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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.