). Canadian Disaster Database. Retrieved on February 28, 2011 from:
    http://www.publicsafety.gc.ca/prg/em/cdd/srch-eng.aspx
  6. Public Safety Canada. (2011-01). Emergency Management Framework for Canada, Second Edition. Retrieved on February 4, 2011, from:
    http://www.publicsafety.gc.ca/prg/em/_fl/emfrmwrk-2011-eng.pdf
  7. Public Safety Canada. (2009). Federal Emergency Response Plan. Retrieved on February 4, 2011, from:
    http://www.publicsafety.gc.ca/prg/em/ferp-eng.aspx
  8. World Health Organization. (2005). International Health Regulations. Retrieved on February 4, 2011, from:
    http://whqlibdoc.who.int/publications/2008/9789241580410_eng.pdf
  9. Government of Canada (2006) Canadian Pandemic Influenza Plan for the Health Sector
  10. Government of Canada. (2010-03) Speech from the Throne: A Stronger Canada. A Stronger Economy. Now and for the Future. Retrieved on February 4, 2011, from:
    http://www.speech.gc.ca/grfx/docs/sft-ddt-2010_e.pdf
  11. Government of Canada. (2007). Emergency Management Act. Retrieved on February 4, 2011, from:
    http://laws.justice.gc.ca/PDF/Statute/E/E-4.56.pdf
  12. Public Health Agency of Canada and Health Canada. (2010-11) Lessons Learned Review: Public Health Agency of Canada and Health Canada Response to the 2009 H1N1 Pandemic. Retrieved on February 4, 2011, from:
    http://www.phac-aspc.gc.ca/about_apropos/evaluation/reports-rapports/2010-2011/h1n1/pdf/h1n1-eng.pdf
  13. Public Health Agency of Canada and Health Canada. (2010-11) Lessons Learned Review: Public Health Agency of Canada and Health Canada Response to the 2009 H1N1 Pandemic. Retrieved on February 4, 2011, from:
    http://www.phac-aspc.gc.ca/about_apropos/evaluation/reports-rapports/2010-2011/h1n1/pdf/h1n1-eng.pdf
  14. Government of Canada. (2007). Emergency Management Act. Retrieved on February 4, 2011, from:
    http://laws.justice.gc.ca/PDF/Statute/E/E-4.56.pdf
  15. Government of Canada. (1985). Financial Administration Act. Retrieved on February 4, 2011, from:
    http://laws.justice.gc.ca/en/f-11/
  16. Public Health Agency of Canada, Audit Services. (2010). Audit of Emergency Preparedness and Response.
  17. Canadian Pharmacists Association (2010-12). Canadian Drug Shortages Survey Final Report. Retrieved on February 4, 2011, from:
    http://www.pharmacists.ca/content/About_CPHA/Whats_Happening/
    CPhA_in_the_News/CPhADrugShortagesReport_Dec2010.pdf, p. 11
  18. Government of Ontario. (2009). Pandemic (H1N1) 2009: A Review of Ontario's Response. Retrieved on February 4, 2011, from:
    http://www.health.gov.on.ca/en/public/publications/ministry_reports/h1n1_review/h1n1_review.pdf, p. 33
  19. Government of Ontario. (2011-02-04) Health Emergency Stockpiling Program for the Health and Broader Public Sector. http://www.health.gov.on.ca/english/providers/program/emu/bps/bps_qa.html
  20. Public Safety Canada. (2011-01). Emergency Management Framework for Canada, Second Edition. Retrieved on February 4, 2011, from:
    http://www.publicsafety.gc.ca/prg/em/_fl/emfrmwrk-2011-eng.pdf
  21. Government of Canada. (2010-03) Speech from the Throne: A Stronger Canada. A Stronger Economy. Now and for the Future. Retrieved on February 4, 2011, from:
    http://www.speech.gc.ca/grfx/docs/sft-ddt-2010_e.pdf
  22. Public Safety Canada. (2009). Federal Emergency Response Plan. Retrieved on February 4, 2011, from:
    http://www.publicsafety.gc.ca/prg/em/ferp-eng.aspx
  23. World Health Organization. (2005). International Health Regulations. Retrieved on February 4, 2011, from:
    http://whqlibdoc.who.int/publications/2008/9789241580410_eng.pdf
  24. Government of Canada (2006) Canadian Pandemic Influenza Plan for the Health Sector
  25. Government of Canada. (2007). Emergency Management Act. Retrieved on February 4, 2011, from:
    http://laws.justice.gc.ca/PDF/Statute/E/E-4.56.pdf
  26. Government of Canada. (2007). Emergency Management Act. Retrieved on February 4, 2011, from:
    http://laws.justice.gc.ca/PDF/Statute/E/E-4.56.pdf
  27. Government of Canada. (1985). Financial Administration Act. Retrieved on February 4, 2011, from:
    http://laws.justice.gc.ca/en/f-11/
  28. Public Health Agency of Canada and Health Canada. (2010-11) Lessons Learned Review: Public Health Agency of Canada and Health Canada Response to the 2009 H1N1 Pandemic. Retrieved on February 4, 2011, from:
    http://www.phac-aspc.gc.ca/about_apropos/evaluation/reports-rapports/2010-2011/h1n1/pdf/h1n1-eng.pdf
  29. Public Health Agency of Canada and Health Canada. (2010-11) Lessons Learned Review: Public Health Agency of Canada and Health Canada Response to the 2009 H1N1 Pandemic. Retrieved on February 4, 2011, from:
    http://www.phac-aspc.gc.ca/about_apropos/evaluation/reports-rapports/2010-2011/h1n1/pdf/h1n1-eng.pdf
  30. Public Safety Canada. (2011). An Emergency Management Framework for Canada, Second Edition. Retrieved on February 4, 2011, from:
    http://www.publicsafety.gc.ca/prg/em/_fl/emfrmwrk-2011-eng.pdf
  31. Government of Canada. (2007). Emergency Management Act. Retrieved on February 4, 2011, from:
    http://laws.justice.gc.ca/PDF/Statute/E/E-4.56.pdf
  32. Security and Prosperity Partnership of North America. (2007). North American Plan for Avian and Pandemic Influenza. Retrieved on November 8, 2010, from
    http://www.spp-psp.gc.ca/eic/site/spp-psp.nsf/vwapj/pandemic-influenza.pdf/$FILE/pandemic-influenza.pdf (External link)
Report a problem or mistake on this page
Please select all that apply:

Thank you for your help!

You will not receive a reply. For enquiries, contact us.

Date modified: