Department of Defense 

Office of the Assistant Secretary of Defense 

Homeland Defense 

Department of Defense Implementation Plan for 

Pandemic Influenza 

AUGUST 2006 

2 

TABLE OF CONTENTS 

PURPOSE....................................................................................................................................... 3 

BACKGROUND ............................................................................................................................ 3 

Pillar #1: Preparedness and Communication ............................................................................. 4 

Pillar #2: Surveillance and Detection ........................................................................................ 4

Pillar #3: Response and Containment........................................................................................ 4 

IMPLEMENTATION OF THE NATIONAL STRATEGY .......................................................... 4 

Implementation Plan ................................................................................................................... 4 

Interagency Tasks and Plan Organization................................................................................... 5 

Priority Actions........................................................................................................................... 5 

DEPARTMENT OF DEFENSE IMPLEMENTATION ................................................................ 7 

Planning Assumptions ................................................................................................................ 7 

Planning Priorities....................................................................................................................... 9 

Critical Planning Tasks............................................................................................................. 10 

Critical Planning Task Alignment With National Strategy Pillars And Priorities.................... 11 

Pre-Scripted Requests for Assistance ....................................................................................... 17 

Pandemic Influenza Task Force................................................................................................ 17

CONCLUSION............................................................................................................................. 18 

ANNEX A, DEPARTMENT OF DEFENSE PANDEMIC INFLUENZA PREPAREDNESS 

AND RESPONSE TASKS ........................................................................................................... 20

ANNEX B, INTELLIGENCE ...................................................................................................... 61 

ANNEX C, FORCE HEALTH AND PROTECTION ................................................................. 62 

ANNEX D, CONTINUITY OF OPERATIONS/CONTINUITY OF GOVERNMENT ............. 70 

ANNEX E, PUBLIC AFFAIRS ................................................................................................... 81 

ANNEX F, REFERENCES .......................................................................................................... 84
3 

DEPARTMENT OF DEFENSE IMPLEMENTATION PLAN 

FOR PANDEMIC INFLUENZA 

“Together we will confront this emerging threat and together, as Americans, we will be prepared 

to protect our families, our communities, this Great Nation, and our world.” 

- President George W. Bush, 

National Strategy for Pandemic Influenza

PURPOSE 

The Secretary of Defense’s principal responsibility in responding to a pandemic will be to 

protect U.S. interests at home and abroad. This implementation plan sets forth Department of 

Defense (DoD) guidance and addresses key policy issues for pandemic influenza planning. This 

guidance will enable the Combatant Commanders, Military Departments, and DoD agencies to 

develop plans to prepare for, detect, respond to, and contain the effects of a pandemic on military 

forces, DoD civilians, DoD contractors, dependents, and beneficiaries. Additionally, plans will 

address the provision of DoD assistance to civil authorities both foreign and domestic. Finally, 

attention to the key security concerns, such as humanitarian relief and stabilization operations 

that may arise as a result of a pandemic, will be addressed. 

BACKGROUND

The President issued the National Strategy for Pandemic Influenza in November 2005 to guide 

“our preparedness and response to an influenza pandemic with the intent of (1) stopping, slowing 

or otherwise limiting the spread of a pandemic to the United States; (2) limiting the domestic 

spread of a pandemic, and mitigating disease, suffering and death; and (3) sustaining 

infrastructure and mitigating impact to the economy and the functioning of society.”1

The National Strategy is built upon three pillars “to address the full spectrum of events that link 

a farmyard overseas to a living room in America.”2 They are: 

 

1

 Homeland Security Council, National Strategy for Pandemic Influenza, (November: 2005), p. 2. 2

 Ibid, p. 3. 
4 

Pillar #1: Preparedness and Communication 

These are activities that should be undertaken before a pandemic to ensure preparedness and the 

communication of roles and responsibilities to all levels of government, segments of society and 

individuals, including: 

• Planning for a Pandemic 

• Communicating Expectations and Responsibilities 

• Producing and Stockpiling Vaccines, Antivirals, and Medical Materiel 

• Establishing Distribution Plans for Vaccines and Antivirals 

• Advancing Scientific Knowledge and Accelerating Development of Countermeasures 

• Developing a common operating picture (COP) for disease surveillance. 

Pillar #2: Surveillance and Detection 

These are the domestic and international systems that provide continuous “situational awareness” 

to ensure the earliest warning possible of outbreaks among animals and humans to protect the 

population, including: 

• Ensuring International Transparency and Rapid Reporting of Outbreaks 

• Using Surveillance to Limit Spread 

Pillar #3: Response and Containment

These are the actions to limit the spread of the outbreak among humans and to mitigate the 

health, national security, social, and economic impacts of a pandemic, including: 

• Containing Outbreaks 

• Leveraging National Medical and Public Health Surge Capacity 

• Sustaining Infrastructure, Essential Services, and the Economy 

• Ensuring Effective Risk Communication 

IMPLEMENTATION OF THE NATIONAL STRATEGY 

Implementation Plan 

In May 2006, the President issued the Implementation Plan for the National Strategy for 

Pandemic Influenza that provides a directive framework to the National Strategy and assigns 

preparedness and response tasks to Federal departments and agencies and describes U.S. 

Government (USG) expectations of non-Federal entities, including State and local governments, 

the private sector, international partners, and individuals. 
5 

The Implementation Plan for the National Strategy acknowledges that because preparedness for 

a pandemic requires the establishment of infrastructure and capacity, a process that can take 

years, significant steps must be taken now. It also makes clear that every segment of society 

must be involved in the preparations, as well as the response. For this reason, significant steps 

must be taken now.3

Interagency Tasks and Plan Organization 

The National Implementation Plan translates the National Strategy into over 300 tasks that will 

allow all Federal departments and agencies to engage fully their personnel and resources by 

taking specific, coordinated steps to achieve the goals of the National Strategy. Because 

preparedness and response activities also depend upon entities outside of the Federal 

government, it also outlines expectations of non-federal stakeholders in the United States and 

abroad. 

If efforts to contain human-to-human transmission of a potential pandemic influenza outbreak at 

its source fail, the resources of the USG will not be sufficient to prevent the spread of a 

pandemic across the nation. Accordingly, the USG will use all instruments of national power to 

address the pandemic threat. Any effective response will require the full participation of all 

levels of government and the private sector. 

The Implementation Plan for the National Strategy is organized into functional areas that address 

the full range of consequences of a pandemic: Federal Government Response for a Pandemic; 

International Efforts; Transportation and Border Security; Protection of Human Health; 

Protection of Animal Health; Law Enforcement, Public Safety, and Security; and Protection of 

Personnel and Ensuring Continuity of Operations. These chapters are further divided to reflect 

each of the three pillars that comprise the National Strategy for Pandemic Influenza. 

Priority Actions 

The HSC conducted an assessment of the Implementation Plan tasks and identified thirteen 

priority action areas.4

 While DoD will work to implement all of the tasks assigned in the 

National Implementation Plan, particular attention will be paid to implementing the tasks that 

address the following areas in a timely manner. They are: 

1. Advance International Cooperation. Secure international commitment to transparency, 

scientific cooperation, rapid reporting of human and animal cases, and sharing of data 

and viral isolates. 

 

3

 Homeland Security Council, “Implementation Plan for the National Strategy for Pandemic Influenza”, p. 7. 4

 Homeland Security Council, “Priority Actions in the Implementation for the National Strategy for Pandemic 

Influenza,” May, 2006. 
6 

2. Build International Capacity. Provide technical assistance to build veterinary and 

public health capacity in at-risk countries and to detect and contain animal and human 

outbreaks of avian influenza, including the development and exercise of preparedness 

plans. 

3. Ensure Rapid Response. Develop USG capability to respond rapidly, either 

independently or in support of an international response, to animal or human outbreaks of 

influenza with pandemic potential for purposes of assessment and containment. Support 

development and implementation of World Health Organization (WHO) and the United 

Nations Food and Agriculture Organization (FAO)/World Animal Health Organization 

(OIE) strategy and capacity for international response and containment of animal and 

human outbreaks of influenza with pandemic potential and pandemic influenza. 

4. Ensure Early Warning and Situational Awareness. Enhance avian influenza 

surveillance in humans, wild birds, and poultry.

5. Establish a Border and Transportation Strategy. Develop a comprehensive border 

and transportation strategy that strikes a balance between efficacy of interventions to 

limit the spread of disease and the economic and societal consequences, international 

implications, and operational feasibility of these interventions.

6. Establish Screening Protocols and Implementation Agreements. Establish 

arrangements with international partners to limit voluntarily travel and establish 

screening for travelers from affected areas. 

7. Ensure Effective Risk Communication. Implement educational and risk 

communication programs to increase national and international awareness of the risks of 

avian influenza, and appropriate behaviors to reduce these risks. Ensure that timely, 

accurate, and credible information is provided by spokespeople at all levels of 

government during an outbreak.

8. Provide Guidance on Maximizing Surge Capacity with Available Resources. 

Develop and share with State, local, and tribal public health officials, and the medical 

community, strategies for optimizing the allocation of scarce medical resources during 

periods of severe medical surge, and mechanisms for incorporating additional healthcare 

providers within defined settings.

9. Provide Comprehensive Guidance on Community Shielding. Develop for State, 

local, and tribal partners a template for community containment that builds upon data 

available from state-of-the art modeling, and scientific understanding of influenza 

biology and patterns of transmission.

