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<ul><li>The FDA said though the agency is not aware of instances of this reduced activity occurring in the clinical setting but, is continuing to evaluate all data related to remdesivir.</li><li>The safety and efficacy of remdesivir for the treatment of COVID-19 continue to be evaluated, and preliminary clinical trial results have shown that on average, patients treated with remdesivir had more rapid time to recovery.</li><li>The Health Ministry on June 13 recommended the use of antiviral drug remdesivir in moderate stage of COVID-19 while backtracking from its earlier stance on hydroxychloroquine, saying the anti-malarial drug should be used in the early course of the disease and not on critically ill patients</li></ul> The US Food and Drug Administration (USFDA) warned healthcare providers against co-administration of <keyword id="9143069" type="PERSON" weightage="20" keywordseo="gilead-sciences-remdesivir">Gilead Sciences remdesivir</keyword>, which received emergency use authorization for COVID-19 patients, along with chloroquine phosphate or <keyword id="9409526" type="UNKNOWN" weightage="20" keywordseo="hydroxychloroquine-sulfate">hydroxychloroquine sulfate</keyword> as it may reduce the efficacy of the former. The FDA said though the agency is not aware of instances of this reduced activity occurring in the clinical setting but, is continuing to evaluate all data related to remdesivir. "FDA is warning health care providers that co-administration of remdesivir and chloroquine phosphate or hydroxychloroquine <keyword id="3860417" type="PERSON" weightage="20" keywordseo="Sulfate">sulfate</keyword> is not recommended as it may result in reduced antiviral activity of remdesivir. The agency is not aware of instances of this reduced activity occurring in the clinical setting but is continuing to evaluate all data related to remdesivir," the FDA said in a statement. Following an evaluation of the emergency use authorization criteria and scientific evidence available, the FDA issued an emergency use authorization (EUA) in May 2020 allowing remdesivir to be distributed in the US to treat COVID-19 in adults and pediatric patients hospitalised with severe disease. The safety and efficacy of remdesivir for the treatment of COVID-19 continue to be evaluated, and preliminary clinical trial results have shown that on average, patients treated with remdesivir had more rapid time to recovery. The Health Ministry on June 13 recommended the use of antiviral drug remdesivir in moderate stage of COVID-19 while backtracking from its earlier stance on hydroxychloroquine, saying the anti-malarial drug should be used in the early course of the disease and not on critically ill patients. Some of the Indian drug makers including Dr Reddys, Hetero, Jubilant Life Sciences and Cipla -- with which the original drug maker <keyword id="190845" type="COMPANY" weightage="20" keywordseo="Gilead-Sciences-Inc">Gilead Sciences Inc</keyword> have entered into non-exclusive licensing agreements are still awaiting the nod from DCGI for manufacturing and selling remdesivir in India.

FDA warns against co-administration of remdesivir with CQ or HCQ for COVID-19 patients

