11

Department of DefenseDepartment of DefenseMedical Support in a Contingency Medical Support in a Contingency

EventEventPrevention…Preparing…Responding…Prevention…Preparing…Responding…

RecoveringRecovering

Ms. Ellen P. EmbreyMs. Ellen P. EmbreyDeputy Assistant Secretary of Defense for Force Health Protection & ReadinessDeputy Assistant Secretary of Defense for Force Health Protection & Readiness

13 September 200513 September 2005

22

Defining Homeland Security/Homeland Defense/DoD Civil Defining Homeland Security/Homeland Defense/DoD Civil Support Support

ASD/HAASD/HA Roles & Responsibilities in Supporting a Catastrophic EventRoles & Responsibilities in Supporting a Catastrophic Event Anticipated Inter-Agency Medical Support Decisions Anticipated Inter-Agency Medical Support Decisions

Anticipated DoD Medical Support RequestsAnticipated DoD Medical Support Requests Available DoD Personnel/Equipment/Regional Planning Available DoD Personnel/Equipment/Regional Planning Planning TrendsPlanning Trends Non-Traditional Requests and SupportNon-Traditional Requests and Support

Road AheadRoad Ahead Visibility and Readiness Status of DoD Medical Assets Visibility and Readiness Status of DoD Medical Assets ASD (HA) LocationsASD (HA) Locations Interagency DiscussionInteragency Discussion Next StepsNext Steps

33

Homeland Security DefinitionHomeland Security Definition

Homeland Security as defined in the National Homeland Security as defined in the National Strategy for Homeland Security, is “a concerted Strategy for Homeland Security, is “a concerted national effort to prevent terrorist attacks within national effort to prevent terrorist attacks within the United States, reduce America’s vulnerability the United States, reduce America’s vulnerability to terrorism, and minimize the damage and to terrorism, and minimize the damage and recovery from attacks that do occur.”recovery from attacks that do occur.”

The Department of Homeland Security is the lead The Department of Homeland Security is the lead Federal Agency for homeland security. In Federal Agency for homeland security. In addition, its responsibilities extend beyond addition, its responsibilities extend beyond terrorism to preventing, preparing for, terrorism to preventing, preparing for, responding to, and recovering from a wide range responding to, and recovering from a wide range of major domestic disasters and other of major domestic disasters and other emergencies. emergencies.

44

The United States shall establish a single, comprehensive approach to domestic incident management …(It) treats crisis and consequence management as an integrated function.

-Homeland Security Presidential Directive #5

Evolving Homeland Security Evolving Homeland Security StrategyStrategy

55

AUTHORITIESAUTHORITIES

ROBERT T. STAFFORD ACT FEDERAL RESPONSE PLAN

THE ECONOMY ACT NATIONAL CONTINGENCY PLAN

THE LEASING ACT FEDERAL RADIOLOGICALEMERGENCY RESPONSE PLAN

PL 84-99 (FLOOD CONTROL AND COASTAL EMERGENCY) DODD 3025.1 MSCA EXECUTIVE ORDERS DODD 3025.15 MACA PDD- 39 (21 JUN 95) POSSE COMITATUS ACT

PDD - 62 & 63 (22 MAY 98) INSURRECTION ACT

HOMELAND SECURITY PRESIDENTIAL DIRECTIVES (1-8)

NATIONAL RESPONSE PLAN (NRP)

66

Support Annexes

Emergency Support Function Annexes

Appendices

Base Plan

Incident Annexes

Groups capabilities & resources into functions that are most likely needed during an incident (e.g., Transportation, Firefighting, Mass Care, etc.)

Describes common processes and specific administrative requirements (e.g., Public Affairs, Financial Management, Worker Safety & Health, etc.)

Outlines core procedures, roles and responsibilities for specific contingencies (e.g., Bio, Radiological, Cyber, HAZMAT Spills)

Concept of Operations, Coordinating Structures, Roles and Responsibilities, Definitions, etc.