10. Provide Clear Guidance for the Private Sector and Institutions. Develop pandemic 

planning guidance for private sector, Federal, State, local and tribal entities.
7 

11. Develop Rapid Diagnostics. Support development of rapid, sensitive, and accurate 

diagnostic tests, to be used in the clinical setting and for screening.

12. Establish Stockpiles of Vaccine and Antivirals. Build stockpiles of pre-pandemic 

vaccine and antiviral medications and define strategies for their use.

13. Advance Technology and Production Capacity for Influenza Vaccine. Develop cellbased vaccines manufacturing methods and increase domestic vaccine production 

capacity.

DEPARTMENT OF DEFENSE IMPLEMENTATION 

Preparing and responding to a pandemic influenza will require an active, layered defense. This 

active, layered defense is global, integrating seamlessly, U.S. capabilities in the forward regions 

of the world, in approaches to the U.S. territory, and within the United States. It is a defense in 

depth.5

 It will include assisting partner countries to prepare for and detect an outbreak, respond 

should one occur, and manage the key second-order effects that could lead to an array of 

challenges. The top priority is the protection of DoD forces, comprised of the military, DoD 

civilians and contractors performing critical roles, as well as the associated resources necessary 

to maintain readiness. Also, it is critical to ensure DoD is able to sustain mission assurance and 

the ability to meet our strategic objectives. Priority consideration is also given to protect the 

health of DoD beneficiaries and dependents. 

Planning Assumptions 

• Developed countries will be quicker in preparing for, detecting, and responding to 

outbreaks than less developed countries. 

• Some Coalition partners, allies, and host nation governments will request military 

assistance and training from the USG for pandemic influenza preparedness, surveillance 

and detection, and response. 

• An efficient human-to-human outbreak will most likely occur outside of the United States 

and may not be contained effectively. 

• A pandemic outbreak will last between 6-12 weeks and multiple pandemic waves will 

follow. 

• Pandemics travel in waves; not all parts of the world will be affected at the same time or 

affected to the same degree (e.g., multiple waves). 

 

5

 Department of Defense, “Strategy for Homeland Defense and Civil Support,” (June 2005). 
8 

• DoD can expect requests from interagency partners to support civilian mortuary affairs 

operations. 

• If a pandemic influenza starts outside the United States, it will enter the U.S. at multiple 

locations and spread quickly to other parts of the country. 

• A pandemic in the United States could result in 20-35% of the population becoming ill, 

3% being hospitalized, and a fatality rate of 1%. 

• A vaccine (pandemic specific strain) will not be available for distribution for a minimum 

of 6-9 months after the clinical confirmation of sustained human-to-human pandemic 

influenza transmission. 

• State, tribal and local jurisdictions will be overwhelmed and unable to provide or ensure 

the provision of essential commodities and services. 

• Infected people, confirmed (when possible) or suspected, will not be transported to any 

facilities beyond the affected area unless their medical condition demands movement. 

• International and inter-state transportation will be restricted to contain the spread of the 

virus. 

• Voluntary, community-based measures, such as limiting public gatherings, closing 

schools, and minimum manning procedures, are most effective to limit exposure to the 

disease if implemented before or at the onset of the event. Quarantine and other 

movement restrictions, especially if the restrictions are involuntary, will have minimal 

effect on the spread of the disease due to a very short incubation period and the ability of 

asymptomatic individuals to shed the virus. 

• The provision of routine security services for the protection of critical infrastructure will 

require Federal augmentation. 

• Military and civilian medical treatment facilities will be overwhelmed. 

 

• Military treatment facilities and other installation support functions will be short staffed 

due to the use of some uniformed providers providing support elsewhere. 

• DoD will conduct Non-Combatant Evacuation Operations (NEOs) of non-infected 

individuals from areas abroad experiencing outbreaks. 

• DoD will be called upon to assist in the transportation of American citizens living abroad 

if deemed necessary by public health officials or the U.S. State Department. 

• In accordance with existing agreements, and in limited circumstances, under Immediate 

Response Authority, DoD will provide support to local communities’ medical efforts 
9 

with personnel, equipment, pharmaceuticals, supplies, and facilities within DoD 

capabilities, as requested. 

• Under applicable authorities, DoD will assist civil authorities in the event of a pandemic. 

• DoD reliance on "just-in-time" procurement will compete adversely with U.S. and 

foreign civilian businesses for availability of critical supplies. 

• DoD will support security and possibly staffing of National Critical Infrastructure at all 

levels (e.g., air traffic control, security for National critical infrastructure, etc.). 

• DoD Reserve component forces will need to be quickly mobilized to provide surge 

capabilities, especially in the areas of medical, transportation, and logistics. 

Planning Priorities 

DoD will take all necessary actions to prepare for and respond to pandemic influenza. Under the 

National Implementation Plan, department and agencies focus on four areas: (1) protection of 

the health and safety of personnel and resources, (2) determination of essential functions and 

services and the maintenance of each in a pandemic influenza outbreak, (3) support to Federal, 

State, and local governments, and (4) effective communications. The DoD plan will include a 

fifth area – support to international partners and international stability and security. The DoD 

Implementation Plan will address each of the five planning priorities under the three pillars of 

the national strategy. 

Stages of the Federal Government Response 

The World Health Organization (WHO) pandemic phases provide succinct statements about the 

global risk for a pandemic and provide benchmarks against which to measure global response 

capabilities (See Annex B, Force Health and Protection). In order to describe the Federal 

Government approach to the pandemic response, however, it is more useful to characterize the 

stages of an outbreak in terms of the immediate and specific threat a pandemic virus poses to the 

U.S. population. The National Implementation Plan (Chapter 3) provides a framework for 

Federal Government actions: 

• Stage 0: New Domestic Animal Outbreak in At-Risk Country 

• Stage 1: Suspected Human Outbreak Overseas 

• Stage 2: Confirmed Human Outbreak Overseas 

• Stage 3: Widespread Human Outbreaks in Multiple Locations Overseas 

• Stage 4: First Human Case in North America 

• Stage 5: Spread throughout United States 

• Stage 6: Recovery and Preparation for Subsequent Waves 
10 

A common and uniform phasing construct will be essential to DoD planning. The Joint Staff 

will provide more detailed planning guidance for the synchronization of and phasing integration 

into Combatant Command planning. 

Critical Planning Categories 

The following nineteen Critical Planning Categories should be considered in DoD PI plans. 

These categories were developed from the five HSC planning priorities and the thirteen HSC 

priority areas (in parenthesis), and are based on DoD capabilities. Each HSC priority area is 

aligned with one or more DoD Critical Planning Categories. Each task will include planning 

factors for Reserve component forces as appropriate. These tasks are: 

• Category #1: Intelligence (Advance International Cooperation, Ensure Early 

Warning/Situational Awareness, Ensure Effective Risk Communication).

• Category #2: Force Protection (Establish Stockpiles of Vaccines, Establish a 

Border/Transportation Strategy, Provide Comprehensive Guidance on Community 

Shielding). 

• Category #3: Biosurveillance, Disease Detection and Information Sharing (Ensure 

Rapid Response, Ensure Early Warning/Situational Awareness, Establish Screening 

Protocols and Implementation Agreements, Provide Comprehensive Guidance on 

Community Shielding, Develop Rapid Diagnostics, Advanced Technology/Production 

for Influenza Vaccine). 

• Category #4: Interagency Planning Support (Establish a Border/Transportation 

Strategy, Ensure Rapid Response, Ensure Effective Risk Communication, Provide 

Guidance on Maximizing Surge Capacity, Provide Clear Guidance for Private 

Sector/Institutions). 

• Category #5: Surge Medical Capability to Assist Civil Authorities (Lab, Public 

Health Teams, Diagnostics, Medical Personnel) (Provide Guidance on Maximizing Surge 

Capacity, Develop Rapid Diagnostics, Establish Stockpiles of Vaccine).

• Category #6: Medical Care to U.S. Forces (Establish Stockpiles of Vaccine). 

• Category #7: Patient Transport and Strategic Airlift (Establish a 

Border/Transportation Strategy, Establish Stockpiles of Vaccine and support evacuation 

of non-infected individuals). 

• Category #8: Installation Support to Civilian Agencies (Advance International 

Cooperation, Ensure Rapid Response, Ensure Early Warning/Situational Awareness). 

• Category #9 Bulk Transport of Pharmaceuticals/Vaccines (Establish Stockpiles of 

Vaccine). 

• Category #10: Security in Support of Pharmaceutical/Vaccine Production (Critical 

Infrastructure Protection (CIP) (Establish Stockpiles of Vaccine). 
11 

• Category #11: Security in Support of Pharmaceutical/Vaccine Distribution

(Establish Stockpiles of Vaccine). 

• Category #12: Communications Support to Civil Authorities (Ensure Early Warning/ 

Situational Awareness, Interoperability and Communication Assurance).

• Category #13: Quarantine Assistance to U.S. Civil Authorities (Ensure Rapid 

Response). 

• Category #14: Military Assistance for Civil Disturbances (Establish a Border/ 

Transportation Strategy). 

• Category #15: Mission Assurance: Defense Industrial Base (Advance 

Technology/Production Capacity for Influenza Vaccine).

• Category #16: Mortuary Affairs (Ensure Rapid Response).

• Category #17: Continuity of Operations & Continuity of Government (Establish a 

Border/Transportation Strategy, Provide Clear Guidance for Private Sector/Institutions). 