By Lalit K Jha Washington, Apr 25 () The US Food and Drug Administration has issued a safety communication regarding the known side effects of malaria drug hydroxychloroquine and chloroquine touted by President Donald Trump for treating coronavirus. The side effects include serious and potentially life-threatening heart rhythm problems.The FDA in a Drug Safety Communication said that hydroxychloroquine has been given Emergency Use Authorisation for the treatment of patients who have tested positive with coronavirus. These risks, FDA said are already in the drug labels for their approved uses and may be mitigated when health care professionals closely screen and supervise these patients such as in a hospital setting or a clinical trial. "We understand that health care professionals are looking for every possible treatment option for their patients and we want to ensure we're providing them with the appropriate information needed for them to make the best medical decisions," said FDA Commissioner Stephen M. Hahn."While clinical trials are ongoing to determine the safety and effectiveness of these drugs for COVID-19, there are known side effects of these medications that should be considered," he said. "We encourage health care professionals making individual patient decisions closely screen and monitor those patients to help mitigate these risks. The FDA will continue to monitor and investigate these potential risks and will communicate publicly when more information is available," Hann said. FDA said as of now it has issued an emergency use authorisation to allow hydroxychloroquine and chloroquine products donated to the Strategic National Stockpile (SNS) to be distributed and used in limited circumstances, such as for certain hospitalised patients with COVID-19. These drugs are able to be distributed from the SNS to states for doctors to prescribe to adolescent and adult patients hospitalized with COVID-19, as appropriate, when a clinical trial is not available or feasible. The EUA requires that fact sheets with important information about using these drugs in treating COVID-19, including the known risks and drug interactions, as well as appropriate screening and monitoring, be made available to health care providers and patients, FDA said. Hydroxychloroquine and chloroquine are FDA-approved to treat or prevent malaria. Hydroxychloroquine sulfate is also FDA-approved to treat lupus and rheumatoid arthritis. FDA said these medicines have not been proven safe or effective for treating COVID-19. However, clinical trials are underway and additional trials are being planned to determine if these drugs can benefit patients with COVID-19. These trials are also examining whether the drugs can prevent COVID-19 among health care workers, first responders or people who have been in close contact with someone with COVID-19. Trump has been an advocate of use of this drug, which has reportedly cured a large number of patients in New York and several other place. Reports indicates that the malaria drug has been effective during the initial phases of a person being infected by coronavirus but poses dangers to those having heart ailments. LKJ RHL

COVID-19: FDA warns against side effects of hydroxychloroquine

New York, Apr 7 () A New Jersey-based generic pharmaceutical company, co-founded by two Indian-Americans has donated millions of hydroxychloroquine sulfate tablets to Louisiana, New York and Texas to help COVID19 patients.Amneal Pharmaceuticals has pledged to donate 400,000 hydroxychloroquine sulfate tablets to the State of Louisiana to help respond to the COVID-19 health emergency, according to a press release dated March 30 from Louisiana Attorney General Jeff Landry.However, the US government's top infectious disease specialist Anthony Fauci has been vocal about his concern that there is not enough evidence to suggest that Hydroxychloroquine is the drug that cures COVID19.The release said that the large donation will go toward clinical trials and patient treatment in Louisiana.Hydroxychloroquine, an old and inexpensive drug used to treat malaria, is seen as a viable therapeutic solution by President Trump to coronavirus that has so far killed more than 10,000 Americans and infected over 3.6 lakh within weeks. Bridgewater, New Jersey-headquartered Amneal was founded in 2002 by Chirag Patel and Chintu Patel, who are also the Co-CEOs. "Amneal has donated millions of hydroxychloroquine sulfate tablets in total to states other than Louisiana, including New York and Texas, and stated they will provide more as needed. The company also announced donations of products directly to hospitals across the country," the release added.The press release from the Louisiana Attorney General quoted Chirag and Chintu Patel as saying that "all of us at Amneal are committed to supporting our communities in the global fight against COVID-19. We are working with urgency to assist the hardest hit states and hospitals around the country to benefit as many patients as possible during this critical time."Amneal's hydroxychloroquine sulfate tablets are approved by the United States Food and Drug Administration (FDA) to treat malaria, rheumatoid arthritis, lupus, childhood arthritis, and other autoimmune diseases. Hydroxychloroquine is not FDA-approved for the treatment of COVID-19; but it has been identified as a possible treatment for COVID-19, and the US Government has requested its immediate availability, the release said.Landry thanked Amneal for the donation and said "it is important we all work together to help solve the COVID-19 crisis." The Louisiana State University School of Medicine is working to launch two different clinical trials using hydroxychloroquine in relation to COVID-19. One trial will utilise hydroxychloroquine on those who have significant COVID-19 disease.The other trial protocol will use and test the drug as a preventative measure for those healthcare workers on the front lines battling the epidemic. Trials will be conducted at the University Medical Center in New Orleans and at the LSU Medical School locations in Baton Rouge and Lafayette.Dean of LSUHSC School of Medicine Steve Nelson said the donation will allow them to conduct clinical trials examining how hydroxychloroquine may help clear the virus from the lungs of infected patients and to potentially help shield healthcare workers who are on the front lines treating patients."The hydroxychloroquine donation by Amneal comes at an important time. The Louisiana Board of Pharmacy has noted serious concerns over the availability of this drug and has issued specific guidance on the dispensing of the drug, including its March 25th guidance noting that it should be dispensed for COVID-19 when the prescription bears a COVID-19 diagnosis," the release said. YAS PMSPMS

