CBRN Chemical Medical Countermeasures Program

Improving the Health Outcome for All Victims of Chemical Exposures.

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The Chemical Medical Countermeasures (Chem MCM) Program supports development of drugs and interventions to address chemical threats including opioids, chlorine, vesicants, nerve agents, and other priority chemicals. Because chemical incidents are unpredictable, injury happens quickly, and few diagnostics exist, medical providers must treat what they see. For this reason, our program focuses on developing threat-agnostic treatments aimed to "treat the injury, not the agent."

We take a holistic approach to ensuring that responders will have ready access the tools they need. This includes developing multipurpose treatments, repurposing common drugs, and always keeping the end user in mind.

Hear directly from Dr. Devon Andres about CBRN Chemical Medical Countermeasures Program 2022 priorities.
BARDA Industry Day 2021
Devon Andres, Biologist with the CBRN Vaccines Program
Pre-recorded for November 3, 2021 Download Video Transcript


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Broad Spectrum Medical Countermeasures

Broad Spectrum Medical Countermeasures

The sheer number of chemical threats, the unpredictability of chemical incidents, and the rapid onset of life-threatening injuries requires ready access to effective treatments. These challenges mean that the necessary MCMs must be widely available rather than distributed from centralized stockpiles. To best address chemical threats, we aim for a threat agnostic and broad spectrum approach that aligns with toxidrome identification, a standard practice of emergency medicine. To this end, the Chem MCM branch aims to develop MCMs that treat the injury, not the agent.

Exposure to chemicals can cause injuries that share symptomology, or toxidrome, with commonly seen medical conditions. Our priority threats can be binned into five diagnostic toxidromes: neurologic, pulmonary, respiratory, metabolic, and vesicating. Recognizing these toxidromes allows for the assessment and treatment of chemical injury without the need to identify the specific chemical causing such injury—allowing for broad spectrum therapeutic utility and aligning with standard emergency medicine practice. Treat the injury, not the agent is our watchword.

The strategy of using drugs which are already FDA approved (or in development for common clinical indications) to treat chemical injury provides opportunities to develop multipurpose, broad-spectrum drug candidates that would be readily available to emergency responders where and when they need them. BARDA has several mechanisms in place that provide opportunities for companies to partner with us for the advanced research and development of their candidates for a chemical MCM indication, including the ReDIRECT EZ-BAA as well as the traditional BARDA BAA.

Drug Repurposing

Drug Repurposing

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.

End-User Engagement

End-User Engagement

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.

Enabling Technologies and Simplified Drug Delivery

Enabling Technologies and Simplified Drug Delivery

To accelerate the development of chemical MCMs, the Chem MCM Program is investing in innovative enabling technologies for identification of promising drugs to treat chemical injury. These technologies include organ-on-a-chip platforms and artificial intelligence-driven drug screening to modernize drug delivery systems to rapidly deploy and administer life-saving treatments. Applying these cutting-edge technologies provides novel and innovative approaches to identify, screen, develop and repurpose broad spectrum MCMs for our priority chemical threats.

A second major area of interest is the development and manufacture of novel and simplified drug delivery technologies for rapid administration of MCMs. The purpose of this work is to find ways to easily deliver life-saving treatments in often harsh and chaotic emergency response situations. We also aim to develop platform technologies that can be rapidly adapted to address specific needs and can promote competition and reduce reliance on specific individual suppliers.

BARDA Programs

CBRN has a proven track record of developing life-saving medical countermeasures. We will continue to work with partners old and new to treat or prevent the medical consequences that result from CBRN threats.

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