• Category #18: Support to International Allies and Non-Governmental 

Organizations (NGOs) (Advance International Cooperation, Build International 

Capacity, Ensure Rapid Response, Establish Screening Protocols, Ensure Effective Risk 

Communication, Provide Clear Guidance for Private Sector/Institutions). 

• Category #19: Public Affairs Support to Civil Authorities (Ensure Effective Risk 

Communication). 

Critical Planning Category Alignment with National Strategy Pillars and Priorities 

Each DoD Critical Planning Category is aligned below to a national strategy pillar. A category 

can be aligned with more than one national pillar, if appropriate. DoD Tasks are further aligned 

with each task from the National Implementation Plan at Annex A, DoD Pandemic Influenza 

Preparedness and Response Task Matrix. 

Pillar #1: Preparedness and Communications 

• Force Health Protection and Readiness (DoD Category #2: Force Protection). The 

priority of DoD health service support assets will be to ensure sufficient personnel, 

equipment, facilities, materiel, and pharmaceuticals are ready to provide the highest 

possible level of health support and preserve worldwide operational effectiveness of DoD 

forces, civilians, contractors, dependents, and beneficiaries (See Annex C, Force Health 

and Protection). 

• Pandemic Phases. DoD's health support activities with respect to pandemic influenza 

are correlated to the six phases of a pandemic as described by the WHO (reference b) and 

the phases outlined in the Homeland Security Council, National Strategy for Pandemic 

Influenza Implementation Plan, (reference w). 
12 

o . DoD will utilize these guidelines to the maximum extent possible, but will do so 

in an advisory capacity only. Within each of these phases are the three pillars of 

the National Strategy that form the basis of DoD's health service support activities 

both domestically and abroad. 

o Medication Recommendations and Guidance. Specific recommendations and 

guidance for immunizations (reference b) and the distribution of anti-viral 

medications (reference e) have been developed. Modifications to this guidance 

will be released during the course of the pandemic, as required. Planning and 

coordination activities have been conducted with other Federal departments, 

including the Department of Agriculture and the Department of Health and 

Human Services (DHHS). DoD established a medical WATCHBOARD that can 

be accessed on the Internet (https://fhp.osd.mil/aiWatchboard/index.html) to 

provide the latest information as well as links to other sources of information. 

DoD is coordinating closely with the DHHS to obtain supplies of influenza 

vaccine when it becomes available. Additionally, DoD is working to obtain 

reliable sources of medical supply items such as personal protective equipment 

for patients, caregivers, and health care providers. 

• Continuity of Essential Functions and Services (DoD Category #17: Continuity of 

Operations & Continuity of Government). National policy requires DoD to develop a 

comprehensive continuity of operations (COOP) program to ensure the continuation of 

essential functions during any emergency or situation that may disrupt normal operations, 

and in conjunction with other government departments and agencies, to preserve the 

overall continuity of government (COG). Unlike other catastrophic events, an influenza 

pandemic has no direct affect on an organization’s communications or physical 

infrastructure, but will affect directly its personnel. Therefore, it is critical that DoD 

focus planning efforts on the potential impact of an influenza pandemic on its personnel 

and the ability to continue essential functions. 

• Defense Support to Civil Authorities. DoD established the Pandemic Influenza Task 

Force (PITF) to coordinate within DoD and with other Federal departments and agencies. 

Additionally, Combatant Commanders and Military Departments are currently 

developing plans that include preparatory actions in support of international partners, 

under applicable authorities, and as directed by the President and/or the Secretary of 

Defense.

o DoD Category #4: Interagency Planning Support. DoD will plan 

appropriately for homeland defense and domestic contingency missions, as well 

as provide planning support to interagency partners for domestic support 

operations. 

o DoD Category #9: Bulk Transportation of Pharmaceuticals/Vaccines. DoD 

will provide distribution of medical supplies and medications in support of 

pandemic influenza preparedness and response efforts, when directed by the 
13 

President or upon approval by the Secretary of Defense of a request from a 

Federal department or agency.

o DoD Category #10: Security in Support of Pharmaceutical/Vaccine 

Production, DoD #11: Security in Support of Pharmaceutical/Vaccine 

Distribution. Consistent with applicable laws, DoD will provide security in 

support of pharmaceutical/vaccine production and distribution efforts, when 

directed by the President or upon approval by the Secretary of Defense of a 

request from a Federal department or agency. 

o DoD Category #15: Mission Assurance: Defense Industrial Base. As 

appropriate, DoD will coordinate with the private sector on all issues concerning 

the Defense Industrial Base in the event of a pandemic influenza. 

• Communications. DoD will prepare communication plans and provide communication 

support at the tactical, operational, and strategic levels in support of DoD personnel and 

civil authorities, as required.

o DoD Category #12: Communications Support to Civil Authorities. As 

resources permit, DoD will provide communications equipment support with 

associated training to civil authorities as requested in preparation for and during a 

pandemic influenza outbreak.

o DoD Category #19: Public Affairs Support to Civil Authorities. DoD will 

coordinate all public affairs guidelines and messages for a pandemic influenza 

outbreak with interagency partners.

• Support to International Partners (DoD Category #18: Support to International 

Allies and NGOs). In coordination with the Department of State (DoS), DoD will 

provide support to host nations and militaries as resources are available and as requested. 

Combatant Commanders and Military Departments will develop plans that include 

preparatory actions in support of international partners, under applicable authorities and 

as directed by the President and/or the Secretary of Defense.

o Improve Military Relations. Continue efforts to improve military relations with 

host nation military partners by providing assistance in preparing, mitigating, and 

responding to a potential pandemic influenza. 

o Assess Military Preparedness. Propose and support bi-lateral and multi-lateral 

assessments of “high-risk country” military preparedness. Depending on the 

individual needs of the host nation military, these assessments can include 

reviewing their national military pandemic influenza plans, assessing their 

military lab diagnostic and surveillance capacity, assessing their military response 

capacity for containing and managing outbreaks, determining their military 

capacity for avian influenza information management and reviewing their military 

public awareness campaign. 
14 

o Support Pandemic Influenza (PI) Training and Exercises. Provide limited 

support of training activities and exercises that develop host nation military 

pandemic influenza response plans and development of rapid response teams. In 

addition, this support can assist training of military health personnel in pandemic 

influenza infection control and case management, quarantine operations, and 

developing of a military public response campaign. 

o Assist with Protective Equipment Procurement. Provide limited assistance to 

host nation militaries in procuring personal protective equipment (animal and 

human control), laboratory diagnostic equipment, portable field assay testing 

equipment, passive and active animal and human surveillance equipment, and 

essential disease information communication equipment. 

Pillar #2: Surveillance and Detection. DoD is continually conducting influenza surveillance at 

laboratories within the United States and on its installations worldwide. Policies have been 

developed, or are under development, to enhance detection capabilities at the lowest possible 

level. Information systems are in place that can identify outbreaks of disease in deployed forces. 

Detailed planning and execution tasks are located in the Intelligence Annex (Part of Annex B is 

Classified Confidential/NOFORN (C/NF) –Disseminated Separately). 

• Force Health Protection and Readiness.

o DoD Category #1: Intelligence. Intelligence derived from the collection, 

evaluation, analysis, and interpretation of foreign medical, bio-scientific, 

infectious disease, and environmental information. The intelligence is of interest 

to strategic medical planning and operations for the preservation of readiness and 

the formation of assessments of foreign medical capabilities in both military and 

civilian sectors (See Annex B, Intelligence (Part of Annex B is Classified 

Confidential/NOFORN (C/NF) –Disseminated Separately)). 

o DoD Category #3: Biosurveillance, Disease Detection, and Information 

Sharing. The ongoing, systematic collection of health data essential to the 

evaluation, planning, and implementation of public health practice, integrated 

closely with the timely dissemination of data as required by higher authority.

• Defense Support to Civil Authorities. DoD currently conducts medical surveillance 

and detection domestically and abroad in coordination with the appropriate Federal 

departments and agencies. 

• Communications. DoD will ensure that surveillance and detection assets are integrated 

into interagency reporting protocols and procedures. This integration will provide 

effective dissemination of information and timely warning to DoD forces and civil 

authorities in the event of a suspected pandemic influenza outbreak.
15 

o DoD Category #12: Communications Support to Civil Authorities. As 

resources permit, DoD will provide communications equipment support with 

associated training to civil authorities as requested in preparation for a pandemic 

influenza outbreak.

o DoD Category #19: Public Affairs Support to Civil Authorities. DoD will 

coordinate all public affairs guidelines and messages for a pandemic influenza 

outbreak with interagency partners.

• Support to International Partners (DoD Task #18: Support to International Allies 

and Non-Governmental Organizations). DoD currently conducts medical surveillance 

and detection domestically and abroad in coordination with the appropriate Federal 

departments and agencies. Detailed planning and execution tasks are located in the 

Intelligence Annex (Part of Annex B is Classified (C/NF) –disseminated separately). 

Pillar #3: Response and Containment. DoD will ensure policies and guidelines are in place to 

limit the spread of a pandemic influenza outbreak and to mitigate health, national security, 

economic, and social impacts. Examples include: Clinical guidelines concerning the screening, 

diagnosis, treatment, and management of patients with confirmed infection or suspected 

exposure to pandemic influenza have been developed (reference b) along with policy guidance 

for commanders to exercise emergency health powers. 

• Force Health Protection and Readiness (DoD Category #6: Medical Care to U.S. 