Glossary, Acronyms, Authorities, and Compendium of National Interagency Plans

NRP StructureNRP Structure

77

1.1. TransportationTransportation2.2. CommunicationsCommunications3.3. Public Works and Public Works and

EngineeringEngineering4.4. FirefightingFirefighting5.5. Emergency Emergency

ManagementManagement6.6. Mass Care, Housing, Mass Care, Housing,

and Human Servicesand Human Services7.7. Resource SupportResource Support8.8. Public Health and Public Health and

Medical ServicesMedical Services

9.9. Urban Search and Urban Search and RescueRescue

10.10. Oil and Hazardous Oil and Hazardous Materials ResponseMaterials Response

11.11. Agriculture and Natural Agriculture and Natural ResourcesResources

12.12. EnergyEnergy13.13. Public Safety and Public Safety and

SecuritySecurity14.14. Long-Term Community Long-Term Community

Recovery and MitigationRecovery and Mitigation15.15. External AffairsExternal Affairs

ESF’s 1 to 15ESF’s 1 to 15

88

Military Support to Civil AuthoritiesMilitary Support to Civil Authorities

“FROM THE ARMY TO THE CJCS: TRANSITION THE FUNCTIONS AND ASSOCIATED RESOURCES OF THE OFFICE OF THE DIRECTOR OF MINITARY SUPPORT (DOMS) RELATED TO SUPPORT TO CIVILIAN AUTHORITIES AND SPEICAL EVENTS… THE ASD(HD) WILL EXERCISE POLICY OVERSIGHT OF THE DOMS ON BEHALF OF THE SECRETARY.”

DEPSECDEF MEMO

99

Homeland Security MissionsHomeland Security Missions

It is the primary mission of the Department of Homeland It is the primary mission of the Department of Homeland Security to prevent terrorist attacks within the United States. Security to prevent terrorist attacks within the United States. The Attorney General leads our Nation’s law enforcement The Attorney General leads our Nation’s law enforcement effort to detect, prevent, and investigate terrorist activity effort to detect, prevent, and investigate terrorist activity within the United States.within the United States.

Accordingly, the Department of Defense does not have the Accordingly, the Department of Defense does not have the assigned responsibility to stop terrorists from coming across assigned responsibility to stop terrorists from coming across our borders, to stop terrorists from hijacking aircraft inside or our borders, to stop terrorists from hijacking aircraft inside or outside the United States (these responsibilities belong to outside the United States (these responsibilities belong to the Department of Homeland Security).the Department of Homeland Security).

Nor does DoD have the authority to seek out and arrest Nor does DoD have the authority to seek out and arrest terrorists in the United States (these responsibilities belong terrorists in the United States (these responsibilities belong to the Department of Justice) to the Department of Justice)

1010

Homeland DefenseHomeland Defense

Homeland Defense is the protection of the United Homeland Defense is the protection of the United States sovereignty, territory, domestic population, States sovereignty, territory, domestic population, and critical defense infrastructure against and critical defense infrastructure against external threats and aggression, or other threats external threats and aggression, or other threats as directed by the President. The Department of as directed by the President. The Department of Defense is responsible for homeland defense.Defense is responsible for homeland defense.

1 - Homeland Defense includes missions such as domestic air 1 - Homeland Defense includes missions such as domestic air

defense. The Department recognizes that threats planned or defense. The Department recognizes that threats planned or inspired by “external” actors may materialize internally. The inspired by “external” actors may materialize internally. The reference to “external threats” does not limit where or how attacks reference to “external threats” does not limit where or how attacks could be planned or executed. The Department of Defense is could be planned or executed. The Department of Defense is prepared to conduct homeland defense missions, whenever the prepared to conduct homeland defense missions, whenever the President, exercising his constitutional authority as Commander in President, exercising his constitutional authority as Commander in Chief, authorizes military actions.Chief, authorizes military actions.