Pharma company founded by Indian-Americans donates hydroxychloroquine tablets in US

By Lalit K Jha(Eds: Updating with more inputs) Washington, May 19 () US President Donald Trump has disclosed that he is taking daily doses of antimalarial drug hydroxychloroquine to ward off the coronavirus, though health officials have warned it may be unsafe. Speaking at a meeting of restaurant executives on Monday, Trump said he began taking the drug after consulting the White House doctor, though stopped short of saying his physician had actually recommended it."A couple of weeks ago, I started taking it," the president said. "I have been taking it (hydroxychloroquine) for about a week and a half," he told reporters, asserting that he has zero symptoms of the deadly COVID-19, which has killed over 90,000 Americans in the past three months. There is no evidence hydroxychloroquine can fight off coronavirus, though clinical trials are under way. Medical experts and the US Food and Drug Administration have questioned the efficacy of the antimalarial drug and warned of the potentially harmful side effects. Trump said he consulted his doctors but was not explicitly recommended by the White House physicians. "White House doctor didn't recommend. I asked him, what do you think? He said well, if you'd like it. I said yeah, I'd like it. I'd like to take it," he said. Trump said he has been taking a pill of the antimalarial drug daily. "I take a pill every day. At some point, I'll stop. What I'd like to do is I'd like to have the cure and/or the vaccine, and that will happen, I think, very soon," he asserted. Soon after Trump revealed to the world that he has been taking the medicine, the White House doctor said the president is in good health. "The president is in very good health and remains symptom-free. He receives regular COVID-19 testing, all negative to date," Dr Sean P Conley, White House physician, said in a memorandum to Press Secretary Kayleigh McEnany. Two weeks ago, one of the president's support staff had tested positive for coronavirus. "After numerous discussions, he and I had regarding the evidence for and against the use of hydroxychloroquine, we concluded the potential benefit from treatment outweighed the relative risk," Dr Conley said. Observing that a lot of people have been taking this malaria drug, Trump said lot of frontline workers are taking hydroxychloroquine. "I don't take it because, hey, people said oh maybe he owns the company. No, I don't own the company. You know what, I want the people of this nation to feel good. I don't want them being sick. And there's a very good chance that this has an impact, especially early on," Trump said. "I take it (hydroxychloroquine) because I think I hear very good things. Again, you have to go to frontline workers. Many frontline workers take it, and they seem to be doing very well," Trump added. The president said he has zero symptoms of coronavirus. "No, I haven't had any symptoms. I test every couple of days they want to test me, you know, for obvious reasons. So every couple of days I get tested, and I've shown always negative, right, negative. …. Totally negative, no symptoms, no nothing," he said. Hydroxychloroquine sulfate was first synthesised in 1946 and is in a class of medications historically used to treat and prevent malaria. It is approved by the US Food and Drug Administration to treat malaria, rheumatoid arthritis, lupus, childhood arthritis, and other autoimmune diseases. The drug is not FDA-approved for the treatment of COVID-19 but it has been identified as a possible treatment for the infection and the US government has requested its immediate availability. LKJ RDK AKJ

