Skip directly to search Skip directly to A to Z list Skip directly to navigation Skip directly to page options Skip directly to site content

Medical Countermeasure Readiness

Medical countermeasures, or MCMs, are life-saving medicines and medical supplies regulated by the U.S. Food and Drug Administration (FDA) that can be used to diagnose, prevent, protect from, or treat conditions associated with chemical, biological, radiological, or nuclear (CBRN) threats, emerging infectious diseases or a natural disaster.

MCMs can include:

  • Biologic products, such as vaccines, blood products and antibodies
  • Drugs, such as antimicrobial or antiviral drugs
  • Devices, including diagnostic tests to identify threat agents, and personal protective equipment (PPE), such as gloves, respirators (face masks), and ventilators.

Cities Readiness Initiative

CDC’s Cities Readiness Initiative (CRI) is a federally funded program designed to enhance preparedness in the nation’s largest population centers, where nearly 60% of the population resides, to effectively respond to large-scale public health emergencies needing life-saving medications and medical supplies. State and large metropolitan public health departments use CRI funding to develop, test, and maintain plans to quickly receive medical countermeasures from CDC’s Strategic National Stockpile and distribute them to local communities. The Strategic National Stockpile is the nation’s largest supply of medical countermeasures for use in a public health emergency severe enough to cause local supplies to run out.

Participating Cities and Metropolitan Areas

The CRI project began in 2004 with 21 cities and has expanded to include a total of 72 cities and metropolitan statistical areas (MSAs) with at least one CRI city in every state.

CRI Cities and Metropolitan Areas
Albany, NY
Albuquerque, NM
Anchorage, AK
Atlanta, GA
Baltimore, MD
Baton Rouge, LA
Billings, MT
Birmingham, AL
Boise, ID
Boston, MA
Buffalo, NY
Burlington, VT
Charleston, WV
Charlotte, NC
Cheyenne, WY
Chicago, IL
Cincinnati, OH
Cleveland, OH
Columbia, SC
Columbus, OH
Dallas, TX
Denver, CO
Des Moines, IA
Detroit, MI
District of Columbia
Dover, DE
Fargo, ND
Fresno, CA
Hartford, CT
Honolulu, HI
Houston, TX
Indianapolis, IN
Jackson, MS
Kansas City, MO
Las Vegas, NV
Little Rock, AR
Los Angeles, CA
Louisville, KY
Manchester, NH
Memphis, TN
Miami, FL
Milwaukee, WI
Minneapolis, MN
Nashville, TN
New Haven, CT
New Orleans, LA
New York City, NY
Oklahoma City, OK
Omaha, NE
Orlando, FL
Peoria, IL
Philadelphia, PA
Phoenix, AZ
Pittsburgh, PA
Portland, ME
Portland, OR
Providence, RI
Richmond, VA
Riverside, CA
Sacramento, CA
Salt Lake City, UT
San Antonio, TX
San Diego, CA
San Francisco, CA
San Jose, CA
Seattle, WA
Sioux Falls, SD
St. Louis, MO
Tampa, FL
Trenton, NJ
Virginia Beach, VA
Wichita, KS


CRI is funded through CDC’s PHEP cooperative agreement. Funds are provided to the states for further distribution to the local level and to four large metropolitan areas: Chicago, Los Angeles County, New York City, and Washington, D.C., in support of all-hazards medical countermeasure distribution and dispensing planning and preparedness.

FY 2016 Cities Readiness Initiative Funding

Technical Assistance to Ensure MCM Operational Readiness

CDC’s Office of Public Health Preparedness and Response (OPHPR), Division of State and Local Readiness (DSLR), provides technical assistance to the participating CRI jurisdictions for developing plans and testing their capability to receive, distribute, and dispense medical countermeasures. To ensure continued readiness, CDC and state public health personnel conduct operational readiness reviews to better determine a CRI jurisdiction’s ability to implement plans for distributing and dispensing medicines and medical supplies in response to an incident or exercise requiring medical countermeasures from CDC’s Strategic National Stockpile.

On-TRAC Logo

CDC developed the Online Technical Resource and Assistance Center (On-TRAC) to provide state and local public health departments a secure, user-friendly platform for requesting technical assistance. On-TRAC also offers access to new and existing preparedness systems, tools, and resources to assist with the distribution and dispensing of life-saving medications in a large-scale public health emergency.How to Access On-TRAC
Public health professionals must be registered with CDC Join to access On-TRAC. Individuals who already have a CDC Join account with DSLR are automatically provided with access to On-TRAC. Individuals who have not yet registered can complete and submit the CDC Join registration form. Make sure to check the On-TRAC box when completing the form. If you need help with your CDC Join user name and/or password, contact CDC JOIN by email at