What it is
STANAG 2121 is a NATO Standardization Agreement, not a technical specification in its own right. It is the agreement by which NATO nations commit to implement a publication, and here that publication is AMedP-1.19, Edition A. The STANAG itself is short: a letter of promulgation, the agreement to implement, and the machinery for ratification, implementation and review. The substance, the actual cylinder markings and valve arrangements, lives in AMedP-1.19, which has its own record.
The interoperability problem it answers
The agreement responds to a stated interoperability requirement: NATO forces need to be able to cross-service each other's medical gas cylinders. Participating nations agree to adopt a standard colour code system for identifying medical gas cylinders and to fit compatible cylinder outlet valves. Where that compatibility is not yet fully achieved, nations agree that it is "necessary to stock adapters to establish compatibility between the standards allowing proper cross-servicing of medical gas cylinders as far as possible." Neither the specific codes nor the valve specifications are printed in this cover; they are set out in AMedP-1.19.
What ratifying nations commit to
Participating nations agree to implement "the following standard": AMedP-1.19, Edition A. Their ratification and implementation decisions, including any reservations, are recorded by NATO in the NATO Standardization Document Database, not restated here. Partner nations are separately invited to adopt the STANAG. This is Edition 5 of STANAG 2121, dated 1 February 2017, and it supersedes Edition 4.
How it takes effect and is reviewed
A STANAG does not bind a supplier directly. It is implemented "when the necessary orders/instructions have been issued directing the forces concerned to put the content of the covered standard into effect", meaning a nation's own instructions, or a contract that invokes AMedP-1.19, are what actually create a requirement for an organisation to meet. Nations report their effective implementation using the form in Annex H to AAP-03(J); partner nations use Annex G of the same publication. The STANAG "is to be reviewed at least once every three years", and any nation or NATO body can propose a change at any time to the tasking authority for processing at the next review.
Related documents
This cover names AMedP-1.19 as the standard it puts into force; that is where the requirement itself lives, and it is not restated here. It also lists other related documents for context: STANAG 1059 (letter codes for geographical entities) and two civil standards on marking and colour-coding gas cylinders for medical use, ISO 32 and EN 1089-3, neither of which is in our catalogue.