Trump says he is taking unproven drug hydroxychloroquine to ward off coronavirus

By Yoshita Singh New York, Apr 7 () President Donald Trump, who has aggressively promoted the use of hydroxychloroquine to treat coronavirus patients in and has asked India to export the anti-malarial drug to the US, has a "small personal financial interest" in the French pharma giant Sanofi, one of the manufacturers of the drug, according to a media report. Hydroxychloroquine, an old and inexpensive drug used to treat malaria, is seen as a viable therapeutic solution by President Trump to coronavirus that has so far killed more than 10,000 Americans and infected over 3.6 lakh within weeks. On Monday, Trump warned India that the US may retaliate if it did not export hydroxychloroquine despite his personal request, saying he would be surprised if New Delhi did not relent as it has good relations with Washington. "If hydroxychloroquine becomes an accepted treatment, several pharmaceutical companies stand to profit, including shareholders and senior executives with connections to the president. Trump himself has a small personal financial interest in Sanofi, the French drugmaker that makes Plaquenil, the brand-name version of hydroxychloroquine," according to a report in The New York Times. The NYT report added that several generic drugmakers are al\gearing up to produce hydroxychloroquine pills, including Amneal Pharmaceuticals, co-founded by Indian-Americans Chirag Patel and Chintu Patel. Amneal is donating 400,000 hydroxychloroquine sulfate tablets to the State of Louisiana and has donated millions of the tablets to other states, including New York and Texas. Amneal also announced donations of products directly to hospitals across the country. The NYT report said that Chirag Patel is a member of Trump National Golf Course Bedminster in New Jersey and "has golfed with Trump at least twice since he became president," according to a person who saw them, the NYT said. Patel, whose company is based in Bridgewater, N.J., did not respond to a request by NYT for comment. Other generic drugmakers are ramping up production, including Mylan and Teva Pharmaceutical Industries. However, the US government's top infectious disease specialist Anthony Fauci has been vocal about his concern that there is not enough evidence to suggest that Hydroxychloroquine is the drug that cures COVID-19. Making his concern clear last week, Fauci said on Fox News, "I think we've got to be careful that we don't make that majestic leap to assume that this is a knockout drug. We still need to do the kinds of studies that definitively prove whether any intervention, not just this one, any intervention is truly safe and effective." A Sanofi spokeswoman Ashleigh Koss said the company no longer sells or distributes Plaquenil in the United States, although it does sell it internationally. The NYT report added that while Trump may ultimately be right about the use of the drug, "the president's assertiveness in pressing the case over the advice of advisers like Dr Anthony S Fauci, the government's top infectious disease specialist, has driven a wedge inside his coronavirus task force and has raised questions about his motives." It said that some of Trump's associates have "financial interests" in the issue. "Sanofi's largest shareholders include Fisher Asset Management, the investment company run by Ken Fisher, a major donor to Republicans, including Mr. Trump," the NYT report said. It added that another investor in both Sanofi and Mylan, another pharmaceutical firm, is Invesco, the fund previously run by Commerce Secretary Wilbur Ross. In a statement Monday, Ross said that he "was not aware that Invesco has any investments in companies producing" the drug, "nor do I have any involvement in the decision to explore this as a treatment." As of last year, Trump reported that his three family trusts each had investments in a Dodge &amp; Cox mutual fund, whose largest holding was in Sanofi. Roberto Mignone, a Teva board member, reached out to the team of Jared Kushner, the president's son-in-law and senior adviser, through Nitin aigal, who used to work for Mignone and is a friend of Kushner's, according to people informed about the discussions, the report said. YAS PMS AKJ PMSPMS

Trump has small financial interest in French pharma giant that makes hydroxychloroquine: NYT