Forces). The priority of DoD health service support assets will be to ensure sufficient 

personnel, equipment, facilities, materiel, and pharmaceuticals are ready to provide the 

highest possible level of health support and preserve worldwide operational effectiveness 

of DoD forces, contractors, dependents, and beneficiaries (See Annex C, Force Health 

and Protection). 

 

• Continuity of Essential Functions and Services (DoD Category #17: Continuity of 

Operations & Continuity of Government). DoD will execute the appropriate 

continuity of operations and continuity of government policies and procedures in the 

event of a pandemic influenza outbreak. Departments and agencies will have specific 

plans to mitigate the effects of absenteeism within their subordinate commands and 

organizations. 

• Defense Support to Civil Authorities. DoD will provide support to a civil authority 

responding to a pandemic influenza when directed by the President or upon approval, by 

the Secretary of Defense, of a request from a Federal department or agency. This 

assistance may include support to containment operations. 

o DoD Category #5: Surge Medical Capability to Assist Civil Authorities. 

DoD may provide medical surge capability to other Federal, State, or local 

agencies when requested or directed to by the President or Secretary of Defense 

(See Annex C, Force Health and Protection). 
16 

o DoD Category #7: Patient Transport and Strategic Airlift. DoD will provide 

transportation support to civilian communities in support of a pandemic influenza 

preparedness and response efforts, when directed by the President, or upon 

approval by the Secretary of Defense, of a request from a Federal department or 

agency. 

o DoD Category #8: Installation Support to Civilian Agencies. DoD will 

provide support to civilian communities in support of pandemic influenza 

preparedness and response efforts, when directed by the President, or upon 

approval by the Secretary of Defense, of a request from a Federal department or 

agency. 

o DoD Category #10: Security in Support of Pharmaceutical/Vaccine 

Production, DoD #11: Security in Support of Pharmaceutical/Vaccine 

Distribution. Consistent with applicable laws, DoD will provide security in 

support of pharmaceutical/vaccine production and distribution efforts, when 

directed by the President, or upon approval by the Secretary of Defense, of a 

request from a Federal department or agency. 

o DoD Category #13: Quarantine Assistance to U.S. Civil Authorities. When 

directed by the President, DoD may assist U.S. civil authorities responsible for 

isolating and/or quarantining groups of people in order to minimize the spread of 

disease during an influenza pandemic. Isolation is a commonly used public health 

practice for the separation and restriction of movement of ill persons to stop the 

spread of a contagious illness. People in isolation may be cared for in their 

homes, in hospitals, or at designated health care facilities. Isolation is primarily 

used on an individual level, but may be applied to populations. It is often 

voluntary, but may be mandatory. Quarantine, in contrast, applies to the 

separation and restriction of movement of well persons presumed to have been 

exposed to a contagion. Quarantine may be enacted at a home or other residential 

facility. It may also be voluntary or mandatory. 

o DoD Category #14: Provide Defense Assistance for Civil Disturbances. 

When directed by the President, DoD will provide support to civil authorities in 

the event of a civil disturbance. DoD will augment civilian law enforcement 

efforts to restore and maintain order in accordance with existing statutes. 

o DoD Category #16: Mortuary Affairs. Mortuary Affairs (MA) capabilities 

within DoD are extremely limited. When directed by the President, or upon 

approval by the Secretary of Defense, of a request from a Federal department or 

agency, DoD can provide search, recovery, receiving, processing, and can 

coordinate evacuation of remains of the deceased. 

• Communications. 
17 

o DoD Category #12: Communications Support to Civil Authorities. As 

resources permit, DoD will provide communications equipment support with 

associated training to civil authorities as requested in the event of a pandemic 

influenza outbreak.

o DoD Category #19: Public Affairs Support to Civil Authorities. DoD will 

coordinate all public affairs guidelines and messages for a pandemic influenza 

outbreak with Interagency partners.

• Support to International Partners. DoD will provide support in response to a 

pandemic influenza when directed by the President, or upon approval by the Secretary of 

Defense, of a request from a Federal department or agency. This assistance may include 

support to containment operations and stability operations. 

Pre-Scripted Requests for Assistance 

During pandemic influenza planning, the DoD assigned Office of Primary Responsibility (OPR) 

will coordinate with primary federal agencies to determine pre-identified gaps that DoD can fill 

based upon analysis within their own Pandemic Influenza response plans. The analysis to 

determine gaps must be done by those federal agencies with interagency leads for the 19 DoD 

categories. Upon completion of the analysis, the primary federal agency will nominate potential 

Request for Assistance (RFA’s) with a capability statement that supports possible requests for 

assistance from domestic civil authorities. The DoD OPRs will further task Combatant 

Commanders through the Joint Staff to develop, prior to an incident, a “pre-scripted request for 

assistance matching DoD capability with pre-determined interagency gaps. These pre-scripted 

requests for assistance are not pre-approved requests. 

OASD(HD) will provide supervision of the overall effort, along with the Joint Staff. Members 

of the working group will include appropriate stakeholders from DoD and interagency partners. 

Pandemic Influenza Task Force 

In November 2005, the Deputy Secretary of Defense directed that a pandemic task force be 

established within DoD. The Assistant Secretary of Defense for Homeland Defense (ASD(HD)) 

was named as the lead for the Pandemic Influenza Task Force (PITF). The Assistant Secretary 

of Defense for Health Affairs (ASD(HA)) is supporting the effort as the Department’s lead for 

health service support for pandemic influenza preparedness and response. The PITF is charged 

with the coordination and implementation of policies and plans which will (1) prepare for, detect, 

respond to, and contain the effects of a pandemic on military forces, DoD civilians, contractors, 

dependents, and beneficiaries; (2) ensure the Department’s continued ability to protect American 

interests at home and abroad; and (3) be prepared to render appropriate assistance to civilian 

authorities in the United States (to include Commonwealths, Territories, and Possessions). 6

 

6

 Department of Defense memorandum, subject: “Avian Influenza Pandemic Task Force”, November 2005. 
18 

• Roles and Responsibilities. The ASD(HD) serves as the principal civilian advisor to the 

Deputy Secretary of Defense for all matters concerning pandemic influenza preparedness 

and response, as well as coordinates all efforts of the PITF. These efforts will include 

coordination of pandemic influenza preparedness, mitigation, and response policy within 

DoD and among appropriate interagency, international, governmental and nongovernment agencies and host nation partners. 

o ASD(HA) will serve as the principal civilian advisor to the Deputy Secretary of 

Defense for health service support for pandemic influenza preparedness and 

response. 

o Office of the Assistant Secretary of Defense for Special Operations and Low 

Intensity Conflict (ASD(SO/LIC)) will provide policy oversight of the DoD 

Pandemic Influenza bilateral and multilateral international partnership capacity 

building program. 

• Other Task Force Representatives. Other representatives include the Office of the 

Under Secretary of Defense for Intelligence (USD(I)), Office of the Under Secretary of 

Defense for Acquisition, Technology, and Logistics (USD(AT&L)), the Under Secretary 

for Personnel and Readiness (USD(P&R)), Assistant Secretary of Defense for Public 

Affairs (ASD(PA)), the Joint Staff, and Combatant Commanders. Military Departments, 

Defense Agencies, and other DoD entities will be directed to support Task Force efforts 

as required. 

CONCLUSION 

The Implementation Plan for the National Strategy for Pandemic Influenza provided guidance 

for Federal departments and agencies to implement preparedness and response tasks for a 

pandemic influenza outbreak. In response, DoD developed this document to provide planning 

and implementation guidance to the Office of the Secretary of Defense, Combatant 

Commanders, Military Departments, and DoD Agencies. A recent article published by the 

Centers for Disease Control and Prevention remarked that “...the H5N1 influenza threat is 

viewed with disturbing complacency; a frequently heard statement is ‘since the virus has not 

adapted to continuing human-to-human transmission by now, it is unlikely to do so in the future.’ 

Such complacency is akin to living on a geologic fault line and failing to take precautions against 

earthquakes and tsunamis.”7

It is imperative that DoD develop policies and plans that provide for an active, layered defense 

and coordinate with our Federal partners to ensure that governments at all levels domestically 

and abroad are prepared to face a pandemic threat. 

 

7

 Centers for Disease Control and Prevention, Emerging Infectious Diseases, “H5N1 Outbreaks and Enzootic 

Influenza,” January 2006, p. 3. 
19 

ANNEXES 

A – DoD Pandemic Influenza Preparedness and Response Task Matrix 

B – Intelligence (Annex is Classified (C/NF) –Disseminated Separately) 

C – Force Health and Protection 

D – Continuity of Operations/Continuity of Government 

E – Public Affairs 

F – Definitions 

G – References 
20 

ANNEX A, DEPARTMENT OF DEFENSE PANDEMIC INFLUENZA 

PREPAREDNESS AND RESPONSE TASKS 

PURPOSE 

This annex lists all tasks assigned to the Department of Defense (DoD) in the National 

Implementation Plan for the National Strategy for Pandemic Influenza. It additionally assigns 

tasks to primary and supporting offices within the Department. 

There are 114 total tasks of which 31 have DoD in the primary role (in red), and 83 with DoD in 

a supporting role (in blue). 