1111

Defense Support of Civil AuthoritiesDefense Support of Civil Authorities

Defense support of civil authorities, often referred to as Defense support of civil authorities, often referred to as civil support, is Department of Defense support, civil support, is Department of Defense support, including Federal military forcers, DoD’s career civilian including Federal military forcers, DoD’s career civilian and contractor personnel, and component assets, for and contractor personnel, and component assets, for domestic emergencies and for other designated law domestic emergencies and for other designated law enforcement and other activities.enforcement and other activities.

The Department of Defense provides defense support of The Department of Defense provides defense support of civil authorities when directed to do so by the President civil authorities when directed to do so by the President or the Secretary of Defense.or the Secretary of Defense.

The Strategy for Homeland Defense and Civil Support The Strategy for Homeland Defense and Civil Support embodies the core principles articulated in the United embodies the core principles articulated in the United States Constitution, the Nation’s laws, and in Presidential States Constitution, the Nation’s laws, and in Presidential and Secretary of Defense guidance. It also responds to and Secretary of Defense guidance. It also responds to the challenges posed by the security environment over the challenges posed by the security environment over the next decade.the next decade.

1212

ORDER

1

2 3

5

6RFAOrder

Coord/Aprv

Process(Military Is Not Lead)

• Lead Federal Agency

(LFA) initiates RFA

• RFA sent to DoD ExecSec

• DoD ExecSec assesses/

processes RFA

• RFA sent to ASD-HD /

JDOMS

• JDOMS processes order

• SecDef w/ASD-HD

approves order

•JDOMS issues order

1

2

3

4

5

6

ExecSec

Combatant

Cdrs

Military Services

Asst Sec Def Homeland Defense

4

JDOMS

Asst Sec Def Health Affairs

Request for AssistanceRequest for Assistance

Info

1313

ASD (HA) Organization ChartASD (HA) Organization Chart

1414

Mission: To enhance Department of Defense Mission: To enhance Department of Defense and our Nation’s security by providing health and our Nation’s security by providing health support for a full range of military sustaining support for a full range of military sustaining the health of those entrusted to our care.the health of those entrusted to our care.

Vision: A world-class health system that Vision: A world-class health system that supports the military mission by fostering, supports the military mission by fostering, protecting and sustaining.protecting and sustaining.

Assistant Secretary of Defense (Health Assistant Secretary of Defense (Health Affairs)Affairs)

1515

• Provide Advice To The Secretary Of Defense Provide Advice To The Secretary Of Defense Concerning Medical Services And SupportConcerning Medical Services And Support• Conduct Situation MonitoringConduct Situation Monitoring• Prepare Specific Policy Guidance; Manage DoD Prepare Specific Policy Guidance; Manage DoD Health ResourcesHealth Resources• Relocate Emergency Staff To Alternative Sites And Relocate Emergency Staff To Alternative Sites And Establish OperationsEstablish Operations• Complete Crisis Actions And CoordinationComplete Crisis Actions And Coordination• Prepare To Execute Plans To Cover Mobilization Prepare To Execute Plans To Cover Mobilization Contingencies, To Include Activation & Coordination Of Contingencies, To Include Activation & Coordination Of The National Disaster Medical System for Military The National Disaster Medical System for Military ContingenciesContingencies• Provide Military Medical Support To Civil Authorities, Provide Military Medical Support To Civil Authorities, As Authorized/ RequestedAs Authorized/ Requested

ASD (HA) Crisis TasksASD (HA) Crisis Tasks

1616

• Assess national/regional medical response Assess national/regional medical response architecture developed by DoD subordinate architecture developed by DoD subordinate organizations and articulate value/contribution of organizations and articulate value/contribution of each capability directly to Secretary of Defenseeach capability directly to Secretary of Defense

• Works with ASD (HD) to jointly develop domestic Works with ASD (HD) to jointly develop domestic medical disaster response and preparedness policies medical disaster response and preparedness policies

