Homeland Security Presidential Directive/HSPD–18—Medical Countermeasures Against Weapons of Mass Destruction

BACKGROUND (1) Weapons of Mass Destruction (WMD)—chemical, biological, radiological, and nuclear agents (CBRN)—in the possession of hostile states or terrorists represent one of the greatest security challenges facing the United States. An attack utilizing WMD potentially could cause mass casualties, compromise critical infrastructure, adversely affect our economy, and inflict social and psychological damage that could negatively affect the American way of life. (2) Our National Strategy to Combat Weapons of Mass Destruction (December 2002) and Biodefense for the 21st Century (April 2004) identify response and recovery as key components of our Nation’s ability to manage the consequences of a WMD attack. Our primary goal is to prevent such an attack, but we must be fully prepared to respond to and recover from an attack if one occurs. Accordingly, we have made significant investments in our WMD consequence management capabilities in order to mitigate impacts to the public’s health, the economy, and our critical infrastructure. The development and acquisition of effective medical countermeasures to mitigate illness, suffering, and death resulting from CBRN agents is central to our consequence management efforts. (3) It is not presently feasible to develop and stockpile medical countermeasures against every possible threat. The development of vaccines and drugs to prevent or mitigate adverse health effects caused by exposure to biological agents, chemicals, or radiation is a time-consuming and costly process. This directive builds upon the vision and objectives articulated in our National Strategy to Combat Weapons of Mass Destruction and Biodefense for the 21st Century to ensure that our Nation’s medical countermeasure research, development, and acquisition efforts: (a) Target threats that have potential for catastrophic impact on our public health and are subject to medical mitigation; (b) Yield a rapidly deployable and flexible capability to address both existing and evolving threats; (c) Are part of an integrated WMD consequence management approach informed by current risk assessments of threats, vulnerabilities, and capabilities; and (d) Include the development of effective, feasible, and pragmatic concepts of operation for responding to and recovering from an attack. (4) In order to address the challenges presented by the diverse CBRN threat spectrum, optimize the investments necessary for medical countermeasures development, and ensure that our activities significantly enhance our domestic and international response and recovery capabilities, our decisions as to the research, development, and acquisition of medical countermeasures will be guided by three overarching principles: (a) Our preparations will focus on countering current and anticipated threat agents that have the greatest potential for use by state and non-state actors to cause catastrophic public health consequences to the American people. (b) We will invest in medical countermeasures and public health interventions that have the greatest potential to prevent, treat, and mitigate the consequences of WMD threats.