Offices of Primary Responsibility (OPR) will begin assigned actions or begin coordination of 

tasks upon receipt of this framework. OPRs will coordinate all actions with other appropriate 

offices within the Office of the Secretary of Defense, as well as Joint Staff and/or Military 

Services and DoD Agency counterparts, as appropriate. OPR abbreviations are: 

• USD (P&R) – Office of the Under Secretary for Personnel and Readiness 

• HD - Office of the Assistant Secretary of Defense for Homeland Defense 

• HA - Office of the Assistant Secretary of Defense for Health Affairs 

• SOLIC - Office of the Assistant Secretary of Defense for Special Operations and LowIntensity Conflict 

• NGB – National Guard Bureau 
21 

PANDEMIC INFLUENZA PREPAREDNESS AND RESPONSE TASK MATRIX 

DOD 

Planning 

Category 

National 

Plan 

Action 

Number 

Actions Timeframe 

(Months) 

Interagency 

Leads 

DOD 

OPR DOD Role 

Support to 

International 

Allies and NGOs 

4.1.1.3 Conduct Military-Military 

Assistance Planning 

DOD, in coordination with DOS and 

other appropriate Federal agencies, 

host nations, and regional alliance 

military partners, shall, within 18 

months: (1) conduct bilateral and 

multilateral assessments of the avian 

and pandemic preparedness and 

response plans of the militaries in 

partner nations or regional alliances 

such as NATO focused on preparing 

for and mitigating the effects of an 

outbreak on assigned mission 

accomplishment; (2) develop 

solutions for identified national and 

regional military gaps; and (3) 

develop and execute bilateral and 

multilateral military-to-military 

influenza exercises to validate 

preparedness and response plans. 

Measure of performance: all 

countries with endemic avian 

influenza engaged by U.S. efforts; 

initial assessment and identification of 

exercise timeline for the military of 

each key partner nation completed. 

18 DOD DOS SOLIC Primary 

Agency 

Support to 

International 

Allies and NGOs 

4.1.2.6. Priority Country Military-Military 

Infection Control Training 

DOD, in coordination with DOS, host 

nations, and regional alliance military 

partners, shall assist in developing 

priority country military infection 

control and case management 

capability through training programs, 

within 18 months. Measure of 

performance: training programs 

carried out in all priority countries with 

increased military infection control 

and case management capability. 

18 DOD DOS SOLIC Primary 

Agency 
22 

Biosurveillance, 

Disease 

Detection and 

Information 

Sharing 

4.1.8.4. Open Source Information Sharing 

HHS and DOD, in coordination with 

DOS, shall enhance open source 

information sharing efforts with 

international organizations and 

agencies to facilitate the 

characterization of genetic sequences 

of circulating strains of novel 

influenza viruses within 12 months. 

Measure of performance: publication 

of all reported novel influenza viruses 

which are sequenced. 

12 HHS DOD

DOS 

HA Primary 

Agency 

Biosurveillance, 

Disease 

Detection and 

Information 

Sharing 

4.2.2.5. Inpatient and Out patient Disease 

Surveillance 

DOD shall develop active and 

passive systems for inpatient and 

outpatient disease surveillance at its 

institutions worldwide, with an 

emphasis on index case and cluster 

identification, and develop 

mechanisms for utilizing DOD 

epidemiological investigation experts 

in international support efforts, to 

include validation of systems/tools 

and improved outpatient/inpatient 

surveillance capabilities, within 18 

months. Measure of performance: 

monitoring system and program to 

utilize epidemiological investigation 

experts internationally are in place. 

18 DOD HA Primary 

Agency 

Biosurveillance, 

Disease 

Detection and 

Information 

Sharing 

4.2.2.6. Monitoring Health of Military 

Forces Worldwide 

DOD shall monitor the health of 

military forces worldwide to include 

the appropriate monitoring of Reserve 

component forces (CONUS and 

OCONUS bases, deployed 

operational forces, exercises, units, 

etc.), and in coordination with DOS, 

coordinate with allied, coalition, and 

host nation public health communities 

to investigate and respond to 

confirmed infectious disease 

outbreaks on DOD installations, 

within 18 months. Measure of 

performance: medical surveillance 

“watchboard” reports show results of 

routine monitoring, number of 

validated outbreaks, and results of 

interventions. 

18 DOD DOS HA Primary 

Agency 
23 

Biosurveillance, 

Disease 

Detection and 

Information 

Sharing 

4.2.2.7. Assist with Influenza Surveillance 

in Host Nations 

DOD, in coordination with DOS and 

with the cooperation of the host 

nation, shall assist with influenza 

surveillance of host nation 

populations in accordance with 

existing treaties and international 

agreements, within 24 months. 

Measure of performance: medical 

surveillance “watchboard” expanded 

to include host nations. 

24 DOD DOS HA 

coord 

with 

SOLIC 

Primary 

Agency 

Biosurveillance, 

Disease 

Detection and 

Information 

Sharing 

4.2.3.8. Develop/Enhance DoD Network of 

Overseas Infrastructure 

DOD, in coordination with HHS, shall 

develop and refine its overseas 

virologic and bacteriologic 

surveillance infrastructure through 

Global Emerging Infections 

Surveillance and Response System 

(GEIS) and the DOD network of 

overseas labs, including fully 

developing and implementing 

seasonal influenza laboratory 

surveillance and an animal/vector 

surveillance plan linked with WHO 

pandemic phases, within 18 months. 

Measure of performance: 

animal/vector surveillance plan and 

DOD overseas virologic surveillance 

network developed and functional. 

18 DOD HHS HA Primary 

Agency 

Biosurveillance, 

Disease 

Detection and 

Information 

Sharing 

4.2.3.9. Refinement of DoD Laboratory 

Methods 

DOD, in coordination with HHS, shall 

prioritize international DOD laboratory 

research efforts to develop, refine, 

and validate diagnostic methods to 

rapidly identify pathogens, within 18 

months. Measure of performance: 

completion of prioritized research 

plan, resources identified, and tasks 

assigned across DOD medical 

research facilities. 

18 DOD HHS HA Primary 

Agency 
24 

Support to 

International 

Allies and NGOs 

4.2.3.10. Assess Foreign Country Military 

Lab Capacity

DOD shall work with priority nations’ 

military forces to assess existing 

laboratory capacity, rapid response 

teams, and portable field assay 

testing equipment, and fund essential 

commodities and training necessary 

to achieve an effective national 

military diagnostic capability, within 

18 months. Measure of performance: 

assessments completed, proposals 

accepted, and funding made 

available to priority countries. 

18 DOD SOLIC 

Coord 

with HA 

Primary 

Agency 

Public Affairs 

Support to Civil 

Authorities 

4.2.4.2. Combatant Command Public 

Health Reports for Area Personnel 

DOD shall incorporate international 

public health reporting requirements 

for exposed or ill military international 

travelers into the Geographic 

Combatant Commanders’ pandemic 

influenza plans within 18 months. 

Measure of performance: reporting 

requirements incorporated into 

Geographic Combatant 

Commanders’ pandemic influenza 

plans. 

18 DOD HA Primary 

Agency 

Installation 

Support to 

Civilian 

Agencies 

4.3.2.2. Identify DoD Facilities to Serve as 

Points of Entry from Outbreak 

Countries 

DOD, in coordination with DOS, HHS, 

DOT, and DHS, will limit official DOD 

military travel between affected areas 

and the United States. Measure of 

performance: DOD identifies military 

facilities in the United States and 

OCONUS that will serve as the points 

of entry for all official travelers from 

affected areas, within 6 months. 

6 DOD DOS 

HHS DOT 

DHS 

HD Primary 

Agency 

Force Protection 

Patient 

Transport and 

Strategic Lift 

Military 

Assistance for 

Civil 

Disturbances 

5.1.1.5. Assessment of Military Support for 

Transportation and Borders 

DOD, in coordination with DHS, DOT, 

DOJ, and DOS, shall conduct an 

assessment of military support 

related to transportation and borders 

that may be requested during a 

pandemic and develop a 

comprehensive contingency plan for 

Defense Support to Civil Authorities, 

within 18 months. Measure of 

performance: Defense Support to 

Civil Authorities plan in place that 

addresses emergency transportation 

and border support. 

18 DOD DHS 

DOT DOJ 

DOS 

HD Primary 

Agency 
25 

Force Protection 5.3.4.8. Strategic Military Deployment Use 

of Airports and Seaports 

DOD, in coordination with DHS and 

DOS, shall identify those domestic 

and foreign airports and seaports that 

are considered strategic junctures for 

major military deployments and 

evaluate whether additional riskbased protective measures are 

needed, within 18 months. Measure 

of performance: identification of 

critical air and seaports and 

evaluation of additional risk-based 

procedures, completed. 

18 DOD DHS 

DOS 

HD Primary 

Agency 

Military 

Assistance for 

Civil 

Disturbances 

Bulk Transport 

of 

Pharmaceuticals

/Vaccines 

Patient 

Transport and 

Strategic Lift 

5.3.5.5. Monitor and Report on Military 

Assets Requested for Border 

Protection 

DOD, when directed by Secretary of 

Defense and in accordance with law, 

shall monitor and report the status of 

the military transportation system and 

those military assets that may be 

requested to protect the borders, 

assess impacts (to include 

operational impacts), and coordinate 

military services in support of Federal 

agencies and State, local, and tribal 

entities. Measure of performance: 

when DOD activated, regular reports 

provided, impacts assessed, and 

services coordinated as needed. 

 DOD HD Primary 

Agency 

Medical Care to 

US Forces 

Surge Medical 

Capability to 

Assist Civil 

Authorities 

6.1.6.3. Conduct Medical Materiel 

Requirements Gap Analysis 

DOD, as part of its departmental 

implementation plan, shall conduct a 

medical materiel requirements gap 

analysis and procure necessary 

materiel to enhance Military Health 

System surge capacity, within 18 

months. Measure of performance: 

gap analysis completed and 

necessary materiel procured. 

