missioned the Institute of Medicine (IOM) to undertake a study that would inform the use of prepositioned antibiotics for the public for protection against an anthrax attack (Box 1-1).

To respond to this charge, the IOM appointed the Committee on Prepositioned Medical Countermeasures for the Public, bringing together 16 experts with a broad spectrum of expertise, including state and local public health preparedness, emergency medicine and response, infectious disease, pediatrics, toxicology, systems analysis and operations research, materials management and supply chains, economics, health systems, the

BOX 1-1
Statement of Task

In response to a request from the Department of Health and Human Services (HHS) Office of the Assistant Secretary for Preparedness and Response (ASPR), the Institute of Medicine will convene an ad hoc committee of subject matter experts to inform the use of prepositioned medical countermeasures (MCM) for the public. The committee will focus on prepositioning antibiotics for protection against a terrorist attack using Bacillus anthracis or a similar pathogen. More specifically, the ad hoc committee will produce a report that will:

• Consider the role of prepositioned medical countermeasures for the public (e.g., prepositioning at home, local stockpiles, and workplace caches) within an overall MCM dispensing strategy that includes traditional MCM dispensing and distribution strategies such as points of dispensing (PODs), taking into account both logistical and non-logistical factors (e.g., safety and ethics).

• Identify and describe key factors and variables that should be included in a strategy for prepositioning MCM for the public (e.g., population demographics, threat status, proximity to high-value targets, proximity to healthcare facilities).

• Discuss preliminary considerations for the development of an incremental and phased MCM prepositioning strategy.

• Based on available evidence, describe economic advantages and disadvantages of various MCM prepositioning strategies for the public.

The committee will develop scenarios, as needed, to illustrate the interaction of the strategic considerations, key factors, and variables in different situations and environments. The committee will base its recommendations on currently available published literature and other available guidance documents and evidence, expert testimony, as well as its expert judgment.

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