Because chemical incidents are unpredictable, and the onset of chemical injury very rapid, it is vital that FDA-approved treatments are readily available at the scene to quickly treat victims of chemical exposure. The existing national stockpiles have focused capabilities to treat specific chemical incidents, e.g., CHEMPACK for nerve agent release; however, drug supply is limited and distance may delay timely delivery of lifesaving MCMs to the scene of a chemical incident. To address these limitations, our “treat the injury not the agent” approach has led us to invest in the repurposing of drugs used to treat common injuries that are similar to those caused by chemicals, to support their use in chemical incidents. The goal of the repurposing program is to enable the use of existing hospital formularies and emergency supply caches to develop an MCM armamentarium of readily available--and familiar-- treatments for use in a chemical emergency.

Repurposing of common drugs that are available locally in hospitals and pharmacies will reduce reliance on centralized stockpiles. This will, in turn, reduce the need for emergency managers and authorities to develop complex deployment strategies for stockpiled treatments during a chemical emergency. Using common drugs to treat chemical injury will simplify response and ensure that responders are able to rapidly access the drugs to treat victims in an emergency.

To best address MCM needs in our communities, it is imperative for BARDA to understand the priorities, requirements, and needs of the emergency response and medical personnel – the end users – who respond to public health emergencies caused by chemical agents. To this end, and to support the repurposing paradigm, the Chemical MCM Program is expanding end user engagement to understand our customers’ MCM needs and to ensure that BARDA’s priorities are aligned with responders’ needs on issues related to novel chemical MCM development, strategies to support community use of repurposed drugs, and development of improved technologies for simple and rapid drug delivery. Direct engagement provides an opportunity to ensure that BARDA is providing treatments and technologies with the end user in mind, with the goal of improving preparedness for both known and unknown chemical threats. End-user engagement and clear regulatory guidance will enable success in our mission to improve the health outcomes for all victims of chemical exposure.