18 DOD HA Primary 

Agency 
26 

Medical Care to 

US Forces 

Surge Medical 

Capability to 

Assist Civil 

Authorities 

6.1.6.4. Maintain Antiviral and Vaccine 

Stockpiles 

HHS, DOD, VA and the States shall 

maintain antiviral and vaccine 

stockpiles in a manner consistent with 

the requirements of FDA’s Shelf Life 

Extension Program (SLEP) and 

explore the possibility of broadening 

SLEP to include equivalently 

maintained State stockpiles, within 6 

months. Measure of performance: 

compliance with SLEP requirements 

documented; decision made on 

broadening SLEP to State stockpiles. 

6 HHS DOD 

VA

HA Primary 

Agency 

Medical Care to 

US Forces 

Surge Medical 

Capability to 

Assist Civil 

Authorities 

6.1.7.4. Establish Stockpiles of Vaccine 

Against H5N1 

DOD shall establish stockpiles of 

vaccine against H5N1 and other 

influenza subtypes determined to 

represent a pandemic threat 

adequate to immunize approximately 

1.35 million persons for military use 

within 18 months of availability. 

Measure of performance: sufficient 

vaccine against each influenza virus 

determined to represent a pandemic 

threat in DOD stockpile to vaccinate 

1.35 million persons. 

18 DOD HA Primary 

Agency 

Medical Care to 

US Forces 

Surge Medical 

Capability to 

Assist Civil 

Authorities 

6.1.9.3. Procure 2.4 Million Antiviral 

Medications 

DOD shall procure 2.4 million 

treatment courses of antiviral 

medications and position them at 

locations worldwide within 18 months. 

Measure of performance: aggregate 

2.4 million treatment courses of 

antiviral medications in DOD 

stockpiles. 

18 DOD HA Primary 

Agency 

Medical Care to 

US Forces 

Surge Medical 

Capability to 

Assist Civil 

Authorities 

6.1.13.8. Supply Military Units/Bases with 

Influenza Medication 

DOD shall supply military units and 

posts, installations, bases, and 

stations with vaccine and antiviral 

medications according to the 

schedule of priorities listed in the 

DOD pandemic influenza policy and 

planning guidance, within 18 months. 

Measure of performance: vaccine 

and antiviral medications procured; 

DOD policy guidance developed on 

use and release of vaccine and 

antiviral medications; and worldwide 

distribution drill completed. 

18 DOD HA Primary 

Agency 
27 

Medical Care to 

US Forces 

Surge Medical 

Capability to 

Assist Civil 

Authorities 

6.2.2.9. Enhance Public Health Response 

Capabilities 

DOD shall enhance influenza 

surveillance efforts within 6 months 

by: (1) ensuring that medical 

treatment facilities (MTFs) monitor 

the Electronic Surveillance System 

for Early Notification of Communitybased Epidemics (ESSENCE) and 

provide additional information on 

suspected or confirmed cases of 

pandemic influenza through their 

Service surveillance activities; (2) 

ensuring that Public Health 

Emergency Officers (PHEOs) report 

all suspected or actual cases through 

appropriate DOD reporting channels, 

as well as to CDC, State public health 

authorities, and host nations; and (3) 

posting results of aggregated 

surveillance on the DOD Pandemic 

Influenza Watchboard and (4) 

ensuring that the Reserve 

components have a mechanism in 

place to report actual or suspected 

cases to the respective Services,; all 

within 18 months. Measure of 

performance: number of MTFs 

performing ESSENCE surveillance 

greater than 80 percent; DOD 

reporting policy for public health 

emergencies, including pandemic 

influenza completed. 

18 DOD HA Primary 

Agency 

Biosurveillance, 

Disease 

Detection and 

Information 

Sharing 

6.2.3.4. Access to Improved Rapid 

Diagnostic Tests 

HHS-, DOD-, and VA-funded 

hospitals and health facilities shall 

have access to improved rapid 

diagnostic tests for influenza A, 

including influenza with pandemic 

potential, within 6 months of when 

tests become available. Measure of 

performance: diagnostic tests, if 

found to be useful, are accessible to 

federally funded health facilities. 

6 HHS DOD 

VA 

HA Primary 

Agency 

Biosurveillance, 

Disease 

Detection and 

Information 

Sharing 

6.2.4.3. Provide Health Statistics on 

Influenza-Like Illnesses 

DOD and VA shall be prepared to 

track and provide personnel and 

beneficiary health statistics and 

develop enhanced methods to 

aggregate and analyze data 

documenting influenza-like illness 

from its surveillance systems within 

12 months. Measure of performance: 

influenza tracking systems in place 

and capturing beneficiary clinical 

encounters. 

12 DOD VA HA Primary 

Agency 
28 

Force Protection 6.3.2.4. DoD Guidance to Personnel 

Protective Measures 

As appropriate, DOD, in consultation 

with its Combatant Command 

commanders, shall implement 

movement restrictions and individual 

protection and social distancing 

strategies (including unit shielding, 

ship sortie, cancellation of public 

gatherings, drill, training, etc.) within 

their posts, installations, bases, 

facilities, and stations. DOD 

personnel and beneficiaries living offbase should comply with local 

community containment guidance 

with respect to activities not directly 

related to the installation. DOD shall 

be prepared to initiate within 18 

months. Measure of performance: 

the policies/procedures are in place 

for at-risk DOD posts, installations, 

bases, stations, and for units to 

conduct an annual training evaluation 

that includes restriction of movement, 

shielding, personnel protection 

measures, health unit isolation, and 

other measures necessary to prevent 

influenza transmission. 

18 DOD HA Primary 

Agency 

Medical Care to 

US Forces 

6.3.2.5. Implement Infection Control 

Campaigns 

All HHS-, DOD-, and VA-funded 

hospitals and health facilities shall 

develop, test, and be prepared to 

implement infection control 

campaigns for pandemic influenza, 

within 3 months. Measure of 

performance: guidance materials on 

infection control developed and 

disseminated on 

www.pandemicflu.gov and through 

other channels. 

3 HHS DOD

VA 

HA Primary 

Agency 
29 

Biosurveillance, 

Disease 

Detection and 

Information 

Sharing 

6.3.4.7. Enhance Influenza Surveillance 

Reporting Techniques 

DOD shall enhance its public health 

response capabilities by: (1) 

continuing to assign epidemiologists 

and preventive medicine physicians 

within key operational settings; (2) 

expanding ongoing DOD participation 

in CDC’s Epidemic Intelligence 

Service (EIS) Program; and (3) within 

18 months, fielding specific training 

programs for PHEOs that address 

their roles and responsibilities during 

a public health emergency and (4) 

ensuring that the Reserve 

components have a mechanism in 

place to report actual or suspected 

cases to their respective Services. 

Measure of performance: all military 

PHEOs fully trained within 18 months; 

increase military trainees in CDC’s 

EIS program by 100 percent within 5 

years; ASD(RA) completion of RC 

reporting policy. 

18 DOD HA Primary 

Agency 

Medical Care to 

US Forces 

Surge Medical 

Capability to 

Assist Civil 

Authorities 

6.3.7.2. Be Prepared to Augment 

State/Local Government Medical 

Response 

DOD and VA assets and capabilities 

shall be postured to provide care for 

military personnel and eligible 

civilians, contractors, dependants, 

other beneficiaries, and veterans and 

shall be prepared to augment the 

medical response of State, territorial, 

tribal, or local governments and other 

Federal agencies consistent with their 

ESF #8 support roles, within 3 

months. Measure of performance: 

DOD and VA pandemic preparedness 

plans developed; in a pandemic, 

adequate health response provided to 

military and associated personnel. 

3 DOD VA USDP&R Primary 

Agency 

Medical Care to 

US Forces 

6.3.7.5. Reserve Medical Personnel 

Mobilization 

DOD shall develop and implement 

guidelines defining conditions under 

which Reserve Component medical 

personnel providing health care in 

non-military health care facilities 

should be mobilized and deployed, 

within 18 months. Measure of 

performance: guidelines developed 

and implemented. 

18 DOD USDP&R 

Primary 

Agency 
30 

Force Protection 

Public Affairs 

Support to Civil 

Authorities 

6.3.8.2. Update Risk Communication 

Material 

DOD and VA, in coordination with 

HHS, shall develop and disseminate 

educational materials, coordinated 

with and complementary to messages 

developed by HHS but tailored for 

their respective departments, within 6 

months. Measure of performance: 

up-to-date risk communication 

material published on DOD and VA 

pandemic influenza websites, HHS 

website www.pandemicflu.gov, and in 

other venues. 

6 DOD VA 

HHS 

HA Primary 

Agency 

Military 

Assistance for 

Civil 

Disturbances 

Security in 

Support of 

Pharmaceutical/

Vaccine 

Production(CIP) 

8.1.2.5. National Guard Training for State 

Law Enforcement 

DOD, in consultation with DOJ and 

the National Guard Bureau, and in 

coordination with the States as such 

training applies to support of State 

law enforcement, shall assess the 

training needs for National Guard 

forces in providing operational 

assistance to State law enforcement 

under either Federal (Title 10) or 

State (Title 32 or State Active Duty) in 

a pandemic influenza outbreak and 

provide appropriate training guidance 

to the States and Territories for units 

and personnel who will be tasked to 

provide this support, within 18 

months. Measure of performance: 

guidance provided to all States. 

