## Dod Directive 6420.02 Dod Biosurveillance



Originating Component:
Office of the Under Secretary of Defense for Personnel and Readiness

Effective:
September 17, 2020

Releasability:
Cleared for public release.  Available on the Directives Division Website at https://www.esd.whs.mil/DD/.

Reissues and Cancels:
Deputy Secretary of Defense Memorandum, "Interim Guidance for
Implementing the National Strategy for Biosurveillance," June 13, 2013

Approved by:
David L. Norquist, Deputy Secretary of Defense
Purpose: This issuance:
- Establishes the DoD Biosurveillance Program. - Establishes policy and assigns responsibility for enterprise wide biosurveillance coordination to
enhance force health and warfighter readiness through more integrated, accountable, efficient, and effective biosurveillance activities.
- Postures the Department to support timely bioincident prevention, detection, assessment, response
and recovery in accordance with the National Strategies for Biosurveillance and National Biodefense Strategy.
- Provides timely and actionable information in support of the DoD Global Pandemic Influenza and
Infectious Disease (PI&ID) response and other public health emergencies.
- Designates the Office of the Under Secretary of Defense for Personnel and Readiness (USD(P&R))
as the office of primary responsibility for the DoD Biosurveillance Program.

## Table Of Contents

 SECTION 1:  GENERAL ISSUANCE INFORMATION ........ 3
1.1.  Applicability. ........ 3 1.2.  Policy. ........ 3 1.3.  Information Collections. ........ 4
SECTION 2:  RESPONSIBILITIES ........ 5
2.1.  USD(P&R). ........ 5 2.2.  Assistant Secretary of Defense for Health Affairs (ASD(HA)). ........ 5 2.3.  Director, DHA........ 6 2.4.  Under Secretary of Defense for Intelligence and Security (USD(I&S)). ........ 7 2.5.  Director, Defense Intelligence Agency (DIA). ........ 8
2.6.  Director, National Center for Medical Intelligence. ........ 8
2.7.  USD(A&S). ........ 8 2.8.  Assistant Secretary of Defense for Nuclear, Chemical, and Biological Defense
Programs. ........ 9
2.9.  Director, DTRA. ........ 9 2.10.  Under Secretary of Defense for Research and Engineering. ........ 9 2.11.  Under Secretary of Defense for Policy. ........ 9 2.12.  DoD Component Heads. ........ 10 2.13.  Secretaries of the Military Departments and the Commandant, United States Coast
Guard........ 10
2.14.  CJCS. ........ 10 2.15.  Combatant Commanders. ........ 11 2.16.  Commander, United States Special Operations Command. ........ 11 2.17.  Commander, United States Northern Command. ........ 12
GLOSSARY ........ 13
G.1.  Acronyms. ........ 13 G.2.  Definitions. ........ 13
REFERENCES ........ 15

## Section 1:  General Issuance Information 1.1.  Applicability.

This issuance applies to OSD, the Military Departments (including the Coast Guard at all times, including when it is a Service in the Department of Homeland Security by agreement with that Department), the Office of the Chairman of the Joint Chiefs of Staff (CJCS) and the Joint Staff, the Combatant Commands, the Office of Inspector General of the Department of Defense, the Defense Agencies, the DoD Field Activities, and all other organizational entities within the DoD (referred to collectively in this issuance as the "DoD Components").

## 1.2.  Policy.

a.  Establish a DoD-wide coordinated Biosurveillance Program that readily transforms biosurveillance information into actionable, decision-focused  information at the tactical, operational, and strategic levels.  The program will integrate, synchronize, and standardize biosurveillance-related activities, to support countering weapons of mass destruction (CWMD), biodefense and comprehensive health surveillance and forecasting.

b.  Establish a DoD Biosurveillance Program senior advisory group that will develop and utilize a central framework to guide coordination efforts and periodically review progress of the DoD Biosurveillance Program, consistent with the responsibilities in Section 2.

(1)  The senior advisory group will direct actions for policy, procedure, programming, and organizational and structural reform.

(2)  USD(P&R), the biosurveillance program office of primary responsibility, will coordinate with the Under Secretary of Defense for Acquisition and Sustainment (USD(A&S)) and other DoD Components, as appropriate, to establish the advisory group membership.

