Combating Terrorism

Chemical and Biological Medical Supplies Are Poorly Managed Gao ID: HEHS/AIMD-00-36 October 29, 1999

The ability of the United States to effectively respond to terrorist attacks involving chemical or biological weapons is compromised by poor management controls and the lack of items on a list of required inventory. For example, GAO's review of stockpiles maintained by the Department of Veterans Affairs found discrepancies of more than 12 percent with this list. Although most of these discrepancies were overages, GAO also found shortages. The underlying cause of these problems is that federal agencies have lagged in implementing basic internal controls to help ensure that all medical supplies and pharmaceuticals are current, accounted for, and ready for use. The stakes will be even higher in the future as the Centers for Disease Control and Prevention (CDC) establishes the National Pharmaceutical Stockpile Program, which will set aside large quantities of antidotes and other medical supplies to be used in the event of domestic chemical and biological attacks. Although CDC is still in the early stages of developing this program, its current plan lacks comprehensive internal controls that would prevent the types of problems that GAO found at other agencies.

GAO noted that: (1) the U.S. ability to effectively respond to chemical or biological terrorist incidents is compromised by poor management controls and the lack of required items; (2) GAO's physical inventory of the Office of Emergency Preparedness' (OEP) stockpiles, which the Department of Veterans Affairs (VA) manages, compared with OEP's required list showed a discrepancy of more than 12 percent; (3) although most discrepancies were overages, GAO also found shortages; (4) GAO found 3,400 excess gloves at one location and 400 extra diazepam vials at another; (5) GAO also found that the inventory was short of 1,000 required diazepam injectors at one location and another location had 500 fewer vials of diazepam than required; (6) in addition, when GAO compared its inventory with VA's inventory records, GAO found expired items; (7) at one location, the entire amount of amyl nitrate listed in VA's records had expired 8 months before GAO's visit, and at another location GAO found more than 400 vials of pralidoxime whose expiration date was recorded incorrectly; (8) in comparing the Marine Corps Chemical Biological Incident Response Force's (CBIRF) medical supplies with the records in its inventory tracking system, for approximately 26 percent of the inventory items GAO found either discrepancies between the inventory records and the amount in stock or errors in the recording of lot numbers and expiration dates; (9) the principal cause of problems GAO identified is that the responsible federal agencies did not implement basic internal controls that would reasonably assure that all medical supplies and pharmaceuticals are current, accounted for, and available for use; (10) consistent with the Federal Managers' Financial Integrity Act of 1982, agencies should have efficient and effective internal controls over their operations and programs; (11) neither OEP nor CBIRF explained its lack of compliance, and GAO identified problems in all major aspects of internal controls; (12) as a result, these systems cannot be relied upon to consistently and accurately account for the items required to be in the stockpiles; (13) even more will be at stake in the future as the Centers for Disease Control and Prevention (CDC) establishes the National Pharmaceutical Stockpile Program; and (14) although CDC is still in the early phases of developing this program, its current plan does not include comprehensive internal controls to prevent the types of problems found at the other agencies.

Recommendations

Our recommendations from this work are listed below with a Contact for more information. Status will change from "In process" to "Open," "Closed - implemented," or "Closed - not implemented" based on our follow up work.

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