Abstract Background The COVID-19 pandemic highlighted the need to improve preparedness for emerging health threats. This includes reserving assets for use in health emergencies, such as, shelters, energy supply items, and a stockpile of medical countermeasures (MCMs). Learnings from the recent pandemic are key to improving future strategies for preparedness in Ireland and across Europe. Methods Semi-structured interviews were conducted with key representatives in France, Latvia, Lithuania, the Netherlands, and Norway. These countries were chosen as they have a similar threat profile to Ireland. The interviews aimed to understand the national approach taken in each country to stockpiling of MCMs for public health emergencies. Interview summaries were developed and reviewed by key representatives for clarity. Thematic analysis was conducted. Results All of the key representatives interviewed were working within their associated Department of Health, or a government affiliated public health agency. Themes and key findings identified included scope and current stockpiling approaches; cost considerations and efficiency, and an understanding of how stockpiling approaches have evolved overtime. While some countries stockpiled items such as facemasks, gloves and ventilators during the COVID-19 pandemic, this is being reviewed, due to the high costs involved. Additionally, all countries reported that waste due to unused stock was a challenge, however, the use of stock rotation can reduce stock waste. Choice of supplier is also key for security of supply. Using indigenous suppliers can facilitate a scale up of supply in times of crises. Conclusions National MCMs stockpiles are a key resource that may be deployed as part of a response to health emergencies and disasters. Reducing waste was a key priority and challenge for all countries. Measures identified to reduce waste in future included active management of stockpiles, stock rotation and the use of indigenous suppliers. Key messages • As a result of the COVID-19 pandemic, many countries are reviewing their current approach to stockpiling. • Key issues for countries included preventing waste and ensuring security of MCM supply.