(3)  The senior advisory group will establish a relevant agenda to ensure warfightersupport, joint force focused, streamlined, efficient, and effective program.

c.  Establish a centralized DoD biosurveillance hub and standard portal within the Defense Health Agency (DHA).  The hub and portal will integrate collected internal and external data and information links across the Services and Combatant Commands.  The hub and portal will ensure that decision making is informed by biosurveillance data, risk assessments, forecasting/modeling and operational input.  The hub will drive solutions for the coordinated collection, analysis and sharing of biosurveillance information that affect the forces.

d.  Apply DoD-wide resources, tools and expertise to enable decision making through organized data collection, processing, sharing, and analysis of biosurveillance-related information to:
(1)  Support the DoD Global Campaign Plan for PI&ID Response and public health emergencies, such as a highly infectious respiratory illness, as described in DoD Instruction 6200.03.

(2)  Ensure that DoD domestic and international biosurveillance information sharing systems are coordinated across U.S. departments and agencies within compatible information technology platforms.

(3)  Coordinate sharing and receiving biosurveillance information, within the DoD and with other U.S. departments and agencies and international partners.  Sharing may be authorized, as requested and approved, by the authorities designated in the references section identified as
"Biosurveillance-Related Information Sharing Authorities" in this issuance.

e.  Develop and disseminate unclassified biosurveillance data and information products to the maximum extent possible and without compromising operational security, for use by the DoD Biosurveillance Program and DoD Components.

f.  Implement processes and training for biosurveillance-related activities across the DoD, including data and information collection and sharing to ensure a common understanding of the use of data and methods.  These will include using interoperable systems where feasible.

g.  Develop and implement methods for forecasting and modeling events that could impact force health to support decision making.

h.  Enforce existing restrictions on the management and sharing of certain types of data and information, in accordance with applicable laws and regulations, including DoD Directive
(DoDD) 5230.11, DoD Instructions 2030.08, 2040.02, 5015.02, 6025.18, 8320.02, DoD Manual (DoDM) 6025.18, and DoD 5400.11-R.

## 1.3.  Information Collections.

The biosurveillance data collection, referred to throughout this issuance, does not require licensing with a report control symbol in accordance with Enclosure 3, Paragraph 1.b.(9), Volume 1 of DoDM 8910.01.



## Section 2:  Responsibilities

2.1.  USD(P&R).

The USD(P&R):
a.  Serves as the office of primary responsibility for the DoD Biosurveillance Program activities, including;

(1)  Integration. (2)  Synchronization.
(3)  Coordination of biosurveillance-related information.
b.  Coordinates requirements for DoD Biosurveillance Program activities across DoD
Components.

c.  Establishes and co-chairs, with USD(A&S), the DoD Biosurveillance Program senior advisory group and submits a group charter for approval within 120 days of the effective date of this issuance.

d.  Coordinates with DoD Components regularly to review DoD Biosurveillance Program policies, issues, systems, and activities through the DoD Biosurveillance Program senior advisory group.
e.  Sponsors periodic capability-based assessments of biosurveillance-related systems, operations, and activities (e.g., data sharing, analyses, information products) to:
(1)  Inform programmatic decisions required for enhancement and sustainment of capabilities that directly support warfighter health protection and force readiness.

(2)  Ensure effectiveness and efficiency.

## 2.2.  Assistant Secretary Of Defense For Health Affairs (Asd(Ha)).

Under the authority, direction, and control of the USD(P&R), the ASD(HA):
a.  Develops policy, guidance, and partnerships to direct development, collection, and storage of biosurveillance-related information in systems, allowing for the timely sharing, analysis, and reporting of such information by and to appropriate departments and agencies.
b.  Coordinates with the Chemical and Biological Defense Program on biosurveillancerelated activities for chemical, biological and radiological defense in accordance with DoDD 5160.05E and overall situational awareness of health threats to the force.
c.  Requires standard analytic methods, training, and products for biosurveillance-related activities across the military health system during military operations and activities.
d.  Performs regular periodic quality improvement surveys with an established mechanism for feedback to assess the utility of biosurveillance-related systems, data sharing, analyses, and information products developed for users at the tactical, operational, and strategic levels of the DoD.

e.  Ensures the central biosurveillance hub has appropriate health and medical information technology capabilities available.  That it utilizes these health and medical information technology capabilities to effectively collect, store, analyze, and report data to support timely surveillance of the health of the force and inform command decisions at all levels.