By Lalit K Jha Washington, May 19 () US President Donald Trump on Monday said he has been taking anti-malaria drug hydroxychloroquine as a preventive measure against coronavirus. "I have been taking it (hydroxychloroquine) for about a week and a half," Trump told reporters at the White House, asserting that he has zero symptoms of the deadly COVID-19, which has killed over 90,000 Americans in the past three months. Trump said he consulted his doctors in this regard but was not explicitly recommended by White House physicians. "White House doctor didn't recommend. I asked him, what do you think? He said well, if you'd like it. I said yeah, I'd like it. I'd like to take it," he said. Trump said he has been taking a pill of the anti-malaria drug a day. "I take a pill every day. At some point, I'll stop. What I'd like to do is I'd like to have the cure and/or the vaccine, and that will happen, I think, very soon," he asserted. Soon after Trump revealed to the world that he has been taking the medicine, the White House doctor said the president is in good health. "The president is in very good health and remains symptom-free. He receives regular COVID-19 testing, all negative to date," Dr Sean P Conley, White House physician, said in a memorandum to Press Secretary Kayleigh McEnany. Two weeks ago, one of the president's support staff had tested positive for coronavirus. "After numerous discussions, he and I had regarding the evidence for and against the use of hydroxychloroquine, we concluded the potential benefit from treatment outweighed the relative risk," Dr Conley said. Observing that a lot of people have been taking this malaria drug, Trump said lot of frontline workers are taking hydroxychloroquine. "I don't take it because, hey, people said oh maybe he owns the company. No, I don't own the company. You know what, I want the people of this nation to feel good. I don't want them being sick. And there's a very good chance that this has an impact, especially early on," Trump said. "I take it (hydroxychloroquine) because I think I hear very good things. Again, you have to go to frontline workers. Many frontline workers take it, and they seem to be doing very well," Trump added. The president said he has zero symptoms of coronavirus. "No, I haven't had any symptoms. I test every couple of days they want to test me, you know, for obvious reasons. So every couple of days I get tested, and I've shown always negative, right, negative. …. Totally negative, no symptoms, no nothing," he said. Hydroxychloroquine sulfate was first synthesised in 1946 and is in a class of medications historically used to treat and prevent malaria. It is approved by the US Food and Drug Administration to treat malaria, rheumatoid arthritis, lupus, childhood arthritis, and other autoimmune diseases. The drug is not FDA-approved for the treatment of COVID-19 but it has been identified as a possible treatment for the infection and the US government has requested its immediate availability. LKJ RDKRDK

Taking anti-malaria drug for protection against virus, says Trump

<div class="KonaFilter image-container display-table float_right"><div><div class="image on-image">Flickr/Kiran Foster</div></div></div>We just got a better picture of how much money government agencies are spending on prescription drugs.On Monday, the Centers for Medicare and Medicaid Services, which covers roughly 100 million Americans, <a href="https://blog.cms.gov/2016/11/14/updated-medicare-and-medicaid-drug-spending-dashboard/">reported on the drugs</a> it spent the most money on in 2015, as well as how many people are using them. The intent of the report is to "to provide a better sense of the frequency and pervasiveness of these increases," the agency noted.The biggest price increases, not accounting for rebates, between 2014 and 2015 were:<ul><li>Glumetza, a diabetes drug made by Valeant Pharmaceuticals: 381.40%</li><li>Hydroxychloroquine Sulfate, a generic drug that's used to treat arthritis and malaria: 371.80%</li><li>Pennsaid, a topical drug used to treat osteoarthritis pain in the knee: 296.40%</li><li>Econazole Nitrate, a generic antifungal cream: 275.70%</li><li>Mitomycin, a generic chemotherapy drug: 163.10%</li></ul><h2>Biggest expenses</h2>The report also documented the drugs Medicare and Medicaid spent the most money on in 2015. For Medicare, the most money in 2015 was spent on Harvoni, a drug that's used to cure hepatitis C ($7.4 billion). It was followed by Lantus, a type of long-lasting insulin ($4.3 billion) and Crestor came in third at $2.8 billion. It's important to note that these data didn't factor in rebates, or the money drug companies paid back to Medicare.The number of people using Harvoni jumped from 2014 to 75,700 people from 11,718 in 2014, though Lantus and Crestor did not experience that spike. Here's what it looked like for Medicaid (again, rebates aren't factored in here):<div class="KonaFilter image-container display-table"><div><div class="image on-image">CMS</div></div></div><h2>What Medicare gets in rebates</h2>For the first time, CMS was able to give us <a href="https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Information-on-Prescription-Drugs/2014_PartD_Rebates.html">averages of the rebates</a> it got from drug manufacturers for its Part D program, which manages prescription drugs. Overall, that rebate was 17.5%, or $16 billion of the $93 billion paid for drugs in 2014. Rebates to cardiovascular drugs were the highest (26.3%), followed closely by rebates to hormones and synthetic substitutes (25%).Understanding what rebates get paid is critical to understanding the impact increased drug prices are having on the people who pay for them. Without a clear picture of the rebates, the public's understanding of why the prices of prescription drugs continue to climb is limited to just the price we see at the pharmacy counter, or data based on the list price. <div class="margin-top"> <h3>NOW WATCH: <a href="http://www.businessinsider.com/jon-ronson-psychopath-test-psychology-2016-10">CEOs and business leaders are 4 times more likely to be psychopaths than the average person</a></h3> <div> <div> <div class="ooyala-video-player" data-video-autoplay="false" data-video-id="xxMzl3dDow-R28pScWGuiAPHIeSaFV_2" data-player-variable="ooyalapopvideo" id="ooyalaplayer_popvideo" style="width:1280px;height:720px"></div> </div> </div> </div>