18 DOD DOJ HD Primary 

Agency 

Force Protection 

Surge Medical 

Capability to 

Assist Civil 

Authorities 

Communications 

Support to Civil 

Authorities 

Public Affairs 

Support to Civil 

Authorities 

Military 

Assistance for 

Civil 

Disturbances 

Bulk Transport 

of 

Pharmaceuticals

8.1.2.6. Requests for Assistance from 

States/Governors 

DOD, in consultation with DOJ, shall 

advise State Governors of the 

procedures for requesting military 

equipment and facilities, training and 

maintenance support as authorized 

by 10 U.S.C. §§ 372-74, within 6 

months. Measure of performance: 

all State governors advised. 

6 DOD DOJ HD 

NGB 

Primary 

Agency 
31 

/Vaccines 

Patient 

Transport and 

Strategic Lift 

Quarantine 

Assistance to 

U.S. Civil 

Authorities 

8.3.2.1. Plans for Quarantine Enforcement 

DOJ, DHS, and DOD shall engage in 

contingency planning and related 

exercises to ensure they are 

prepared to maintain essential 

operations and conduct missions, as 

permitted by law, in support of 

quarantine enforcement and/or assist 

State, local, and tribal entities in law 

enforcement emergencies that may 

arise in the course of an outbreak, 

within 6 months. Measure of 

performance: completed plans 

(validated by exercise(s)) for 

supporting quarantine enforcement 

and/or law enforcement emergencies. 

6 DOJ DHS 

DOD

HD Primary 

Agency 

Support to 

International 

Allies and NGOs 

4.1.1.1. International and Regional 

Response Exercises 

DOS, in coordination with HHS, 

USAID, DOD, and DOT, shall work 

with the Partnership, the Senior UN 

System Coordinator for Avian and 

Human Influenza, other international 

organizations (e.g., WHO, World 

Bank, OIE, FAO) and through 

bilateral and multilateral initiatives to 

encourage countries, particularly 

those at highest risk, to develop and 

exercise national and regional avian 

and pandemic response plans within 

12 months. Measure of performance: 

90 percent of high-risk countries have 

response plans and plans to test 

them. 

12 DOS HHS 

USAID DOD 

DOT 

SOLIC Support 

Agency 
32 

Biosurveillance, 

Disease 

Detection and 

Information 

Sharing 

4.2.2.3. Expand DoD Unit/Team 

Surveillance Capabilities 

HHS, in coordination with DOD, shall 

provide support to Naval Medical 

Research Unit (NAMRU) 2 in Jakarta, 

Indonesia and Phnom Penh, 

Cambodia, the Armed Forces 

Research Institute of Medical 

Sciences in Bangkok, Thailand, and 

NAMRU-3 in Cairo, Egypt to expand 

and expedite geographic surveillance 

of human populations at-risk for 

H5N1 infections in those and 

neighboring countries through 

training, enhanced surveillance, and 

enhancement of the Early Warning 

Outbreak Recognition System, within 

12 months. Measure of performance: 

reagents and technical assistance 

provided to countries in the network 

to improve and expand surveillance 

of H5N1 and number of specimens 

tested by real-time processing. 

12 HHS DOD HA Support 

Agency 

Support to 

International 

Allies and NGOs 

4.3.1.1. Coordinate Overseas U.S. 

Response Capabilities 

DOS, in coordination with HHS, 

USDA, USAID, and DOD, shall 

coordinate the development and 

implementation of U.S. capability to 

respond rapidly to assess and contain 

outbreaks of avian influenza with 

pandemic potential abroad, including 

coordination of the development, 

training and exercise of U.S. rapid 

response teams; and coordination of 

U.S. support for development, 

training and exercise of, and U.S. 

participation in, international support 

teams. Measure of performance: 

agreed operating procedures and 

operational support for U.S. rapid 

response, and for U.S. participation in 

international rapid response efforts, 

are developed and function 

effectively. 

 DOS HHS 

USDA USAID 

DOD 

SOLIC Support 

Agency 
33 

Support to 

International 

Allies and NGOs 

4.3.1.3. Deploy Investigative Surveillance 

Teams for Potential Outbreaks 

HHS, in coordination with DOS, and 

the WHO Secretariat, and USDA, 

USAID, DOD, as appropriate, shall 

rapidly deploy disease surveillance 

and control teams to investigate 

possible human outbreaks through 

WHO’s GOARN network, as required. 

Measure of performance: teams 

deployed to suspected outbreaks 

within 48 hours of investigation 

request. 

 HHS DOS 

USDA USAID 

DOD 

HA Support 

Agency 

Support to 

International 

Allies and NGOs 

4.3.1.4. Coordinate U.S. Participation in 

International Response 

DOS, in coordination with HHS, and 

the WHO Secretariat, and USDA, 

USAID, DOD, as appropriate, shall 

coordinate United States participation 

in the implementation of the 

international response and 

containment strategy (e.g., assigning 

experts to the WHO outbreak teams 

and providing assistance and advice 

to ministries of health on local public 

health interventions, ongoing disease 

surveillance, and use of antiviral 

medications and vaccines if they are 

available). Measure of performance: 

teams deployed to suspected 

outbreaks within 48 hours of 

investigation request. 

 DOS HHS 

USDA USAID 

DOD 

SOLIC Support 

Agency 

Support to 

International 

Allies and NGOs 

4.3.1.5. Rapid Response Teams Abroad for 

Technical Assistance 

USDA and USAID, in coordination 

with DOS, HHS, and DOD, and in 

collaboration with relevant 

international organizations, shall 

support operational deployment of 

rapid response teams and provide 

technical expertise and technology to 

support avian influenza assessment 

and response teams in priority 

countries as required. Measure of 

performance: all priority countries 

have rapid access to avian influenza 

assessment and response teams; 

deployment assistance provided in 

each instance and documented in a 

log of technical assistance rendered. 

 USDA USAID 

DOS HHS 

DOD

HA Support 

Agency 
34 

Bulk Transport 

of 

Pharmaceuticals

/Vaccines 

4.3.1.7. Develop International Assistance 

Distribution Plan 

DOS, in coordination with and 

drawing on the expertise of USAID, 

HHS, and DOD, shall work with the 

international community to develop, 

within 12 months, a coordinated, 

integrated, and prioritized distribution 

plan for pandemic influenza 

assistance that details a strategy for 

(1) strategic lift of WHO stockpiles 

and response teams, (2) theater 

distribution to high-risk countries, (3) 

in-country coordination to key 

distribution areas, and (4) 

establishment of internal mechanisms 

within each country for distribution to 

urban, rural, and remote populations. 

Measure of performance: 

commitments by countries that 

specify their ability to support 

distribution, and specify the personnel 

and material for such support. 

12 DOS DOD 

USAID HHS 

SOLIC Support 

Agency 

Biosurveillance, 

Disease 

Detection and 

Information 

Sharing 

4.3.2.1. Implement Passenger Screening 

Protocols 

DOS, in coordination with DHS, HHS, 

DOD, and DOT, and in collaboration 

with foreign counterparts, shall 

support the implementation of preexisting passenger screening 

protocols in the event of an outbreak 

of pandemic influenza. Measure of 

performance: protocols implemented 

within 48 hours of notification of an 

outbreak of pandemic influenza. 

None DOS DHS 

HHS DOD 

DOT 

HD Support 

Agency 

Bulk Transport 

of 

Pharmaceuticals

/Vaccines 

4.3.3.1. Deliver Countermeasures to 

Affected Countries 

DOS, in coordination with HHS, 

USAID, USDA, and DOD, shall work 

with the Partnership to assist in the 

prompt and effective delivery of 

countermeasures to affected 

countries consistent with U.S. law 

and regulation and the agreed upon 

doctrine for international action to 

respond to and contain an outbreak 

of influenza with pandemic potential. 

Measure of performance: necessary 

countermeasures delivered to an 

affected area within 48 hours of 

agreement to meet request. 

 DOS HHS 

USAID USDA 

DOD 

SOLIC Support 

Agency 
35 

Support to 

International 

Allies and NGOs 

4.3.6.1. Communicate U.S. Foreign Policy 

Objectives for International 

Response 

DOS, in coordination with HHS, 

USAID, USDA, DOD, and DHS, shall 

lead an interagency public diplomacy 

group to develop a coordinated, 

integrated, and prioritized plan to 

communicate U.S. foreign policy 

objectives relating to our international 

engagement on avian and pandemic 

influenza to key stakeholders (e.g., 

the American people, the foreign 

public, NGOs, international 

businesses), within 3 months. 

Measure of performance: number 

and range of target audiences 

reached with core public affairs and 

public diplomacy messages, and 

impact of these messages on public 

responses to avian and pandemic 

influenza. 

3 DOS HHS 

USAID USDA 

DOD DHS 

SOLIC Support 

Agency 

Patient 

Transport and 

Strategic Lift 

5.1.1.1. Establish Transportation Planning 

Assumptions 

DHS and DOT shall establish an 

interagency transportation and border 

preparedness working group, 

including DOS, HHS, USDA, DOD, 

DOL, and DOC as core members, to 

develop planning assumptions for the 

transportation and border sectors, 

coordinate preparedness activities by 

mode, review products and their 

distribution, and develop a 

coordinated outreach plan for 

stakeholders, within 6 months. 

Measure of performance: 

interagency working group 

established, planning assumptions 

developed, preparedness priorities 

and timelines established by mode, 

and outreach plan for stakeholders in 

place. 