## 2.3.  Director, Dha.

Under the authority, direction, and control of the USD(P&R), through the ASD(HA), and in addition to the responsibilities in Paragraph 2.12., the Director, DHA:
a.  Coordinates the collection, analysis, and sharing of biosurveillance-related information relevant to force health protection both within the DoD and with external partners, to include, but not limited to:

(1)  The U.S. Government. (2)  State public health agencies.
(3)  International public health authorities.
(4)  Coalition forces, as requested and approved by proper DoD authorities.
b.  In coordination with the Military Departments and the Combatant Commands, develop a common, minimum reporting standard for biosurveillance-related information.

c.  Shares data and analytic products from comprehensive health surveillance activities throughout the DoD with appropriate DoD Components.
d.  Regularly shares data and analytic products from:

(1)  DHA health surveillance and medical research assets.
(2)  Environmental and occupational health services.
(3)  Veterinary services. (4)  Food and water safety services.
(5)  Immunization services.
(6)  Deployment health surveillance services, with the relevant DoD Components and integrates with other biosurveillance-related information.

e.  Ensures the Armed Forces Health Surveillance Branch has the authority to operate as the centralized biosurveillance hub and coordinates with other DHA branches,  Services, and other DoD Components, and transforms data to decision support information in support of combat forces.

f.  Coordinates with the DoD Coordinating Authority for CWMD; the Combatant Commands; the Joint Staff, Force Structure, Resources and Assessment, J8; and the Defense Threat Reduction Agency (DTRA) to support development of CWMD situational awareness capabilities that incorporate relevant health surveillance information.

g.  Coordinates across the DoD Components on all comprehensive health surveillance data collection and analysis operations, and identifies significant information sharing challenges.

h.  Shares DoD biosurveillance-related information among:

(1)  The Military Services' health surveillance centers. (2)  Other DoD health surveillance activities.
(3)  Other DoD entities as appropriate.
(4)  Non-DoD organizations (e.g., local, State, national, non-governmental organizations, and international health organizations) where such information can be shared appropriately.

i.  Ensures that originators of biosurveillance-related information apply the lowest level of classification and controls necessary that information remains unclassified where possible, and dissemination of such information does not violate applicable classification or privacy rules, national policy for disclosure of classified military information to foreign governments and international organizations, DoD policy for international transfers, or export control laws and regulations.

j.  Promotes and provides biosurveillance-related training and education opportunities in the techniques and practices of epidemiology, public health, and medical surveillance.

## 2.4.  Under Secretary Of Defense For Intelligence And Security (Usd(I&S)).

The USD(I&S) oversees the production of finished intelligence products and analysis at the appropriate classification levels, to enable integration with other information streams and development of a unified and comprehensive biosurveillance effort to support force health protection and the CWMD missions

## 2.5.  Director, Defense Intelligence Agency (Dia).

Under the authority, direction, and control of the USD(I&S), and in addition to the responsibilities in Paragraph 2.12., the Director, DIA:
a.  Disseminates finished intelligence products and analyses on threats from foreign chemical, biological, radiological, and nuclear weapons and agents at the appropriate classification levels, in accordance with Volume 2 of DoDM 5200.01.
b.  Develops and sustains technical and analytic capabilities to provide timely warnings and projections of significant foreign infectious disease and environmental health risks to DoD personnel.

c.  Consults and develops intelligence products (both medical and non-medical) for the DoD
Coordinating Authority for CWMD mission in accordance with the DoD CWMD policy.

d.  Consults and develops intelligence products (both medical and non-medical) for the DoD
Coordinating Authority for PI&ID.

## 2.6.  Director, National Center For Medical Intelligence.

Under the authority, direction, and control of the Director, DIA, the Director, National Center for Medical Intelligence, disseminates finished medical intelligence analyses to support the effort to develop an integrated DoD Biosurveillance Program.

