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Cities Readiness Initiative

CDCís Cities Readiness Initiative (CRI) is a federally funded program designed to enhance preparedness in the nationís largest cities and metropolitan statistical areas where more than 50% of the U.S. population resides. Through CRI, state and large metropolitan public health departments have developed plans to respond to a large-scale bioterrorist event by dispensing antibiotics to the entire population of an identified MSA with 48 hours.

Participating Cities and Metropolitan Statistical Areas

The program was originally established in 2004 with a 21 cities that were selected based on criteria such as population and potential vulnerability to a bioterrorism threat. The program has grown to now include a total of 72 metropolitan statistical areas (MSAs), with at least one CRI MSA in every state.  

Technical Assistance to Ensure Readiness

CDC’s Office of Public Health Preparedness and Response, Division of Strategic National Stockpile provides technical assistance to the participating 72 MSAs for the development of their plans to receive, distribute, and dispense medical assets received from CDC’s Strategic National Stockpile. To ensure continued readiness, CDC and state public health personnel conduct annual technical assistance reviews to assess the plans for each local jurisdiction within their CRI MSAs and measure capacity for functions considered critical. The TAR scores (reviewed on a scale from zero to 100) for each local jurisdiction are combined to compute an average TAR score for the CRI MSA. A score of 69 or higher indicates a CRI location is performing in an acceptable range in its plans to receive, distribute, and Strategic National Stockpile medical assets.


Funding for the CRI program is provided to the 50 states and four metropolitan areas of Washington, D.C., Chicago, Los Angeles County and New York City through CDC’s Public Health Emergency Preparedness (PHEP) cooperative agreement. CDC’s Office of Public Health Preparedness and Response, Division of State and Local Readiness administers the PHEP cooperative agreement, provides annual guidance on preparedness activities that support the National Response Framework, and coordinates technical assistance.

Response Planning

CDC Emergency MedKit Evaluation Study Summary Fact Sheet
This fact sheet provides an overview of the emergency MedKit evaluation study which was designed to evaluate a strategy that addresses the timeliness of distributing antibiotics to the general public as an effective measure against a release of anthrax.

Page last reviewed May 20, 2010

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