An Ounce of Prevention

Steven D. Bice, guardian of the national pharmaceutical stockpile, lands on the front lines of the terrorism war.

In the late 1990s, before anthrax became a household word, before U.S. Postal Service officials feared becoming a tool of terrorists and the extent of the collapsed Soviet Union's germ research program was widely understood, and long after most Americans thought smallpox was a relic of the past, Steven D. Bice worried about bioterrorism. Then a public health analyst for the Emergency Response Coordination Group at the Centers for Disease Control and Prevention in Atlanta, he wrote a paper advocating the creation of a national stockpile of drugs and medical materiel that could be rapidly dispersed in an emergency.

The paper eventually found its way to the top of the agency and into the hands of congressional staff. CDC already had established small teams that would respond to national medical disasters. "The paper was simply the next step-how would we prepare ourselves if we had to treat 100,000 people or 1 million people for any one disease that was orchestrated, engineered and perpetrated by human beings? The only logical way was to think in terms of a stockpile," Bice says.

CDC officials were surprised to discover they had been awarded $50 million to create a national pharmaceutical stockpile in their 1999 budget. Bice was tapped to design and direct the program.

"There weren't any great stockpile models," Bice says. The Defense and Veterans Affairs departments, which historically had experience in stockpiling drugs, had gone to just-in-time delivery systems to cut costs and manage inventories efficiently. Hospital groups had done the same. "Nobody had any great on-hand stock," he says.

Bice quickly discovered that $50 million doesn't go far in the pharmaceutical marketplace, so CDC partnered with Veterans Affairs to leverage buying power.

On Dec. 27, 1999, the first "push packs" of medicine and equipment were ready for distribution in the event that Y2K computer failures would trigger medical crises. The threat never materialized, but the stockpile was born. Within weeks after the Sept. 11 terrorist attacks, the annual budget for the stockpile rocketed to $645 million, and the former Army infantry officer who honed his leadership and management skills on the battlefield in Vietnam found himself in charge of a major campaign in the war on terrorism.