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Oct. 1, 2017

Increasing Partner-Nation Capacity Through Global Health Engagement

Why the Department of Defense (DOD) and international military sector writ large engage in global health is well documented.1 How DOD conducts global health engagement (GHE) in a systematic way is not. While pundits representing the Office of the Secretary of Defense, Joint Staff, combatant commands, Service components, and other organizations codify DOD policy for GHE, individuals and units implementing this broad guidance from 2013 to today continue to do so in a patchwork manner.2 Using the Indo-Asia Pacific region as a case study, this article presents the background regarding the current state of GHE in the region, develops a standardized GHE approach for engagement, and informs a partner-nation 5-year strategy.

June 20, 2017

Trauma Care in Support of Global Military Operations

The Department of Defense (DOD) Joint Trauma System (JTS) revolutionized combat casualty care by creating a trauma system for the battlefield. Over the past 30 years, U.S. civilian trauma systems have decreased mortality from trauma by 15 to 20 percent. In 2006, senior military and civilian medical leaders partnered to translate this civilian model to the battlefield. The deployed components of the JTS provided real-time data collection and analysis, research to guide rapid implementation of knowledge and material products, clinical guidelines for optimal care, and direct guidance to commanders as a key components of a continuously learning trauma system in two theaters of operation, directly saving lives on the battlefield.

April 1, 2017

The U.S. Government’s Approach to Health Security: Focus on Medical Campaign Activities

The U.S. Government plans, conducts, supports, and participates in activities that reinforce national interests. These interests perpetuate an international order underpinned by stable democratic governments and regional security. One critical component of national stability is the capability to protect citizens from internal and external threats. This capability normally requires a nation to draw upon its citizenry to populate internal forces responsible for providing security; therefore, a healthy populace is a necessity. With the U.S. Government’s increasing responsibility as a security provider and its political emphasis on health security, the U.S. military will undoubtedly be expected to have a larger role in support of health security objectives. While natural or manmade threats to human health can lead to illness or injury, illness transmitted by proximity between humans remains among the foremost dangers to human health, international stability, and the global economy. In other words, health security is crucial to U.S. national security.

Oct. 1, 2016

Applying Smart Power via Global Health Engagement

The U.S. military is entering a period of dramatic redirection and restructuring at a time of broader international upheaval, from Ukraine to Syria. The past decade of global conflict has emphasized the predominant hard power focus of the Armed Forces, often with limited success. The emergence of a new mission—smart power—offers opportunities to shift toward innovative forms of international intervention and conflict resolution by the U.S. military through coordination with national security strategies such as global health diplomacy (GHD).

July 1, 2016

Sharpening Our Cultural Tools for Improved Global Health Engagement

The central theoretical concept in all life sciences is adaptation, the idea that things change over time. Unlike other species, we humans have the full benefit of a dual system of inheritance; that is, we use (or are shaped by) both biological and cultural systems of adaptation. Both systems work in a similar way. Through the process of sexual reproduction, we inherit genetic traits from our parents, and through the process of learning, we inherit culture from our social group. Culture is a central concept in the study of human beings, and its existence has played a major role in the success of our species, including our success with combating, controlling, and containing disease.

March 29, 2016

Fighting Ebola: An Interagency Collaboration Paradigm

An old fable tells that a single stick by itself is weak; bundled with others, however, the stick will be much stronger. Likewise, during the world’s 2014–2015 response to the Ebola crisis in Liberia, interagency, intergovernmental, and international forces were strong and firmly united, moving forward with a singular agenda. If, on the other hand, all 100-plus organizations had not been united by the Liberian government to stamp out Ebola, the effort would have been weak and ineffective.

Jan. 1, 2016

Global Health Engagement: A Military Medicine Core Competency

In his February 2014 testimony to the House Armed Services Committee, Assistant Secretary of Defense for Health Affairs Jonathan Woodson articulated six strategic lines of effort supporting then–Secretary of Defense Chuck Hagel’s “six strategic priorities for reshaping our forces and institutions for a different future.” Dr. Woodson’s sixth line of effort was to “expand our global health engagement strategy.” This article is an overview of U.S. global health engagement, including such topics as current guidelines, health as a strategic enabler, health in disaster management, and future directions for global health engagement.

Jan. 1, 2016

Separate and Equal: Building Better Relationships with the International Humanitarian Community

In today’s complex global landscape, understanding and taking the opportunities to build peace to prevent war are increasingly paramount if a stable and sustainable world is to be realized. As such, we need to sharpen the focus of the roles the military and the humanitarian assistance community have in this important call to action and, at the least, determine what each side needs to know about the other. This is especially true if we are to find those intersections and circumstances where the military and the humanitarian assistance community are able to work together and to recognize those where they cannot. Toward this goal, this article reviews the identity, principles, and culture of the humanitarian community, what it expects from military forces, and what it wants the military to consider when it is planning health engagement. Additionally, approaches and methods for constructive interaction between the military and community forces are proposed.

Jan. 1, 2016

The Future of Department of Defense Global Health Engagement

The term global health has come into common usage in recent years and encompasses various matters relevant to health, including diseases that cross international borders, factors that affect public health globally, and the interconnectedness of health matters around the globe. Diseases that have been unevenly distributed across the world have been of concern to militaries for centuries, perhaps throughout history. Historians record that the decimation of Napoleon’s army during his invasion of Russia was the result of starvation, severe weather, and disease, the most important of which was typhus, which killed over 80,000 troops.1 His retreating army then spread typhus throughout Europe. Likewise, typhoid fever was a serious problem in World War I and the American Civil War.2 Spanish troops were severely affected by yellow fever during the Spanish-American War, and Spanish influenza had disproportionate and decisive effects during World War I.3 Colonization of Africa, Asia, and Latin America by Western powers led to increased awareness of diseases that were generally exotic to the imposing country, motivating interest in developing means of prevention and control of diseases. Examples of efforts emanating from such interest include the work of Walter Reed and William C. Gorgas in defining the transmission and prevention of yellow fever, research regarding cholera and diarrhea in Bangladesh, and the establishment of research laboratories (for example, the Pasteur Institute and Medical Research Council laboratories in Africa). Conversely, the invasion and colonization of foreign lands has also long been known to result in the introduction of exotic disease into the occupied lands, with the importation of smallpox and syphilis into North America by colonists as outstanding examples.

Jan. 1, 2016

Global Health Concepts, and Engagements: Significant Enhancer for U.S. Security and International Diplomacy

The United States and its global allies face a multitude of challenges to peace and stability. Civil wars in Syria, Yemen, Ukraine, and parts of Africa compound sectarian disorder in the aftermath of U.S. operations and subsequent withdrawal from Iraq and Afghanistan. Moreover, decades-old Israeli-Palestinian conflict, political unrest in Egypt and Turkey, and Iran’s attempts to dominate the region—countered by pushback from Saudi Arabia and Gulf allies—contribute to geopolitical turmoil. Compounding matters are the emergence of Daesh (the Islamic State of Iraq and the Levant) and other extreme theocratic groups and the uprooting of more than 9 million human beings, causing a complex humanitarian catastrophe rarely witnessed in modern times. Against these overwhelming difficulties, Muslims, Arabs, and the rest of the world expect and anticipate U.S. forward engagement to help resolve many of these threats.