2.7.  USD(A&S).

The USD(A&S):
a.  Leverages existing technologies and leads the development and delivery of capabilities to collect, integrate, and analyze data or information and report information produced by DoD biosurveillance-related activities at all levels in support of requirements identified by OSD, Office of the CJCS, the Military Departments, and the Combatant Commands.

b.  Budgets for the Chemical and Biological Defense Program elements for research, development, test and evaluation, and procurement in support of biosurveillance related CWMD
capabilities to enhance and sustain warfighter health protection and force readiness.

c.  Coordinates with the ASD(HA) and the Director, DIA, in the development of technologies and analytic methods that integrate biosurveillance-related information to enable early detection and warning and contribute to overall situational awareness of health threats to the force.

d.  Shares relevant information on environment, safety, and occupational health program activities with the ASD(HA) and the Director, DHA, in a timely manner that supports the integration of that information with other biosurveillance-related information.
e.  Coordinates with the Combatant Commands and the Military Services to capture biosurveillance requirements in the Joint Capabilities Integration and Development System.
f.  In coordination with the USD(P&R), co-chairs the DoD Biosurveillance Program senior advisory group.

## 2.8.  Assistant Secretary Of Defense For Nuclear, Chemical, And Biological Defense Programs.

Under the authority, direction, and control of the USD(A&S), the Assistant Secretary of Defense for Nuclear, Chemical, and Biological Defense Programs serves as the principal advisor to the Secretary of Defense, the Deputy Secretary of Defense, and the USD(A&S) on chemical and biological defense in accordance with DoDD 5160.05E.

## 2.9.  Director, Dtra.

Under the authority, direction, and control of USD(A&S), through the Assistant Secretary of Defense for Nuclear, Chemical, and Biological Defense Programs, and in addition to the responsibilities in Paragraph 2.12., the Director, DTRA, incorporates relevant health surveillance information from the DHA and medical intelligence agencies when developing CWMD situational awareness capabilities that supports analysts, planners, war fighting centers, and decision makers.

## 2.10.  Under Secretary Of Defense For Research And Engineering.

The Under Secretary of Defense for Research and Engineering designates a DoD Modeling and Simulation Coordination Agent for biosurveillance in accordance with DoDD 5000.59 as needed.

## 2.11.  Under Secretary Of Defense For Policy.

The Under Secretary of Defense for Policy:
a.  Coordinates with the USD(P&R), the USD(A&S), the USD(I&S), and the CJCS on Department biosurveillance-related efforts.

b.  In coordination with the USD(P&R), represents the DoD on inter-Agency biosurveillance issues.

c.  Coordinates the exchange of biosurveillance information with other departments and agencies.

d.  Provides coordination on biosurveillance policy, as appropriate.

## 2.12.  Dod Component Heads.

The DoD Component heads:
a.  For DoD Components with biosurveillance program responsibilities, develop processes to ensure accountability for those biosurveillance activities, update guidance and implementation procedures to comply with this issuance and other guidance, and integrate biosurveillance activities across DoD Components.

b.  Implement programs, guidance and procedures to collect, analyze, report, archive, and share essential garrison and deployment health information with DHA.

c.  Recommend and implement reforms where necessary to maintain an effective and efficient biosurveillance capability.

## 2.13.  Secretaries Of The Military Departments And The Commandant, United States Coast Guard.

In addition to the responsibilities in Paragraph 2.12., the Secretaries of the Military Departments and the Commandant, United States Coast Guard:
a.  Make their biosurveillance-related information, data products, reporting, and analyses available for integration at the tactical, operational, and strategic levels.

b.  Submit requirements and integrated priorities for biosurveillance through normal departmental processes and identify training and personnel requirements.

c.  Collect, share, analyze, and provide, to the DHA, the DoD Coordinating Authority for CWMD, the DoD Coordinating Authority for PI&ID, and the Combatant Commanders, biosurveillance-related information of their Military Services to improve situational awareness of threats to the force and inform decisions at the tactical, operational, and strategic levels.

d.  In coordination with the Director, DHA; the Combatant Commanders; and the Chiefs of the Military Service, develop a common, minimum reporting standard for biosurveillance-related information.