These drugs had the highest price increases in 2015 - according to the government agency that pays for them

<ul class="summary-list"><li>Under President Bill Clinton, the US government began stockpiling antitoxins and vaccines in case of a large-scale bioterror attack. Medical equipment was added in 2003, when the reserve was renamed the Strategic National Stockpile.</li><li>Stored in secret warehouses around the US, SNS supplies can be deployed via "push packages" containing more than 50 tons of drugs, masks, ventilators, and other life-saving equipment.</li><li>SNS assets have been used to address 9/11, Hurricane Katrina, and the 2009 H1N1 pandemic. But analysts say now the depleted reserves aren't nearly enough to address the coronavirus pandemic.</li><li>Adequately funding and supplying the stockpile, former SNS director Greg Burel told Business Insider, is "ultimately is a matter of national security."</li><li><a href="https://www.businessinsider.com/?hprecirc-bullet">Visit Business Insider's homepage for more stories</a>.</li></ul>The Strategic National Stockpile is a federally controlled repository of pharmaceuticals and medical equipment that's designed to save American lives in times of crisis.But as the coronavirus pandemic depletes its reserves, experts question whether it has enough supplies - and funding - to achieve that mission.The SNS started as the National Pharmaceutical Stockpile in 1999 after President Bill Clinton <a href="https://www.congress.gov/105/plaws/publ277/PLAW-105publ277.pdf">directed $51 million</a> to the Centers for Disease Control and Prevention to amass a supply of antitoxins and vaccines to combat a possible bioterror attack.The government had previously kept supplies of antibiotics for troops to use, but this marked the first time it gathered a stockpile for civilians. Clinton had read Richard Preston's bioterror thriller "The Cobra Event" and wanted to move swiftly to prepare the country for a possible real-world incident, <a href="https://time.com/5800393/coronavirus-national-stockpile-history/">Time magazine reported</a>.The reserve was <a href="https://www.phe.gov/about/sns/Pages/responses.aspx">renamed the Strategic National Stockpile in 2003</a>, when the Bush administration placed it under the joint management of the Department of Health and Human Services and Homeland Security and expanded it to include medical equipment.A year later, it was <a href="https://chemm.nlm.nih.gov/sns.htm">returned to HHS oversight</a> with the passing of the Project Bioshield Act, which approved $5 billion in vaccines to thwart a bioterrorism attack. Since 2018, Robert Kadlec, HHS Assistant Secretary for Preparedness and Response, has overseen the SNS.<h2>The Strategic National Stockpile wasn't formed to address a global pandemic</h2>"The primary purpose of the Strategic National Stockpile is to be prepared to respond to chemical, biological, radiological, and nuclear (CBRN) events," Greg Burel, the director of the SNS for 12 years until his retirement in January, told Business Insider.Many drugs that would need to be used to respond to CBRN events, Burel said, "cannot be rapidly moved from commercial sources and administered in highly compressed timeframes - often less than 48 hours after an exposure to an agent."Fearing a global influenza pandemic, the Bush administration in 2005 requested personal protective equipment be added to the reserves. A year later, Congress approved the <a href="https://www.nytimes.com/2020/03/25/opinion/coronavirus-face-mask.html">purchase of 52 million surgical masks and 104 million N95 masks</a>.<h2>Where is the stockpile kept?