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The Beginning

At the request of CDC’s National Center for Environmental Health/ Radiation Studies Branch and supported through a supplement to an existing cooperative agreement, the Association of State and Territorial Health Officials (ASTHO) led a project to research the necessity for and feasibility of developing a Radiation Alliance. To determine the feasibility of developing an Alliance a the Steering Committee, comprised of representatives from ASTHO , the Conference of Radiation Control Program Directors (CRCPD), the Council of State and Territorial Epidemiologists (CSTE), the National Association of County and City Health Officials (NACCHO) and the Association of Public Health Laboratories (APHL), with programmatic and subject matter expert support from key radiation officials from CDC/NHEH/RSB was convened in June 2009. The Steering Committee determined that the development of a National Alliance for Radiation Readiness (NARR) was a reasonable and worthwhile endeavor.

In order to begin the development of the NARR it was determined that there would be a one NARR member “sponsoring” organization that would provide administrative support to manage the development and maintenance of the NARR. CDC determined that ASTHO would be the sponsoring organization of the NARR, responsible for managing the cooperative agreement and funding, along with managing the execution of project work plans and deliverables. As a result, ASTHO provides an Executive Secretary to serve as the primary point of contact for NARR-related activities and who has been successfully coordinating the day-to-day activities of the NARR and its growth since its inception.


  • June 2008

    The Centers for Disease Control and Prevention (CDC) and Conference of Radiation Control Program Directors (CRCPD) sponsored a roundtable entitled “Communication and Teamwork: Keys to Successful Radiological Emergency Response”, which recommended the development of an alliance of organizations to expand the nation’s radiological emergency preparedness capabilities, and to elevate recognition of the roles and responsibilities of public health agencies in a radiological emergency.

  • April 2009

    The CDC and CRCPD sponsored a workshop entitled “Alliance to Expand Radiological Emergency Preparedness in Public Health” with the aim of building an alliance among professional organizations for sharing radiological emergency preparedness resources, tools and information.

  • June 2009 - May 2010

    An exploratory committee concludes that a National Alliance for Radiation Readiness is a necessary and viable undertaking, and drafts a mission, vision, purpose, structure, governance, and business plan (Final Report).

  • March 2011

    NARR is officially launched though support provided by CDC.

  • May 2012

    On November 17, 2011, the NARR conducted a 1-day after action review of the U.S. public health system’s response to the Fukushima nuclear incident.  Approximately 70 federal, state, and local officials participated in the AAR and discussed communication, coordination, leadership, data access and interpretation, food safety, population monitoring, lab capacity, along with other sectors of the U.S. public health response to the Fukushima nuclear incident. The review led to the development of an After-Action Report which documents the discussions and outcomes from the meeting.

  • November 2012

    ASTHO led the development of a temporary, ad-hoc subgroup of the NARR, the Laboratory Taskforce. The Taskforce was formed to develop a list of considerations for laboratories in prioritizing samples (clinical, environmental, and other) following a radiological incident. The Taskforce had its inaugural call in February 2012 and continued to meet via conference call monthly through May 2012. ASTHO, along with APHL, compiled the final prioritization document which was approved by all Taskforce members, Prioritization of Laboratory Samples Following a Radiological Event: Considerations.

  • May 2018

    ASTHO conducted a table top exercise (TTX) to test and validate the traveler screening protocol developed by the NARR during the 2011 Fukushima emergency. After the exercise, NARR workgroups formed to shape the guidance. Workgroups were developed to address these four areas: bioassay, communications, emergency management, and Epidemiology and Screening. In May 2018, the NARR published, Guidance for Traveler Screening at Ports of Entry Following an International Radiological Incident.

  • October 2019

    In 2018, ASTHO led a work group of NARR members to develop a series of public health training modules highlighting radiation subject matter experts (SMEs). Radiation emergencies require an all-hazards response with necessary additions to protect responders and receivers, limit health impacts and save lives. These modules are formatted through the four phases of response and approach radiation emergencies from the perspective of a multidisciplinary response across coordinating sectors, National Alliance for Radiation Readiness Radiation Training Modules for Public Health.

  • April 2021

    Beginning in 2021, ASTHO and the NARR have supported the CDC in the development of clinical guidance for the administration of medical countermeasures, including cytokines, that will be needed to save lives following a nuclear detonation. A Working Group comprised of NARR members advises ASTHO staff conducting a systematic review of related published research and will contribute to the development and dissemination of a comprehensive, evidence-based, clinical framework that will aid medical responders maximize benefit to affected patients.