## 2.14.  Cjcs.

In addition to the responsibilities in Paragraph 2.13., and in coordination with the Combatant Commanders, the CJCS:
a.  Monitors the implementation of this issuance, updates joint doctrine as necessary, and provides operational biosurveillance requirements to the USD(P&R), the USD(I&S), and the USD(A&S) to assist them in refining processes and products that enable and enhance biosurveillance.

b.  Ensures biosurveillance-related information is collected, analyzed, and communicated as timely as possible to the Combatant Commands to improve situational awareness of threats and incidents and inform decisions at all levels.

c.  Provides coordination on biosurveillance policy as appropriate.

## 2.15.  Combatant Commanders.

In addition to the responsibilities in Paragraph 2.11., and in coordination with the CJCS, the Combatant Commanders:

a.  Implement guidance during planning and operations consistent with this issuance.
b.  Provide their Combatant Command operational requirements (information and materiel)
to the CJCS.

c.  Collect, analyze, integrate, and share biosurveillance-related information among the geographic Combatant Commands and with DHA, DTRA, the DoD Coordinating Authority for CWMD, and the DoD Coordinating Authority for PI&ID to:

(1)  Improve situational awareness of threats to the force.
(2)  Protect warfighter health.
(3)  Sustain force lethality. (4)  Better inform decisions at the tactical, operational, and strategic levels.
d.  Issue biosurveillance procedural guidance and instruction for health, medical, veterinary, occupational, environmental, and chemical, biological, radiological, and nuclear surveillance in theater, and share collected data and information.
e.  In coordination with the Director, DHA and the Secretaries of the Military Departments, develop a common, minimum reporting standard for biosurveillance-related information.

## 2.16.  Commander, United States Special Operations Command.

In addition to the responsibilities in Paragraphs, 2.12. and 2.15., the Commander, United States Special Operations Command, in coordination with the CJCS:
a.  Per the Unified Command Plan, serves as the DoD Coordinating Authority for CWMD to synchronize and plan for DoD CWMD efforts in coordination with other Combatant Commands, Military Services and, as directed, other appropriate U.S. Government departments and agencies.
b.  Incorporates biosurveillance information from the DHA in developing CWMD situational awareness in support of other Combatant Commanders in CWMD planning an execution.

## 2.17.  Commander, United States Northern Command.

In addition to the responsibilities in Paragraphs 2.11. and 2.14, the Commander, United States Northern Command, in coordination with the CJCS:
a.  Serves as the DoD Coordinating Authority for PI&ID to synchronize and plan response efforts in coordination with other Combatant Commands, Military Services and, as directed, when directed, other appropriate U.S. Government departments and agencies.

b.  Incorporates biosurveillance information from the DHA in developing PI&ID situational awareness in support of other Combatant Commanders in PI&ID response planning and execution.


## Glossary G.1.  Acronyms.

ACRONYM
MEANING
ASD(HA)
Assistant Secretary of Defense for Health Affairs
CJCS
Chairman of the Joint Chiefs of Staff
CWMD
countering weapons of mass destruction
DHA
Defense Health Agency
DIA
Defense Intelligence Agency
DoDD
DoD directive
DoDM
DoD manual
DTRA
Defense Threat Reduction Agency
PI&ID
pandemic influenza and infectious disease
USD(A&S)
Under Secretary of Defense for Acquisition and Sustainment
USD(I&S)
Under Secretary of Defense for Intelligence and Security
USD(P&R)
Under Secretary of Defense for Personnel and Readiness


## G.2.  Definitions.

Unless otherwise noted, these terms and their definitions are for the purpose of this issuance.

TERM
DEFINITION

biosurveillance
The process of gathering, integrating, interpreting, and communicating essential information related to all-hazards threats or
disease activity affecting human, animal, or plant health to achieve early detection and warning, contribute to overall situational awareness of the health aspects of an incident, and to enable better decision making at all levels.

biosurveillancerelated information
Information that informs biosurveillance activities to include, but not limited to, information from health surveillance, medical surveillance, environmental and occupational health surveillance, veterinary health surveillance, disease vector surveillance, and surveillance of chemical, biological, radiological, and nuclear threats.

Defined in DoDD 6490.02E.
comprehensive health surveillance
TERM
DEFINITION
Defined in DoDD 2060.02.