• Key partner with Other Federal Agencies: Key partner with Other Federal Agencies: (DHS/HHS/VA & DoT) to develop USG plans for (DHS/HHS/VA & DoT) to develop USG plans for medical surge support arising from domestic medical surge support arising from domestic emergencies and/or military contingenciesemergencies and/or military contingencies

ASD (HA) Leadership Contingency RoleASD (HA) Leadership Contingency Role

1717

• Contingency Operations: Conducts policy and Contingency Operations: Conducts policy and program oversight and management of issues program oversight and management of issues relating to domestic medical preparedness and relating to domestic medical preparedness and medical contingencies for both natural disasters and medical contingencies for both natural disasters and terrorists eventsterrorists events

• Interagency Coordination: Articulates DoD’s Interagency Coordination: Articulates DoD’s health and medical position in collaborative USG health and medical position in collaborative USG policy development councils, working groups and policy development councils, working groups and committees.committees.

Leadership Contingency Role (con’t)Leadership Contingency Role (con’t)

1818

• Shapes Shapes how the Military Health System (MHS) how the Military Health System (MHS) supports:supports:

• Force Health ProtectionForce Health Protection

• PreventionPrevention

• SurveillanceSurveillance

• PreparednessPreparedness

• ResponseResponse

• RecoveryRecovery

Leadership Contingency Role (con’t)Leadership Contingency Role (con’t)

1919

• 26 Separate Force Projection Points in CONUS

• DoD Beneficiary Population = 9.1 Million (AD, Guard & Reserve, Dependents, Retirees)

Defining the Risk -

• 519 DoD Installations in CONUS

• 175 DoD Medical Treatment Facilities (MTFs) in CONUS

Is DoD prepared to support their needs of their beneficiary population? We need an approach to do so…

DoD Beneficiary Specific ChallengesDoD Beneficiary Specific Challenges

2020

Natural DisastersNatural Disasters EarthquakesEarthquakes FiresFires Hurricanes/FloodsHurricanes/Floods TornadoesTornadoes Meteor (Space Junk)Meteor (Space Junk)

Biological Biological ContagiousContagious Non-ContagiousNon-Contagious

ChemicalChemical Industrial - Lethal MixesIndustrial - Lethal Mixes Persistent weaponizedPersistent weaponized Non-Persistent weaponizedNon-Persistent weaponized

AgriculturalAgricultural Animal – Human Animal – Human Food-Borne Food-Borne Water Borne Water Borne

High Yield ExplosivesHigh Yield Explosives Nuclear/RadiologicalNuclear/Radiological TraditionalTraditional

Anticipated DoD SupportAnticipated DoD Support

Scenario Based Catastrophic Requirements not well Scenario Based Catastrophic Requirements not well defineddefined

2121

Discussionson Process

& Issues

DoDMedicalAssets

DoD MedicalReadiness& Status

FocusOn

PartnershipDecisions

FocusOn Real-Time

Visibility

FocusOn Real-Time

Availability

ASD (HA)ASD (HA)OptionsOptions

DoD MHS Contingency Medical IssuesDoD MHS Contingency Medical Issues

2222

Local Emergency

Management

Tiered Disaster / Emergency Tiered Disaster / Emergency ResponseResponse

State Emergency

Management

President

FEMA

Federal Response

Local ResponseIncident Commander

State Response DISASTER SITEDISASTER SITE

DomesticDomestic

2323

Immediate Response

PERSONNEL/ RESOURCES

Areas of Concern- 72 Hours - Repeated Use- Must notify Higher HQ

CIVIL AUTHORITY

HELP !!!