</h2>The SNS is spread out in a series of secret warehouses around the US that are protected by armed guards. Supplies are constantly being added and removed but the SNS warehouse in Oklahoma, for example, houses roughly 4 million pairs of gloves, 900,000 surgical and medical masks, 173,000 face shields and goggles, and 120,000 gowns, <a href="http://www.apimages.com/metadata/Index/Virus-Outbreak-Oklahoma/598c1e48d7794886852dc60c03d02f8c/8/0">the AP reported</a>.The SNS has 12 <a href="https://www.kdheks.gov/cphp/download/Intro_SNS.pdf">"push packages,"</a> each equipped with more than 50 tons of drugs, sera, IV fluids, bandages, ventilators, and other life-saving equipment. They require 12,000 square feet of floor space - enough to support 300,000 people for up to 10 days - and can be shipped out within 12 hours by unmarked planes and trucks.The federal government deployed push packs to New York and Washington following the 9/11 attacks.There are also caches of nerve agent antidotes, known as CHEMPACKs, strategically placed in more than 1,340 locations nationwide, mostly in hospitals and fire stations.SNS assets have been deployed following Hurricane Katrina, Superstorm Sandy, and other natural disasters. The SNS was used to fight the H1N1 pandemic in 2009, when <a href="https://safetyequipment.org/wp-content/uploads/2015/03/HHSletter20090723.pdf">tens of millions of masks and other PPE</a> were shipped out across the country.But those supplies were never replenished.<a href="https://www.phe.gov/about/sns/Pages/responses.aspx">HHS reported</a> that, as of April 7, 2020, 10,628 tons of SNS cargo has shipped to support US repatriation efforts and state PPE needs during the pandemic.<h2>The stockpile is facing dangerous shortages</h2>At the start of 2020, the SNS had approximately 13 million N95 masks - <a href="https://www.businessinsider.com/usa-1-percent-3-billion-face-masks-needed-coronavirus-pandemic-2020-3">barely 1%</a> of what healthcare workers are expected to need before the coronavirus pandemic is under control.In a statement Wednesday to the House Oversight Reform Committee, HHS officials said 90% of the stockpile's protective equipment has already been used to fight COVID-19. According to federal purchasing records obtained by <a href="https://www.msn.com/en-us/news/us/hhs-federal-stocks-of-protective-equipment-nearly-depleted/ar-BB12lHO4?li=BBnb7Kz">the Associated Press</a>, HHS bought more N95 masks in March, but they won't be delivered until the end of April.The Federal Emergency Management Agency <a href="https://www.nytimes.com/reuters/2020/04/11/us/11reuters-health-coronavirus-usa-ventilators.html">has also acknowledged</a> there aren't enough ventilators in the stockpile to meet current needs.While masks and ventilators can be stored for an extended period, vaccines, antibiotics, and other drugs have a limited shelf life."SNS material is constantly managed and rotated for disposal when it is ultimately expired," Burel said. "The goal is to have acquisitions in place to fill-behind expiring product as it is cycled out due to expiry."In March, pharmaceutical companies donated 30 million doses of hydroxychloroquine sulfate to the SNS for clinical trials or use in treating COVID-19 patients. Early studies in France and China have suggested the drug may be beneficial in combating the coronavirus, but <a href="https://www.businessinsider.com/coronavirus-treatment-clinical-data-on-hydroxychloroquine-in-covid-19-2020-4">experts warn of its side effects and say much more testing is needed</a>.There are also questions about the quality of the equipment in the reserves: At <a href="https://www.whitehouse.gov/briefings-statements/remarks-president-trump-vice-president-pence-members-coronavirus-task-force-press-briefing-21/">an April 7 press briefing</a>, President Donald Trump said the SNS had more than 10,000 ventilators (FEMA puts the number at <a href="http://www.accg.org/docs/Covid-19/FEMA_COVID_Advisory_4.08_20.pdf">8,044</a>), with thousands already deployed to states in need.In March, <a href="https://www.businessinsider.com/new-york-got-damaged-ventilators-from-national-stockpile-2020-3">Business Insider reported</a> that some of the 4,000 ventilators delivered to New York were damaged and missing parts.Chicago Mayor Lori Lightfoot <a href="https://www.businessinsider.com/coronavirus-us-national-stockpile-almost-empty-worst-yet-to-come-2020-4">said</a> she has "serious questions as to whether or not there is a robust stockpile at the federal level."