LINDA WERTHEIMER, HOST:
Today in Your Health, we take a look at some warehouses hidden around the country. They're a key part of the government's plan for responding to a major disaster like a terrorist attack or a disease outbreak. NPR's Nell Greenfieldboyce reports on what's inside those secret warehouses and some of the concerns about them.
NELL GREENFIELDBOYCE, BYLINE: If someone releases smallpox or detonates a small nuclear weapon, the stuff in these warehouses could save tens of thousands of lives. So I asked to go visit one. Surprisingly, the answer was yes. I was told I was the first reporter ever allowed in.
I had to sign a confidentiality agreement, so I can't describe the outside. But the inside is huge. A giant American flag hangs from the ceiling. Packed shelves stand so tall that looking up makes me dizzy. Greg Burel gives me a tour. He's the director of the stockpile program.
GREG BUREL: If you envision, say, a Super Wal-Mart and stick two of those side-by-side and take out all the drop ceiling, that's about the same kind of space that we would occupy in one of these storage locations.
GREENFIELDBOYCE: So how many warehouses like this do you all have?
BUREL: You know, we have an undisclosed number of warehouses.
GREENFIELDBOYCE: OK. But at one recent public meeting, a former government official said there were six. Anyway, you get the idea. The locations are secret. The number of warehouses is secret. Exactly what's in them is secret.
BUREL: If everybody knows exactly what we have, then you know exactly what you can do to us that we can't fix. And we just don't want that to happen.
GREENFIELDBOYCE: What he will reveal is how much it's all worth.
BUREL: We currently value the inventory at a little over $7 billion.
GREENFIELDBOYCE: The Strategic National Stockpile started back in 1999 with a budget of about $50 million. Since then, it's grown. Even though the exact details aren't public, it's clear that the stockpile has amassed millions of doses of vaccines, medicines used to treat radiation sickness, anti-virals in case of a flu pandemic. I notice that one section of the warehouse is caged off and locked. Shirley Mabry, the chief of logistics, says that's required by the Drug Enforcement Administration.
SHIRLEY MABRY: So that there's no pilferage of those items.
GREENFIELDBOYCE: So, like, painkillers and things like that?
MABRY: Yes, those things that could be addictive in nature.
GREENFIELDBOYCE: As we walk, I hear a loud hum. It's a giant freezer packed with products that have to be kept cold. Just outside it, there's rows upon rows of ventilators that could keep sick or injured people breathing.
MABRY: They are in a constant state of ready. If you'll look down to the side, you'll see that there are electrical outlets so that they can be charged once a month.
GREENFIELDBOYCE: Not only that, they get sent out for yearly maintenance. Everything here has to be inventoried. Expiration dates have to be checked. Tending to this vast stash costs more than half a billion dollars a year. These warehouses seem to be well-run. But they're part of a larger system that has some experts concerned.
IRWIN REDLENER: The warehouse is fine in terms of the management of stuff in there. What gets in the warehouse and where does it go after the warehouse and how fast does it go to people? - is where we have questions.
GREENFIELDBOYCE: Irwin Redlener is director of the National Center for Disaster Preparedness at Columbia University. He says, take the decisions about what to add to the stockpile. You've got to first assess what threats you think are realistic and then say - OK, what can we do about them?
REDLENER: That's where we have a huge, complex bureaucracy trying to sort through that.
GREENFIELDBOYCE: The process involves agencies from the Department of Defense to the Food and Drug Administration. They're doing their best to acquire or develop products that can meet the threats. But a lot of the new medicines have some real limitations.
TARA O'TOOLE: These are often very powerful, very exciting and useful new medicines. But they are also very expensive. And they expire after a couple of years.
GREENFIELDBOYCE: Tara O'Toole is a former homeland security official. She chairs a recently formed committee at the National Academies of Sciences, Engineering, and Medicine, which the government asked to study the stockpile program and offer advice. She says, as the inventory of the stockpile goes up and up, the budget to maintain that inventory is staying flat.
O'TOOLE: This is an unsustainable plan.
GREENFIELDBOYCE: So that's the problem with how stuff gets into these warehouses. Now for the other problem - how to get stuff out to the people who need it. Imagine if there's a major anthrax attack and there's just 48 hours to get prophylactic antibiotics to more than a million people.
O'TOOLE: It is not going to be easy or simple to put medicines in the hand of everybody who wants it.
GREENFIELDBOYCE: Back at the warehouse, logistics expert Shirley Mabry shows me rows of big shipping containers.
MABRY: This is the 12-hour push package, approximately 50 tons of material.
GREENFIELDBOYCE: It's stuff that could help after a variety of disasters, designed to be delivered to a city or town within hours. On the outside of each container is a pouch...
MABRY: That has the information that anyone would need if they were to receive those.
GREENFIELDBOYCE: The people who would receive this container or anything else from the stockpile are state and local public health workers. They're the ones who have to figure out how to get pills into mouths and shots into arms. I talked with one of them, Paul Petersen. He's director of Emergency Preparedness for Tennessee. He says local public health officials have had budget cuts and are drastically underfunded.
PAUL PETERSEN: You know, many jurisdictions across the U.S. have less staff and less resources available to them to surge up in large scale events. So, I mean, that's a risk.
GREENFIELDBOYCE: He says, while they do have plans for emergencies and lists of volunteers...
PETERSEN: They're volunteers. And they're not guaranteed to show up in the time of need.
GREENFIELDBOYCE: Over and over, I heard worries about this part of the stockpile program. Tara O'Toole wishes local officials would get more money for things like emergency drills.
O'TOOLE: The notion that this is all going to be top-down - that the feds are in charge and the feds will deliver - is wrong.
GREENFIELDBOYCE: She'd also like to see more interest from Congress in all this because it's a national security issue.
O'TOOLE: These will be do-or-die days for America, should they ever come upon us.
GREENFIELDBOYCE: And having a stockpile in a warehouse will be just the beginning. Nell Greenfieldboyce, NPR News.
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