CWMD
environmental health The programs, activities, and subsequent risk determination
associated with the anticipation, recognition, evaluation, and potential control of hazards identified within the media of the environment.  Environmental health focuses on the reduction or mitigation of the health hazards identified in the operational or garrison environment. Defined in DoDD 6200.04.
force health
protection

forecasting
Calculating a future event or condition as a result of study and analysis of available, pertinent data.  In relation to biosurveillance, forecasting attempts to describe future outcomes or impacts of a current health risk within a given community. Defined in DoDD 6490.02E.
health surveillance
military health system
A health system that supports the military mission by fostering, protecting, sustaining, and restoring health and providing the direction, resources, health care providers, and other means necessary for promoting the health of the beneficiary population.
medical intelligence
Defined in DoD Instruction 6420.01.

medical surveillance
Defined in DoDD 6490.02E.


## References

DoD 5400.11-R, "Department of Defense Privacy Program," May 14, 2007
DoD Directive 5000.59, "DoD Modeling and Simulation (M&S) Management," August 8, 2007,
as amended
DoD Directive 5230.11, "Disclosure of Classified Military Information to Foreign Governments
and International Organizations," June 16, 1992
DoD Directive 6200.04, "Force Health Protection (FHP)," October 9, 2004 DoD Directive 6490.02E, "Comprehensive Health Surveillance," February 8, 2012, as amended DoD Global Campaign Plan for Pandemic Influenza and Infectious Disease 3551-13,
October 15, 2013
DoD Instruction 2030.08, "Implementation of Trade Security Controls (TSCs) for Transfers of
DoD Personal Property to Parties Outside DoD Control," February 19, 2015, as amended
DoD Instruction 2040.02, "International Transfers of Technology, Articles, and Services,"
March 27, 2014, as amended
DoD Instruction 5015.02, "DoD Records Management Program," February 24, 2015, as
amended
DoD Instruction 6025.18, "Health Insurance Portability and Accountability Act (HIPAA)
Privacy Rule Compliance in DoD Health Care Programs," March 13, 2019
DoD Instruction 6200.03, "Public Health Emergency Management (PHEM) Within the
Department of Defense," March 28, 2019
DoD Instruction 6420.01, "National Center for Medical Intelligence (NCMI)," March 20, 2009,
as amended
DoD Instruction 8320.02, "Sharing Data, Information, and Technology (IT) Services in the
Department of Defense," August 5, 2013, as amended
DoD Manual 5200.01, Volume 3, "DoD Information Security Program: Protection of Classified
Information," February 24, 2012, as amended
DoD Manual 6025.18, "Implementation of the Health Insurance Portability and Accountability
Act (HIPAA) Privacy Rule in DoD Health Care Programs," March 13, 2019
DoD Manual 8910.01, Volume 1, "DoD Information Collections Manual: Procedures for DoD
Internal Information Collections," June 30, 2014, as amended
Unified Command Plan, current edition White House, National Biodefense Strategy, September 2018 White House, National Strategy for Biosurveillance, July 2012

## Biosurveillance-Related Information Sharing Authorities

DoD Directive 2060.02, "DoD Countering Weapons of Mass Destruction (WMD) Policy,"
January 27, 2017
DoD Directive 5105.21, "Defense Intelligence Agency (DIA)," March 18, 2008 DoD Directive 5124.02, "Under Secretary of Defense for Personnel and Readiness
(USD(P&R))," June 23, 2008
DoD Directive 5135.02, "Under Secretary of Defense for Acquisition and Sustainment
(USD(A&S))," July 15, 2020
DoD Directive 5136.01, "Assistant Secretary of Defense for Health Affairs (ASD(HA)),"
September 30, 2013, as amended
DoD Directive 5136.13, "Defense Health Agency (DHA)," September 30, 2013
DoD Directive 5137.02, "Under Secretary of Defense for Research and Engineering
(USD(R&E)), July 15, 2020
DoD Directive 5160.05E, "Roles and Responsibilities Associated With The Chemical and
Biological Defense Program (CBDP)," September 8, 2017, as amended
DoD Directive 5240.01, "DoD Intelligence Activities," August 27, 2007, as amended DoD Directive 6400.04E, "DoD Veterinary Public and Animal Health Services," June 27, 2013,
as amended
DoD Instruction 6440.03, "DoD Laboratory Network (DLN)," June 10, 2011, as amended DoD Instruction 6490.03, "Deployment Health," August June 19, 2019