Global Health Engagement U.S. Department of Defense Dr. David Smith Performing the Duties of the Assistant Secretary of Defense for Health Affairs July 25, 2017
DoD Global Health Engagement (GHE) DoD GHE Defined Theater Security Cooperation Building Coalition & Partner Military Medical Interoperability Building Partner Mil Med Capacity Defense HIV-AIDS Prevention Program International Military Education Interactions & Training between DoD and Partner Nation s armed forces Disaster and/or Relief (DR) Subject Matter Expert Exchanges Global Health Security Agenda Humanitarian and Civic Assistance Humanitarian Medical Support to Operational/ Assistance (HA) Stability Ops Contingency GHE activities Plans establish, reconstitute, maintain, or improve Civ-Mil capabilities of Partner Nation s military or civilian health sector, Emergency Biosurveillance Planning Ebola Response and/or those of DoD civilian authorities Disaster Preparedness Program Coordinated with other USG departments and agencies Cooperative Biological Engagement Program Build trust and confidence, share information, coordinate mutual activities, maintain influence, and achieve interoperability Support national security policy and military strategy Cooperative Threat Reduction 2
History of DoD and Global Health DoD has been involved in global health issues for over a century Traditionally viewed global health engagement through the lens of force health protection Established first overseas medical research laboratories after WWII 3
Evolution of DoD Global Health Engagement Over time, DoD has recognized that global health and global security are linked Events like infectious disease crises and natural disasters have caused severe disruption and instability across the globe HIV SARS MERS-CoV Ebola Zika Not in our interest to allow that instability to grow, especially when we have capability to mitigate. Aedes Aegypti mosquito, primary vector of the Zika Virus U.S. Army engineers assist the Liberian military in the construction of an Ebola treatment unit during the 2014 West African Ebola epidemic. 4
Supporting the National Security Strategy We will advance the security of the United States, its citizens, and U.S. allies and partners by: Developing a global capacity to prevent, detect, and rapidly respond to biological threats like Ebola through the Global Health Security Agenda. Leading efforts to reduce extreme poverty, food insecurity, and preventable deaths with initiatives such as Feed the Future and the President s Emergency Plan for AIDS Relief. 5
How does Global Health Engagement contribute to DoD objectives? A powerful national security instrument that directly supports force health protection and security cooperation across the range of military operations around the world, enhancing READINESS GHE provides unique and effective training opportunities for DoD health personnel, and improves ability of PNs to contribute to Globally Integrated Health Service Support PARTNER CAPABILITIES GHE improves interoperability and increases self-reliance COOPERATION GHE enhances collaboration with foreign ministries and civil structures REGIONAL STABILITY GHE contributes to social wellbeing, rule of law, governance, economics, and security 6
DoD s Role in Global Health Focus Areas: Force Health Protection Building Partner Capacity Humanitarian Assistance and Disaster Response Nuclear, Chemical, and Biological Defense Key outcomes: Operational readiness Enhanced military medical capabilities Security Cooperation Stability and security U.S. Army Spc. Chris Springer contributes to the development of a Zika vaccine candidate at the Walter Reed Army Institute of Research. Building military medical capabilities means: Partner Nations can respond rapidly to disasters and outbreaks Partner Nations maintain mission-capable status for peacekeeping missions, and to partner in the fight against threat groups U.S. troop operational readiness enhanced Military exercises provide opportunities to practice interoperability in disaster medicine procedures. 7
8 Global Health Security Agenda A world safe and secure from global health threats posed by infectious diseases, whether naturally occurring, deliberate or accidental
Overview of DoD s Role in the GHSA In the U.S., DoD is in a supportive role to other elements of US Government DoD supports the GHSA through existing missions and activities such as force health protection, threat reduction, cooperative health security engagements and biodefense DoD has a long history of global health security activities that are resourced and conducted to meet national security objectives which also provide benefit toward the achievement of GHSA targets The GHSA aligns with national strategic guidance and offers DoD and other militaries a framework within which to engage and better coordinate with interagency (other ministries) and international partners 9
Global Health Security Agenda Action Packages PREVENT Avoidable Epidemics Prevent 1: Antimicrobial Resistance Prevent 2: Zoonotic Disease Prevent 3: Biosafety and Biosecurity Prevent 4: Immunization DETECT Threats Early Detect 1: National Laboratory System Detect 2/3: Real-time Biosurveillance Detect 4: Reporting Detect 5: Workforce Development RESPOND Rapidly and Effectively Respond 1: Emergency Operations Centers Respond 2: Linking Public Health with Law Enforcement & Multi-sectoral Response Respond 3: Medical Countermeasures and Personnel Deployment
DoD Programs that Benefit GHSA Armed Forces Health Surveillance Branch/Global Emerging Infections Surveillance and Response System (GEIS) Overseas Medical Research Laboratories DoD Cooperative Threat Reduction (CTR)/Cooperative Biological Engagement Program (CBEP) Defense Health Program Research, Development, Test and Evaluation (DHP RDT&E) Chemical and Biological Defense Program (CBDP) Combatant Commands
U.S. Support to GHSA Countries GHSA Phase I Bangladesh Burkina Faso Cameroon Cote d Ivoire Guinea Ethiopia India Indonesia Kenya Liberia Mali Pakistan Senegal Sierra Leone Tanzania Uganda Vietnam GHSA Phase II Cambodia Democratic Republic of Congo Georgia Ghana Haiti Jordan Kazakhstan Laos Malaysia Mozambique Peru Rwanda Thailand Ukraine CARICOM* *Caribbean Community (CARICOM) is an organization of 15 Caribbean nations and dependencies. GHS Phase II will have a regional focus.
DoD s Role in Broader Global Health Efforts Examples: PEPFAR Defense HIV/AIDS Prevention Program (DHAPP) President s Malaria Initiative Defense Malaria Assistance Program (DMAP) 13
Summary v GHE represents a diverse set of DoD activities that collectively establish, reconstitute, maintain, or improve the capabilities or capacities of a partner nation s military or civilian health sector, and/or those of DoD. v DoD GHE activities are key contributors to U.S. national security, directly supporting Force Health Protection and Security Cooperation across the range of military operations. v GHE efforts enhance readiness by providing unique and effective training opportunities for DoD health personnel and improving interoperability with our partner nations. Building PN capabilities to address health issues within their borders and regions reduces health threats to our Joint Force, our PNs, and our homeland. v GHE activities support geographic Combatant Command Theater Campaign Plans as they help to obtain access and influence, strengthen alliances, and foster health security. 14