U.S. Army Medical Research and Materiel Command. Rear Admiral Mary C. Riggs 6 June 2018

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1 U.S. Army Medical Research and Materiel Command Rear Admiral Mary C. Riggs 6 June 2018

2 Disclaimer The views expressed in this presentation are those of the speaker and do not reflect the official policy or position of the U.S. Army, Department of Defense, or the U.S. Government.

3 Learning from the Past (Iraq and Afghanistan); Planning for the Future 3

4 Implications of the Operational Envi. in 2030 Contested Domains, Degraded Operations Because enemies and adversaries threaten U.S. advantages in the land, air, maritime, space, and cyberspace domains and attack systems critical for integrating joint combined arms operations. Lethal Battlefield Because capable and elusive adversaries employ advanced capabilities that challenge ground maneuver and close combat overmatch. Complex Terrain Because enemies will operate among the people and ubiquitous media in megacities and dense urban areas to avoid U.S. military advantages. Challenged Deterrence Because capable and elusive enemies and adversaries operate across the elements of national power by, with, and through proxies and also maintain sophisticated ground forces with capabilities that neutralize Joint Force strengths from deployment through employment. Land Forces Must: Contain agile leaders who seize the initiative in high tempo operations against sophisticated opponents; possess agile formations capable of projecting power across all domains to ensure joint force freedom of action and overmatch in ground combat Land Forces Must: Be mobile, operating in depth across wide areas with the ability to concentrate rapidly; have the lethality to ensure overmatch in combat; and contain Soldiers and systems that are resilient to the effects of enemy weapons Land Forces Must: Be adaptive to the operational environment and win in the battleground of human perception and in restricted urban terrain to protect populations and to defeat threats; be interoperable with partners to present the enemy with multiple dilemmas in Joint and multinational operations Land Forces Must: Have the endurance to consolidate gains for sustainable outcomes through forward presence of capable land forces in high risk regions; while remaining expeditionary to rapidly reinforce threatened areas and respond to crises

5 Multi-Domain Battlefield Achieving Cross-Domain Synergy Maneuver to positions of relative advantage and project power across all domains to ensure freedom of action. Integrate joint, interorganizational, and multinational capabilities to create windows of advantage and preserve Joint Force freedom of maneuver. Exploit temporary domain superiority by synchronizing cross-domain fire and maneuver to achieve physical, temporal, positional, and psychological advantages. x CAS/AI MEB UAS EMS Recon I SO F II I Electronic Warfare SO F SO SO FF Guerrilla SO F I In an era of air and maritime warfare that seems increasingly likely to be dominated by long-range sensors and precision strikes, ground forces [provide the Joint Force] key attributes of resilience, persistence, and sustainability. - Beyond Coast Artillery: Cross-Domain Denial and the Army, Center for Strategic and Budgetary Assessments

6 Multi-Domain Battlefield - Medical Challenges Medical challenges Potential higher casualty numbers and incidents Delays in medical evacuation Need for prolonged field care Increased burden of operational stressors Threats of new/emerging weapons

7 Trends in Medicine - 5 Major Themes Big Data Automation, AI/machine learning, sensors, ubiquitous data collection, improved modeling and simulation capabilities, increasing data integration and sharing, changing privacy concerns Biology AI, automation, synthetic biology, drug design, improved modeling and simulation, prevention and treatment of disease, performance enhancement Enabling Technology Capabilities Development of predictive tools, manipulation of biology, ubiquitous global connectivity, commoditization of complex tools, higher integration of man-machine interface, evolving education and training models Medicine Specialization, decision-support, automation, AI, cost control, N=1 treatment, self-care and autonomy, regenerative medicine The Future Environment Urbanization, demographic, climate change, business models, socio-cultural issues, warfare

8 Science and Technology: New Areas of Investment Defense Health Program» Optimizing Health and Human Performance» Health Protection of Aircrew» Operational Toxicology» Medical Aspects of Cognitive Readiness and Operational Performance» Undersea Physiology and Performance» Emerging Infectious Diseases» Prolonged Field Care» En Route Care and Stabilization» Delayed Evacuation» Patient Movement Management» Survivability in Support of Personnel Recovery Army S&T» Medical Simulation and Information Sciences» Medical Capabilities to Support Dispersed Operations» Autonomous and Unmanned Medical Capability» Medical Aspects on Manned/Unmanned Teaming» Medical Robotics» Virtual Health» Military Operational Medicine» Medical Aspects of Performance Optimization & Enhancement» Bio-effects of Directed Energy Exposure» Medical Standards for Use of and Protection Against Directed Energy» Clinical and Rehabilitative Medicine» Battlefield Pain Management Slide 8

9 Mission and Vision MISSION VISION Responsively and responsibly create, develop, deliver, and sustain medical capabilities for the Warfighter Lead the advancement of military medicine Slide 9

