8.1 Pandemic Planning

The National Medical Stockpile (NMS) was established by the Australian Government in 2002. It is a national strategic reserve of essential vaccines, antibiotics, antiviral drugs, chemical and radiological antidotes and personal protective equipment (PPE). The NMS is designed to supplement existing medical stocks held in the Australian hospital system and by states and territories, to ensure that medical supplies do not run low in response to a health emergency in Australia. Specific details of its contents are not publicly released for security reasons. The NMS is a Commonwealth resource, held in several strategic locations around Australia to ensure that distribution throughout Australia is rapid.

A significant proportion of the NMS is a reserve of PPE, antiviral medication and medical supplies for vaccination (such as syringes, needles, sharps containers and alcohol swabs) for use in an influenza pandemic. Such items are stockpiled to ensure Australia’s self-sufficiency during a time of high global demand and insufficient manufacturing and distribution capacity.

8.1.1 Pandemic supplies

The NMS held 8.7 million courses of antiviral medications, named oseltamivir (Tamiflu®) and zanamivir (Relenza®), prior to the pandemic, including both adult and paediatric preparations and oseltamivir in bulk powder form that could be processed into a solution.

The PPE in the NMS included protective P2 masks (P2 respirator), surgical masks, goggles, gowns, gloves and alcohol rubs to protect individuals from infection. Access to this reserve of PPE is based on risk of exposure and availability of supplies, which are limited.

The NMS also contained a small stock of pre-pandemic, or ‘candidate’, vaccines based on the avian H5N1 influenza virus. The AHMPPI outlines that candidate vaccines are held because they may provide partial protection against a virus if it emerges as a pandemic strain. As planning for the administration of a pandemic vaccine was originally based on mass vaccination clinics, the NMS also included enough ancillary medical supplies (consumables), such as alcohol swabs, hand rubs, needles and syringes, to assist with the administration of the vaccine. When packaged together, these are known as PanFlu VacPacks.

Specific stocks in the NMS were allocated to support border staff and healthcare workers involved in screening and assessing passengers at the Australian border, and arriving international passengers and aircrew in quarantine. These planned supplies of PPE equipment were pre-packed and stored ready for rapid distribution.

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8.1.2 Policies for use of the NMS

The AHMPPI outlines the broad policy for priority access to PPE and antiviral medications from the NMS. Decisions regarding the use of NMS stockpiled items are made on the advice of the AHPC based on the risk of exposure, the availability of supply and the most effective approach to mitigating the risk of pandemic influenza in the community. Planning for the use of antiviral medications from the NMS is based on the recognition that these medicines need to be used strategically because stocks are finite and replenishment during a pandemic may not be possible due to worldwide demand and production limitations.

Planning assumes that, in the early stages of a pandemic while case numbers remain small, general practices would remain responsible for sourcing and storing their own PPE and any other equipment for office staff, as normally occurs for seasonal influenza.

8.1.3 Deployment of the NMS

To ensure rapid and effective distribution of the NMS, the DoHA has held Memoranda of Understanding (MOUs) with each state and territory since 2006. These MOUs set out responsibilities for the receipt, storage and deployment of NMS items. The Australian Government would distribute stocks to predetermined receiving sites in the states and territories, and each state and territory would be responsible for distributing stocks as needed. As international borders are an Australian Government responsibility, deployment of stockpile items required for border workers and quarantine would be an Australian Government responsibility.

The approval process to release supplies from the NMS requires a jurisdictional Chief Health Officer (CHO) to request items from the NMS in writing. Each request would be approved by both a Deputy Secretary of the Department of Health and Ageing and the Chief Medical Officer (CMO). Once approved, the stock would be deployed from NMS supplies and delivered to the nominated jurisdictional receiving site.