Save LivesPrevent Human Suffering

Mitigate Great Property Damage

Federal Response

2424

Assistant Secretary of Defense (Homeland Defense)Assistant Secretary of Defense (Homeland Defense) Supervises Homeland Defense ActivitiesSupervises Homeland Defense Activities DOD Domestic Crisis ManagerDOD Domestic Crisis Manager

Assistant Secretary of Defense (Health Affairs)Assistant Secretary of Defense (Health Affairs) Supervises Military Health System ActivitiesSupervises Military Health System Activities DOD Medical Policy and Resourcing AgentDOD Medical Policy and Resourcing Agent

The Joint Staff, Joint Director of Military SupportThe Joint Staff, Joint Director of Military Support Action AgentAction Agent Liaison between DOD and Lead Federal Liaison between DOD and Lead Federal

AgenciesAgencies Focal point for coordination with COCOMs, Focal point for coordination with COCOMs,

Service and National Guard Service and National Guard

Supported Combatant Commanders Supported Combatant Commanders Principal Planning AgentsPrincipal Planning Agents

Supporting Combatant CommandersSupporting Combatant Commanders Provides resources and assets to COCOMProvides resources and assets to COCOM

Key DoD Players

2525

The DoD Medical Response Challenge

NationalFederal

Response

NationalFederal

Response

Identify Requirements

Identify Requirements

WHO is to moveWHAT is to moveWHERE it is to goWHEN it is needed

there

Lead Health & Human

Services

Lead Health & Human

Services

Multi-LevelDecisionMakers

Multi-LevelDecisionMakers

Whomakes whatdecisions?

Interagencyoperability?

??Personnel,Trans Assets,

Equipment,Supplies, and

Readiness

CISESF #8

CISESF #8

Identify DoDAvailable

Assets

Identify DoDAvailable

Assets

U.S. Department of Agriculture Department of DefenseDepartment of Energy

Department of Homeland SecurityDepartment of JusticeDepartment of Labor Department of State

Department of Transportation Department of Veterans Affairs

Agency for International Development Environmental Protection Agency General Services Administration

U.S. Postal Service American Red Cross

SupportSupport

DoD, NDMS,Federal Partners,

Private Sector,And Others

AFFECTED BY

FALLOUT

Counties Population

Atascosa 8,536

Bastrop 4,858

Bexar 6,164

Caldwell 8,457

Frio 36

Gonzales 62

2626

The DoD Medical Response Challenge

COCOMCOCOMOSDOSD ServicesServices

Provider

Joint StaffJoint Staff

Policy Execution Supported

Policyexceptions, gaps

and policy revision

Plandevelopment

Conductexecution

ForceProvider

2727

USADART

USARAMT

520th

TAML

USACHPPM

DODMTFs

USNRADCON

AFRAT

AFBAT

AFRRI

CB-RRT

MCBAT

CBIRF

MRRF

AFIP

USA MRMCResearch Labs

DeployableHospitals

CasualtyReceiving

Ships

Surgical TeamsVaccination Teams

MedicalEvacuation

MedicalLogisticsTeams

MentalHealthTeams Level I-II

HSS

HospitalShips

Epi Teams

VetTeams

DODFCCs

USNNEPMU

AFIOH

SMART

Strategic MvtVia TRANSCOM

DoD Medical Capability

2828

Policy & Program ConsiderationsPolicy & Program Considerations

Medical Responder PreparednessMedical Responder Preparedness Training & CredentialingTraining & Credentialing EquipmentEquipment SuppliesSupplies Medical & Non-medical ProtectionsMedical & Non-medical Protections

Patient ManagementPatient Management Triage/AccessTriage/Access Medical RecordsMedical Records Decontamination/QuarantineDecontamination/Quarantine TreatmentTreatment StabilizationStabilization EvacuationEvacuation

DoD Installations WorldwideDoD Installations Worldwide

2929

Policy & Program ConsiderationsPolicy & Program Considerations

Medical Intelligence & Alerting SystemsMedical Intelligence & Alerting Systems Bio detection outcome trendsBio detection outcome trends HUMINT, COMINT (global)HUMINT, COMINT (global)

Medical Surveillance Systems/MetricsMedical Surveillance Systems/Metrics Syndromic trendsSyndromic trends Pharmaceutical trendsPharmaceutical trends Lab and RAD diagnostic trendsLab and RAD diagnostic trends Non-traditional indicators Non-traditional indicators

