The DOD works diligently with foreign nations to establish and develop international partnerships through joint medical training exercises and public health initiatives. We aim to support and strengthen the public health capabilities of our partner nations in these engagements, as well as to improve our interoperability with them.

Our laboratories across the globe conduct essential surveillance of biological threats as well as groundbreaking research on infectious diseases. The DOD’s global reach also serves as a force for good around the world, offering humanitarian and disaster response assistance when requested.

The DOD’s global health engagement efforts are part of a whole-of-government approach, conducted in close coordination with other U.S. Government agencies, including the Department of State, Department of Health and Human Services, Department of Agriculture, and the United States Agency for International Development (USAID). The DOD also engages with non-government organizations, academia and private-sector organizations to enhance global health objectives.

DOD’s global health engagement activities are part of a whole-of-government approach to global health.  In addition to our international and NGO partners, we collaborate extensively with our U.S. Government partners.

DOD participates in quarterly meetings with colleagues at the Department of State, Department of Health and Human Services, and the United States Agency for International Development, which helps synchronize our U.S. global health efforts. We generally take a supporting role to these other agencies, using our assets and particular strengths to amplify the reach and effectiveness of their actions, as well as sharing space in our research facilities abroad to ensure that expertise from across the entire spectrum of global health is engaged in the fight against threats to global health security.

• Department of State
• Department of Health and Human Services
• United States Agency for International Development
• Centers for Disease Control and Prevention
• Department of Agriculture

The DOD has been engaged in issues of global health for well over a century.

This engagement has been shaped, first and foremost, by our commitment to force health protection and medical readiness. As American Service members deployed to increasingly exotic locales in the early 1900s, they were confronted with deadly infectious diseases like yellow fever, malaria, and typhoid fever. DOD investment in medical research and development to counter the threat of these diseases led to several notable successes, including prevention campaigns for malaria and yellow fever during the construction of the Panama canal, as well as an early vaccine for typhoid.

Over time, DOD's approach to global health engagement has expanded. At the conclusion of the Second World War, the department established its first overseas laboratory on the island of Guam, which was later followed by additional labs in Egypt, Thailand, Kenya, Peru, and Georgia. These laboratories, each of which also conducts activities in surrounding countries, became the backbone of DOD's global network of biomedical research and surveillance on biological threats, as well as important shared spaces for DOD's interagency partners. They have also served as focal points for research cooperation with partner nations, such as in an Army vaccine trial for HIV/AIDS conducted with the Thai government and military.

Global health engagement has also been defined by an increasing commitment to building and supporting the health system capacities of partner nations, as a reflection of the reality that healthy partner nations can better contribute to global stability and security. Medical Civil Action Programs (MEDCAPs), in which military medical professionals provide limited medical treatment to local populations, were a significant strategic initiative during the Vietnam War. More recently, global health activities have focused on working with host nation health professionals to result in sustainable improvements to local health systems. Efforts to develop health infrastructure and share knowledge have featured prominently in Iraq and Afghanistan as well.

The DOD operates research and surveillance laboratories around the world–including Egypt, Peru, Thailand and several other countries. In close collaboration with host nation colleagues, DOD personnel at these facilities perform imperative, on-the-ground medical epidemiology and research, and monitor emerging global infectious disease threats.  These efforts result in important and long-lasting relationships with our international colleagues, as well as critical knowledge that is shared with counterparts at CDC, USAID, and the broader global health community. 

The DOD has invested hundreds of millions of dollars in research to aid in the fight against global health threats. These investments have led to exciting breakthroughs in preventive medicine and vaccine research, with work underway to develop effective vaccines and other countermeasures to protect Service members, as well as citizens around the world, from deadly diseases like Ebola, malaria, dengue fever, and HIV. 

Preventing the emergence of health crises, and well as mitigating those that have already erupted, is a necessity for ensuring global health security. DOD recognizes this need through its implementation of programs like the Department of Defense HIV/AIDS Prevention Program (DHAPP), an on-the-ground effort that works alongside the President’s Emergency Program for AIDS Relief (PEPFAR) in 60 countries around the world in the prevention, care, and treatment of HIV to help stem the spread of the virus in the developing world.

