NPS, the National Pharmaceutical Stockpile, is a program set up by the U.S. Federal Government in 1999, designed to create a new bioterrorism rapid-response unit, under the auspices of the CDC.

The role of the NPS is to immediately provide life-saving medical supplies and equipment to the site of a biological or chemical attack, specialized gear that would be far too expensive to be maintained by the local governments. To that end, it has set up centralized stockpiles at secure locations throughout the country, ready to be activated and mobilized within minutes of a strike.

The response itself will come in two basic components:

Firstly, there are 8 gigantic caches of drugs and EMS gear, known as "Push Packs", located near strategically-placed air bases across the continental US. As of May 2001, each of the eight stockpiles have now been installed onto custom-designed cargo planes, ready to be deployed within minutes of a strike. According to the master plan, at least one Push Pack can be delivered anywhere in the U.S. within 12 hours of activation, even if it must be disassembled and shipped overland. For obvious reasons, the government hasn't been forthcoming as to the exact locations of these depots. However, one could assume that each is located somewhere in the vicinity of the 8 major CDC branch offices. For the record, those branches are: Atlanta, Georgia, Anchorage, Alaska, Cinncinnati, Ohio, Fort Collins, Colorado, Pittsburgh, Pennsylvania, San Juan, California, Spokane, Washington and Washington, D.C. (Thanks, Ereneta).

Riding shotgun with the Push Pack will be a Technical Advisory Response Unit (or TARU), consisting of top-notch pharmacists, public health experts, and emergency responders. Once on-site, this team will immediately begin preparing for the second phase of the NPS system, called 'VMI' (Vendor-Managed Inventory). VMI will put into effect standing contracts that the U.S. has with several major pharmaceutical companies, giving them instant, highest-priority shipments of needed supplies. The first wave of VMI is set to arrive at the scene within 24-36 hours of the outbreak, and provide continuous supply until the emergency has been contained.

So, just what's in these stockpiles? Well... that's classified. (Heh, betcha didn't see that coming.) This we do know, however: Each Push Pack is identical, and contains about 45 metric tons of medicine and supplies. Since anthrax, pneumonic plague and tularemia can be effectively treated with antibiotics, buying up vast supplies of these was given very high priority. Other pathogens that the CDC has marked as being top-priority: smallpox, botulinum toxin, viral hemorrhagic fever. Other emergency equipment, like IV drips, ventilators, bandages and dressings, are also in there. Supplies of smallpox vaccine do exist, and what we have is probably there. Also, the drug firm Acambis is currently working on a new-generation smallpox vaccine to augment current supplies. A botulism antitoxin is also in development.

With medicines and antibiotics like these, which have a limited shelf-life, constant shifting of supplies is obviously a major part of the program. To that end, a new computerized system is now in place, automatically flagging drugs prior to their expiration, so that they can be resold and replaced with new supplies. Earlier this year, CDC Director James Hughes reported to Congress that the first such rotation of supplies has already been accomplished.

Note: The first ever deployment of the NPS system took place following the September 11th terrorist attacks on New York's World Trade Center, though, fortunately, only the Push Pack's more mundane medical supplies were ever needed.