3030

Policy & Program ConsiderationsPolicy & Program Considerations

Health Sector Critical Infrastructure Protection Health Sector Critical Infrastructure Protection Blood Storage/Blood Processing/Distribution Blood Storage/Blood Processing/Distribution

CapacityCapacity Vaccine & Drug Manufacturing PlantsVaccine & Drug Manufacturing Plants Equipment/Pharmaceutical Suppliers/DepotsEquipment/Pharmaceutical Suppliers/Depots Diagnostic and Research LabsDiagnostic and Research Labs Epidemiologic & Forensic Investigational LabsEpidemiologic & Forensic Investigational Labs Medical Treatment FacilitiesMedical Treatment Facilities Logistical Control/Distribution SystemsLogistical Control/Distribution Systems Bio detection networkBio detection network Veterinary Clinics/HospitalsVeterinary Clinics/Hospitals

3131

Policy & Program ConsiderationsPolicy & Program Considerations

Mortuary SupportMortuary Support Medical Examiner certificationsMedical Examiner certifications Medical Forensic AnalysisMedical Forensic Analysis Remains ManagementRemains Management

Identification/NotificationIdentification/Notification Disposition Disposition Personal PropertyPersonal Property

NOTNOT Medical – but medical Medical – but medical concerns/implicationsconcerns/implications

3232

Policy & Program ConsiderationsPolicy & Program Considerations

Medical Risk Communication Medical Risk Communication Targeted for affected patients/familiesTargeted for affected patients/families

Pre-event Pre-event Event Based Event Based

Targeted for decision-makersTargeted for decision-makers Pre-event Pre-event Event BasedEvent Based

Targeted for public (media)Targeted for public (media) Pre-eventPre-event Event BasedEvent Based

3333

New Model for PreparednessNew Model for Preparedness

At all installations, DoD must have, at a minimum, a medical At all installations, DoD must have, at a minimum, a medical response force necessary to preserve the military mission, which response force necessary to preserve the military mission, which includes care for mission essential personnel (whether military, includes care for mission essential personnel (whether military, civilian or contractor) and over the next 8 years, develop and civilian or contractor) and over the next 8 years, develop and sustain sufficient capacity to respond to 40% of its PAR. sustain sufficient capacity to respond to 40% of its PAR.

DoD installations must develop and report its level of capability to DoD installations must develop and report its level of capability to respond to the needs of the total DoD PAR (on the installation and respond to the needs of the total DoD PAR (on the installation and off the installation within the geographic area defining the off the installation within the geographic area defining the “community”)“community”)

All DoD installations must identify medical response surge All DoD installations must identify medical response surge requirements (manpower, equipment, supplies) necessary to requirements (manpower, equipment, supplies) necessary to administer to the total community DOD PAR. administer to the total community DOD PAR.

Community-Based Planning & ResponseCommunity-Based Planning & Response

3434

New Model for Preparedness (con’t)New Model for Preparedness (con’t)

Military and civilian disaster medical response plans Military and civilian disaster medical response plans and exercises will be jointly developed and executed and exercises will be jointly developed and executed to enhance community preparedness and response.to enhance community preparedness and response.

Using community based vulnerability assessment, Using community based vulnerability assessment, DoD will participate with other community DoD will participate with other community stakeholders to asses community capabilities to stakeholders to asses community capabilities to support total PAR.support total PAR.

Working with Community Stakeholders, DoD will Working with Community Stakeholders, DoD will jointly identify Community surge requirements and jointly identify Community surge requirements and work with other geographically proximate work with other geographically proximate Communities to establish surge agreements to Communities to establish surge agreements to support response to no less than 40% of PAR. support response to no less than 40% of PAR.

3535

New Model for Preparedness (con’t)New Model for Preparedness (con’t)

Disaster Response Communication protocols Disaster Response Communication protocols will be agreed upon among Community will be agreed upon among Community stakeholders and shared with nearby stakeholders and shared with nearby communities to facilitate rapid response to communities to facilitate rapid response to requests for surge support.requests for surge support.