Security threats from health catastrophes are real, and the spillover effects from breakdowns in health systems can be harder to contain than armed conflicts themselves. With this in mind, we are deeply invested in ensuring that our international partners have the capacity and the experience to address serious health threats, both in tandem with the U.S. Government, and on their own. Our collaboration with international partners also helps to improve our interoperability with their forces for future cooperation. 

We conduct regular training exercises in the form of bilateral and multilateral partnership initiatives with foreign militaries to promote improved responses to threats to regional and global public health. These engagements are critical for producing an effective multinational response to threats like infectious disease or natural disaster, and they can also serve as a bridge to broader security and stability among nations. 

• In Operation Tomodochi, after the Japanese earthquake and tsunami in 2011—U.S. forces were instrumental in delivering food, water, blankets, clothing, and medical supplies to support Japanese civilian and military partners.
• During Typhoon Haiyan in the Philippines, service members were on the ground working with the Philippine military to provide essential medical treatment and supplies.
• During the Ebola epidemic in West Africa, service members were involved in constructing treatment centers and providing logistical support to stem the spread of infection.
• In the aftermath of the devastating 2015 Nepal earthquake, U.S. military personnel were instrumental in supporting relief efforts with transportation and medical treatment, and where previous training exercises with the Nepalese military significant improved their capacity to respond to the crisis. 

These engagements have provided invaluable hands-on experience for service members that helps improve our future contributions to disaster relief efforts. They demonstrate time and again the value of our partnership-building activities, as partner nations have improved their disaster response capabilities after joining U.S. military in training exercises.

Helmed by the Defense Threat Reduction Agency (DTRA), CBEP focuses on providing education and training in clinical, laboratory and epidemiological safety and security when dealing with dangerous biological agents.  It also emphasizes working with partner nations to enhance their capacity to detect and report on these threats, and the program is involved in funding scientific research into particularly dangerous pathogens. In coordination with federal partners and the U.S. combatant commands, CBEP helps ensure that efforts to support partner nations in addressing biological threats efficiently utilize the full resources of the U.S. government.

The Global Health Security Strategy (GHSS) outlines the United States approach to strengthen Global Health Security, including through the Global Health Security Agenda, via three interrelated goals.

• Strengthened partner country global health capacities
• Increased international support for global health security
• A homeland prepared and resilient against global health threats

Read the Global Health Security Fact Sheet

The Global Health Security Agenda (GHSA) is a worldwide effort to address this evolving reality. Through a growing multisectoral partnership of international organizations, non-governmental stakeholders, and more than 50 countries, GHSA is accelerating efforts to build countries’ capacity to prevent, detect, and respond to infectious diseases and achieve the core capacities required by the International Health Regulations (IHR).

“We issued a challenge to ourselves and to all nations of the world to make concrete pledges towards three key goals:  prevent, detect and respond.  We have to prevent outbreaks by reducing risks.  We need to detect threats immediately wherever they arise.  And we need to respond rapidly and effectively when we see something happening so that we can save lives and avert even larger outbreaks. —President Obama, 2014 Global Health Security Agenda Summit 

These words encapsulate the aim of the GHSA, a multinational and multi-sectoral initiative to which DOD is proud to be committed. Preventing, detecting, and responding to infectious disease threats requires holistic solutions through strengthened relationships with health services, other government and industry partners, and academia. Cooperation is a force multiplier; cross-cutting collaboration is required at the national as well as the international level as well. Though DOD is in a supporting position, there is a clear and important role to be played by military medicine: the GHSA offers DOD and other militaries a framework to engage and better coordinate with interagency (other ministries) and international partners. 

In addition to collaboration and support, many of DOD’s existing efforts and priorities complement the GHSA. DOD has long focused on bio-threats, even prior to the establishment of the GHSA. Activities within the realms of force health protection, countering weapons of mass destruction, threat reduction, building partner capacity, and supporting science & technology programs work to further goals that align with GHSA objectives.