10 Acquisition Objectives (1 of 3) Saving Lives Begins Here Threat / capability gap based RDA Command» Provides life saving medical and readiness innovations» Originates within USAMRMC or partner labs» Integrates our progress through Program Managers» Teams with Industry partners to field and sustain solutions on the battlefield Freeze-Dried Plasma Providing Solutions to the Warfighter for 60 Years»»»»»» Eight US licensed vaccines (e.g. Adenovirus, Japanese encephalitis, hepatitis A & B, ) REBOA (Resuscitative Endovascular Balloon Occlusion of the Aorta) Blood products (Freeze Dried Plasma) Lab Assay for TBI SAM Junctional Tourniquet Field Autoclave/Sterilizer Solutions coming soon:» Lab Assay for Traumatic Brain Injury (LA-TBI) FDA approved» Compensatory Reserve Index FDA approved» Autonomous Evacuation» MED HUB» Burn Treatment Skin Repair Non-invasive medical device to identify & assess internal brain injuries Slide 10

11 Acquisition Objectives (2 of 3) Operating Responsively and Responsibly» Warfighter needs met via Health Readiness Center of Excellence (HRCoE) and other Army / DoD requirements» DoD 5000 driven process» FDA or EPA approval» Ethical Human and Animal use» Financial accountability across multiple types of funding» Trained / Certified Acquisition Workforce Partnerships for Success» Partners» PEO Soldier wearables; delivery platform for IT-based tools for leader and medic; improved first aid kit (IFAK)» JPEO-CBD - Food and Drug Administration regulatory requirements» SOCOM -STAT, Freeze Dried Plasma» DARPA, Biomedical Advanced Research and Development Authority (BARDA) and other Agencies» Small Business Innovative Research - Invest in innovation» Medical prototype Other Transaction Authority» Advanced Tissue Biofabrication Manufacturing Innovation Institute» BioFab USA - Advanced Regenerative Manufacturing Institute Battlefield Pain Management -STAT Injects pellet-shaped sponges To fill wound and prevent blood loss. Topical Anti-Leishmanial Drug FDA approved Slide 11

12 Acquisition Objectives (3 of 3) Life Cycle Management Command» Six Intramural Laboratories with three OCONUS laboratories» Two (2) Advanced Development / PM Commands» USAMMA» USAMMDA» Materiel / Sustainment Commands» Two OCONUS Commands (USAMMCE & USAMMC-K)» USAMMA» Operating force fielding & sustainment» Operating force maintenance support» APS management Lab Assay for TBI Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) Anti-Malarial IV Artesunate Non-invasive medical device to identify & assess internal brain injuries FDA Cleared Balloon catheter to stop bleeding Slide 12

13 USAMRMC Joint Trauma Joint Trauma Ft. Sam Houston, T System System JBSA, T Slide of 20

14 USAMRMC Life Cycle Management Command, Saving Lives Begins HERE! Focused on materiel and knowledge-based medical solutions to: Enhance recovery, rehabilitation or reintegration Increase and sustain Warfighter readiness COLLABORATIVE COMMAND WE SAVE LIVES Improve fitness, health, protection, and resilience Improve downrange health delivery Slide 14

15 Army & Defense Health Program Congressional Special Interest Funding Medical Simulation and Information Sciences Military Infectious Diseases Tickborne Disease ($5M) Joint Warfighter Medical Research ($50M) Peer Reviewed Medical Research ($330M) Restore Core Research Funding ($291M) Burn Patient Transfer System ($2M)* Joint Warfighter Medical Research ($50M) Peer Reviewed Medical Research ($330M) Traumatic Brain Injury/Psychological Health (TBI/PH) ($125M) Restore Core Research Funding ($291M) Military Operational Medicine Combat Casualty Care Military Burn Research ($8M)* Alzheimer s Research ($15M) Epilepsy Research ($7.5M) Joint Warfighter Medical Research ($50M) Peer Reviewed Medical Research ($330M) Orthopaedic Research ($30M) Spinal Cord Injury Research ($30M) Trauma Clinic Research ($10M) TBI/PH ($125M) Restore Core Research Funding ($291M) Alcohol and Substance Use Disorders ($4M) Alzheimer s Research ($15M) Gulf War Illness ($21M) Joint Warfighter Medical Research ($50M) Peer Reviewed Medical Research ($330M) Spinal Cord Injury Research ($30M) TBI/PH ($125M) Restore Core Research Funding ($291M) Radiation Health Effects Clinical and Rehabilitative Medicine Military Burn Research ($8M)* Alzheimer s Research ($15M) ALS Research ($10M) Gulf War Illness ($21M) Hearing Restoration Research ($10M) Joint Warfighter Medical Research ($50M) Orthotics and Prosthetics Outcomes ($10M) Peer Reviewed Medical Research ($330M) Orthopaedic Research ($30M) Reconstructive Transplant ($12M) Spinal Cord Injury Research ($30M) TBI/PH ($125M) Vision Research ($15M) Restore Core Research Funding ($291M) Joint Warfighter Medical Research ($50M) Peer Reviewed Medical Research ($330M) Restore Core Research Funding ($291M) *Army Congressional Special Interest Funding. Slide 15

16 ? QUESTIONS? Slide 16

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