DoD installation commanders and MTF DoD installation commanders and MTF commanders will work with geographically commanders will work with geographically proximate DoD installations in a region to proximate DoD installations in a region to ensure it has capability to support a response ensure it has capability to support a response (as part of a total community response) for (as part of a total community response) for 60% of its PAR over 14 days. Notifications to 60% of its PAR over 14 days. Notifications to NORTCOM and higher headquarters will be NORTCOM and higher headquarters will be required. required.

3636

Homeland DefenseHomeland Defense

ExtraordinaryCircumstances

DomesticDisaster Relief

DomesticCivil Support

Support to Counter Narcotics

CBRNE Consequence Mgmt

Special Events

Execute Operation Plans

Temporary Circumstances

Emergency Circumstances

DoDInvolveme

nt

Unique Area ofResponsibility

SpecializedCapabilities

3737

Critical medical functions required to assist an affected medical community

Building a NDMS ResponseBuilding a NDMS Response

‘Seamless Continuum of Care’

Definitive medical care

Patient evacuation

Medical responders

3838

Secure Communications-A Challenge

NDMS Policies and SPG Group Secure Communications

3939

Increasing risk of Increasing risk of influenza pandemicinfluenza pandemic

Health Affairs is the lead Health Affairs is the lead DoD agency for the DoD agency for the medical response to an medical response to an influenza pandemic. influenza pandemic.

Health Affairs is actively Health Affairs is actively engaged in planning engaged in planning activities (domestic and activities (domestic and international) with other international) with other DoD and U.S. DoD and U.S. Government agencies.Government agencies.

Avian Influenza

4040

ObjectivesObjectives Enhance DoD’s ability to support USG’s Enhance DoD’s ability to support USG’s

domestic and international avian influenza domestic and international avian influenza programs thru: programs thru:

Increased global capability to identify and report Increased global capability to identify and report avian influenza avian influenza

Protection of the war fighter as first priority, then Protection of the war fighter as first priority, then beneficiary population at risk worldwidebeneficiary population at risk worldwide

Preparedness to contain an outbreak of pandemic Preparedness to contain an outbreak of pandemic influenza globallyinfluenza globally

Improved allied military capability to prevent, Improved allied military capability to prevent, conduct appropriate epidemiologic investigations conduct appropriate epidemiologic investigations and respond to an avian influenza outbreak and respond to an avian influenza outbreak

DoD Avian Influenza Strategy

4141

CountermeasuresCountermeasures Antiviral StockpilesAntiviral Stockpiles

PACOM, CENTCOM, CONUSPACOM, CENTCOM, CONUS Influenza vaccine when available Influenza vaccine when available

SurveillanceSurveillance Enhance DoD’s global situational awareness by Enhance DoD’s global situational awareness by

connecting DoD Surveillance activities and connecting DoD Surveillance activities and standardizing collection, reporting and and standardizing collection, reporting and and analyses of medical surveillance.analyses of medical surveillance.

USG integration of medical intelligence within USG integration of medical intelligence within AFMICAFMIC

DoD Strategy

4242

Laboratory Capacity and CapabilityLaboratory Capacity and Capability Expand existing global lab capacity Expand existing global lab capacity

& capability & capability GEISGEIS EssenceEssence

ResponseResponse Enhance capability for MTF’s and Public Health Enhance capability for MTF’s and Public Health

Emergency Officers to respond to outbreaks at their Emergency Officers to respond to outbreaks at their installationinstallation

Augment epidemiological teams to enhance surge Augment epidemiological teams to enhance surge capacitycapacity

Assist CDC in identifying specific isolates for use in Assist CDC in identifying specific isolates for use in vaccine developmentvaccine development

Development of CONOP’s for all COCOMSDevelopment of CONOP’s for all COCOMS

DoD Strategy

4343

Questions/CommentsQuestions/CommentsDiscussionDiscussion