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It should be guided by a board of governors representing such federal government organizations as the Department of Defense, the Biomedical Advanced Research and Development Authority, the National Institute for Occupational Safety and Health, the Food and Drug Administration (FDA), and the Centers for Disease Control and Prevention (CDC). The SNS needs a higher profile and greater influence. just didn’t understand the complexity of global supply chains…and our efforts to get leadership to act fell by the wayside.” It took weeks of going through red tape for DHHS to act, by which time the global supply of PPE had virtually dried up. “The problems we saw with PPE in Wuhan in January never saw the light of day,” an SNS manager told one of us in an interview. But their warnings were not taken seriously by medical personnel within DHHS.

SNS managers were able to see early on that the medical-equipment supply chain was threatened by manufacturing shutdowns and high demand in China: Wuhan, the location of the pandemic’s origin, is also the world’s main production center for masks and other PPE.

Dominated by virologists and clinicians, DHHS excels at medical assessment but is not geared toward predicting or planning for disasters. Department of Health and Human Services (DHHS). This lack of visibility and clout led to a situation where the SNS was relegated to a small team within the massive bureaucracy of the U.S. For example, the strategic plan for responding to national health emergencies was not renewed after 2017, and funding for replenishing stockpiles was repeatedly cut. It became an afterthought and a low governmental priority. Despite experts’ warnings about the risks of global diseases, the SNS slid into semi-obscurity. When the SNS was created in the aftermath of 9/11, terrorism was foremost on the intelligence community’s collective mind, but in the following years, through two successive administrations, some of the original sense of urgency dwindled. Consequently, its influence and ability to garner support and resources have been limited. The SNS suffers from low visibility - or at least it did before the pandemic. These recommendations are still under consideration, but nothing has changed.

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The federal government task force (the three of us were members of its various teams) identified three major systemic issues and have proposed a series of solutions. While grossly inadequate levels of funding heavily contributed to its poor performance, that is really a symptom of a much larger set of problems. Supplies of other PPE and ventilators were inadequate and were quickly depleted in February. When the virus hit, the supply of masks had not been replenished since the H1N1 pandemic in 2009, and the usage dates for many of the masks had expired. Partly for that reason, the pandemic caught the SNS flat-footed and unprepared. But the SNS, originally intended as a safety net in case of short-term threats such as bio-terror attacks, was not designed to handle a pandemic of this scale.

In a health emergency, states and health-care organizations that run low on medicines and equipment are supposed to be able to rely on the Strategic National Stockpile (SNS), a creation of the George W. The need is critical - both for dealing with possible surges in the virus this fall and for managing future health and terrorism crises whenever they arise. Our team, which was involved in efforts by the federal government’s Supply Chain Task Force to understand and address the problems, found that the deficiencies are very solvable - if the federal government gives the Strategic National Stockpile agency greater clout, provides it with access to better information and technology, and beefs up its expertise. The reason is that a slew of glaring supply-chain deficiencies have yet to be fixed. And while the supply of ventilators is no longer an issue, shortages of ICU medications and test-kit reagents remain. Many organizations must still forage for critically needed equipment through back channels and black markets. Hospitals, nursing homes, and medical practices routinely have to waste time and heighten their disease exposure by decontaminating disposable masks and gloves for reuse. Instead, they continue and some have gotten worse. It may be hard to believe after all these months, but the shortages of personal protective equipment (PPE) and other critical health care supplies for dealing with the pandemic in the United States still haven’t been solved. To get all of HBR’s content delivered to your inbox, sign up for the Daily Alert newsletter.

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