During his first term of office, President Trump issued Executive Order 13944 to create a Strategic Active Pharmaceutical Ingredient Reserve (SAPIR) stockpile, but he maintains that the Biden administration did not advance his initiative. This executive order is aimed at carrying through on Trump’s previous executive order. To that end, the office of the Assistant Secretary for Preparedness and Response (ASPR) within the Department of Health and Human Services is directed to develop a list of approximately 26 drugs that are especially critical to the health and security of the United States and an accounting of existing, available funds that can be utilized to finance the preparation and opening of the SAPIR repository and to obtain and maintain a six-month supply of active pharmacy ingredients (APIs) for critical drugs. Within 90 days of the executive order, the ASPR is to update the ASPR’s 2022 list of 86 essential medicines and medical counter measures along with a plan to obtain from domestic manufacturers, where possible, and store and maintain a six-month supply of APIs of the updated essential medicines list that have not already been included in the list of the 26 drugs.