<h2>Disagreements about the stockpile's purpose</h2>The Trump administration has argued that the SNS wasn't intended to supply states with everything they need. "You also have a situation where, in some states, FEMA allocated ventilators to the states," Senior White House adviser Jared Kushner <a href="https://www.businessinsider.com/jared-kushner-coronavirus-briefing-federal-stockpiles-blames-states-ventilator-shortages-2020-4">said in his first coronavirus task force briefing</a>. "And you have instances where, in cities, they're running out but the state still has a stockpile. And the notion of the federal stockpile was it's supposed to be our stockpile - it's not supposed to be state stockpiles that they then use."The HHS website originally described the stockpile as designed to help "when state, local, tribal, and territorial responders request federal assistance to support their response efforts."After Kushner's comments, though, that <a href="https://www.businessinsider.com/dhhs-rewrites-national-stockpile-definition-to-not-contradict-kushner-2020-4">text changed</a> to more closely reflect his view."The Strategic National Stockpile's role is to supplement state and local supplies during public health emergencies. Many states have products stockpiled, as well," it now reads. "The supplies, medicines, and devices for life-saving care contained in the stockpile can be used as a short-term stopgap buffer when the immediate supply of adequate amounts of these materials may not be immediately available."<h2>'An urgent need to fund public health at all levels'</h2>The SNS's budget has been slow to grow for more than a decade. In the wake of the 2009 swine flu pandemic, the CDC <a href="https://www.astho.org/Programs/Infectious-Disease/H1N1/H1N1-Barriers-Project-Report-Final-hi-res/">urged the federal government</a> to boost funding to prepare for "future events."The Obama administration requested $655 million for the stockpile in 2011, up from roughly $600 million the year prior. Congress ultimately <a href="http://www.cbo.gov/sites/default/files/cbofiles/attachments/hr307.pdf">approved $534 million</a>.In the 2020 federal budget, <a href="https://www.hhs.gov/sites/default/files/fy-2020-budget-in-brief.pdf?language=es">HHS was allocated $620 million</a> to replenish the reserves, up from $610 million in 2019. And Congress's <a href="https://www.appropriations.senate.gov/imo/media/doc/Coronavirus%20Supplemental%20Appropriations%20Summary_FINAL.pdf">$340 billion stimulus bill</a>, passed in March, included a $16 billion cash infusion for the SNS."There is an urgent need to fund public health at all levels from federal to state and local levels," Burel said. That's especially true, he added, if the stockpile "is expected to respond to emerging infectious disease, whether pandemic or not.""This ultimately is a matter of national security and needs to be taken as seriously as funding the Department of Defense to prepare our nation from an enemy attack."Do you have a personal experience with the coronavirus you'd like to share? Or a tip on how your town or community is handling the pandemic? Please email <a href="mailto:covidtips@businessinsider.com">covidtips@businessinsider.com</a> and tell us your story.Get the latest <a href="/coronavirus-business-impact">coronavirus business &amp; economic impact analysis</a> from Business Insider Intelligence on how COVID-19 is affecting industries.

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