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Operation Saline Shield

ASPR Prevented a Nationwide IV Fluid Shortage

In the wake of September 2024's Hurricane Helene, storm damage to one of the nation's largest intravenous (IV) fluid manufacturing facilities posed a major threat to hospital and clinic operations across the United States. Then, a second storm, Hurricane Milton, followed, threatening to worsen the already fragile situation at the North Carolina facility operated by Baxter International, Inc. (producer of roughly 60% of IV fluids used in North America).

To prevent a healthcare crisis, the Administration for Strategic Preparedness and Response's (ASPRs) Incident Based Medical Supply Chain (IBMSC) launched  Operation Saline Shield , a coordinated federal response to stabilize the national IV fluid supply.]

Key Actions Under Operation Saline Shield: 

  • Massive Importation Effort:  ASPR coordinated 98 airlift missions, delivering 13.9 million units of IV fluids from Baxter's international facilities. Flights began arriving in October and continued through the end of 2024.

  • Expedited Customs and Distribution:  Working closely with FDA and DHS, the team cut standard customs processing times from 60 days to same-day approval, allowing IV fluids to move immediately through distribution channels.

  • Domestic Supply Protection:  Anticipating Hurricane Milton, the team helped relocate 60 truckloads of critical IV fluids to ensure continued availability at healthcare facilities.

  • Regulatory Flexibility:  The FDA granted temporary approval for the import of 23 IV and peritoneal dialysis fluid products from five international Baxter sites, helping to meet U.S. demand while domestic production ramped up.

  • Facility Recovery Support:  ASPR used the Defense Production Act to secure remediation materials needed to restart operations at the North Carolina facility. Full utility and IT restoration was achieved quickly, and phased production resumed with 2,500 employees returning to work across multiple round-the-clock shifts. By February 2025, less than five months after the storm, the facility had returned to pre-hurricane production levels. By May, the facility's inventory levels had been restored, and all allocations were removed for virtually all IV Solutions product codes there.

On April 10, ASPR's IBMSC team, along with federal partners from the FDA, DHS Customs and Border Protection, and GSA, received the  Angels for Change Drug Shortage Guardian Award  in recognition of their efforts. The award highlighted the work that ASPR and its partners regularly do behind the scenes to support the private sector healthcare system, helping prevent disruptions in critical medical supply chains after natural disasters and national emergencies.

The Angels for Change advocacy group, which works to prevent drug shortages, called the team's success with Operation Saline Shield "extraordinary, unsung hero work that saved many lives."