6 DHS DOT 

DOS HHS 

USDA DOD 

DOL DOC

HD Support 

Agency 
36 

Biosurveillance, 

Disease 

Detection and 

Information 

Sharing 

5.1.1.2. Support Interagency Modeling 

Group 

HHS and DHS, in coordination with 

the National Economic Council 

(NEC), DOD, DOC, U.S. Trade 

Representative (USTR), DOT, DOS, 

USDA, Treasury, and key 

transportation and border 

stakeholders, shall establish an 

interagency modeling group to 

examine the effects of transportation 

and border decisions on delaying 

spread of a pandemic, and the 

associated health benefits, the 

societal and economic 

consequences, and the international 

implications, within 6 months. 

Measure of performance: 

interagency working group 

established, planning assumptions 

developed, priorities established, and 

recommendations made on which 

models are best suited to address 

priorities. 

6 HHS DHS 

NEC DOD 

DOC USTR 

DOT DOS 

USDA 

TREASURY 

HD Support 

Agency 

COOP/COG 5.1.1.3. Assess Ability to Maintain Federal 

Transport and Border Services 

DHS and DOT, in coordination with 

DOD, HHS, USDA, Department of 

Justice (DOJ), and DOS, shall assess 

their ability to maintain critical Federal 

transportation and border services 

(e.g., sustain National Air Space, 

secure the borders) during a 

pandemic, revise contingency plans, 

and conduct exercises, within 12 

months. Measure of performance: 

revised contingency plans in place at 

specified Federal agencies that 

respond to both international and 

domestic outbreaks and at least two 

interagency exercises carried out to 

test the plans. 

12 DHS DOT 

DOD HHS 

USDA DOJ 

DOS

HD Support 

Agency 
37 

Interagency 

Planning 

Support 

5.1.1.4. Operational Plans for Inbound 

Traffic at Borders or for Mass 

Migration 

DHS and DOT, in coordination with 

DOD, HHS, USDA, USTR, DOL, and 

DOS, shall develop detailed 

operational plans and protocols to 

respond to potential pandemic-related 

scenarios, including inbound 

aircraft/vessel/land border traffic with 

suspected case of pandemic 

influenza, international outbreak, 

multiple domestic outbreaks, and 

potential mass migration, within 12 

months. Measure of performance: 

coordinated Federal operational plans 

that identify actions, authorities, and 

trigger points for decision-making and 

are validated by interagency 

exercises. 

12 DHS DOT 

DOD HHS 

USDA USTR 

DOL DOS

HD Support 

Agency 

Bulk Transport 

of 

Pharmaceuticals

/Vaccines 

5.1.1.6. Assess Federal Emergency 

Transport Capacity 

DOT, in coordination with DHS, DOD, 

DOJ, HHS, DOL, and USDA, shall 

assess the Federal Government’s 

ability to provide emergency 

transportation support during a 

pandemic under NRP ESF #1 and 

develop a contingency plan, within 18 

months. Measure of performance: 

completed contingency plan that 

includes options for increasing 

transportation capacity, the potential 

need for military support, improved 

shipment tracking, potential need for 

security and/or waivers for critical 

shipments, incorporation of 

decontamination and workforce 

protection guidelines, and other 

critical issues. 

18 DOT DHS 

DOD DOJ 

HHS DOL 

USDA 

HD Support 

Agency 

Interagency 

Planning 

Support 

5.1.2.5. Develop Options for 

Commodity/Services Shortages 

DHS and DOT, in coordination with 

DOD and States, shall develop a 

range of options to cope with 

potential shortages of commodities 

and demand for essential services, 

such as building reserves of essential 

goods, within 20 months. Measure of 

performance: options developed and 

available for State, local, and tribal 

governments to refine and 

incorporate in contingency plans. 

20 DHS DOT 

DOD 

HD Support 

Agency 
38 

Support to 

International 

Allies and NGOs 

5.1.4.3. Decontamination Guidelines 

HHS, in coordination with DHS, DOT, 

DOD, Environmental Protection 

Agency (EPA), and transportation 

and border stakeholders, shall 

develop and disseminate 

decontamination guidelines and 

timeframes for transportation and 

border assets and facilities (e.g., 

airframes, emergency medical 

services transport vehicles, trains, 

trucks, stations, port of entry 

detention facilities) specific to 

pandemic influenza, within 12 

months. Measure of performance: 

decontamination guidelines 

developed and disseminated through 

existing DOT and DHS channels. 

12 HHS DHS 

DOT DOD 

EPA 

HD Support 

Agency 

Biosurveillance, 

Disease 

Detection and 

Information 

Sharing 

5.2.1.1. Review Transportation & Border 

Protocols for Quarantine Diseases 

HHS and USDA, in coordination with 

DHS, DOT, DOS, DOD, DOI, and 

State, local, and international 

stakeholders, shall review existing 

transportation and border notification 

protocols to ensure timely information 

sharing in cases of quarantinable 

disease, within 6 months. Measure of 

performance: coordinated, clear 

interagency notification protocols 

disseminated and available for 

transportation and border 

stakeholders. 

6 HHS USDA

DHS DOT 

DOS DOD 

DOI

HD Support 

Agency 

Surge Medical 

Capability to 

Assist Civil 

Authorities 

5.2.2.1. Develop Human Influenza 

Diagnostic Tests 

DHS, in coordination with HHS and 

DOD, shall deploy human influenza 

rapid diagnostic tests with greater 

sensitivity and specificity at borders 

and ports of entry to allow real-time 

health screening, within 12 months of 

development of tests. Measure of 

performance: diagnostic tests, if 

found to be useful, are deployed; 

testing is integrated into screening 

protocols to improve screening at the 

20-30 most critical ports of entry. 

12 DHS HHS 

DOD 

HA Support 

Agency 
39 

Biosurveillance, 

Disease 

Detection and 

Information 

Sharing 

5.2.3.1. Implement Protocols for Retrieving 

Traveler Health Information 

DHS, in coordination with HHS, DOT, 

DOS, and DOD, shall work closely 

with domestic and international air 

carriers and cruise lines to develop 

and implement protocols (in 

accordance with U.S. privacy law) to 

retrieve and rapidly share information 

on travelers who may be carrying or 

may have been exposed to a 

pandemic strain of influenza, within 6 

months. Measure of performance: 

aviation and maritime protocols 

implemented and information on 

potentially infected travelers available 

to appropriate authorities. 

6 DHS HHS 

DOT DOS 

DOD 

HA Support 

Agency 

Biosurveillance, 

Disease 

Detection and 

Information 

Sharing 

5.2.4.5. Develop Protocols to Divert 

International Air/Maritime Traffic 

DOT and DHS, in coordination with 

HHS, DOD, DOS, airlines/air space 

users, the cruise line industry, and 

appropriate State and local health 

authorities, shall develop protocols to 

manage and/or divert inbound 

international flights and vessels with 

suspected cases of pandemic 

influenza that identify roles, actions, 

relevant authorities, and events that 

trigger response, within 12 months. 

Measure of performance: 

interagency response protocols for 

inbound flights completed and 

disseminated to appropriate entities. 

12 DOT DHS 

HHS DOD 

DOS 

HD Support 

Agency 
40 

Biosurveillance, 

Disease 

Detection and 

Information 

Sharing 

5.2.4.6. Develop Protocols for 

Aircraft/Maritime Crews to Identify 

Influenza 

HHS, in coordination with DHS, DOT, 

DOS, DOD, air carriers/air space 

users, the cruise line industry, and 

appropriate State and local health 

authorities, shall develop en route 

protocols for crewmembers onboard 

aircraft and vessels to identify and 

respond to travelers who become ill 

en route and to make timely 

notification to Federal agencies, 

health care providers, and other 

relevant authorities, within 12 months. 

Measure of performance: protocols 

developed and disseminated to air 

carriers/air space users and cruise 

line industry. 

12 HHS DHS 

DOT DOS 

DOD 

HA Support 

Agency 

Biosurveillance, 

Disease 

Detection and 

Information 

Sharing 

5.2.5.1. Develop Safe Loading/Unloading 

Protocols for Cargo Shipments 

HHS and DHS, in coordination with 

DOS, DOT, DOD, DOL, and 

international and domestic 

stakeholders, shall develop vessel, 

aircraft, and truck cargo protocols to 

support safe loading and unloading of 

cargo while preventing transmission 

of influenza to crew or shore-side 

personnel, within 12 months. 

Measure of performance: protocols 

disseminated to minimize influenza 

spread between vessel, aircraft, and 

truck operators/crews and shore-side 

personnel. 

12 HHS DHS 

DOS DOT 

DOD DOL

HA Support 

Agency 

Biosurveillance, 

Disease 

Detection and 

Information 

Sharing 

5.3.1.2. Develop Screening Protocols at 

U.S. Ports of Entry 

DOS, in coordination with DOT, HHS, 

DHS, DOD, air carriers, and cruise 

lines, shall work with host countries to 

implement agreed upon predeparture screening based on 

disease characteristics and 

availability of rapid detection methods 

and equipment. Measure of 

performance: screening protocols 

agreed upon and put in place in 

countries within 24 hours of an 

outbreak. 

 DOS DOT 

HHS DHS 

DOD 

HA Support 

Agency 
41 

Biosurveillance, 

Disease 

Detection and 

Information 

Sharing 

5.3.1.5. Develop Screening Protocols at 

U.S. Ports of Entry 

DHS, in coordination with DOT, HHS, 

DOS, DOD, USDA, appropriate State 

and local authorities, air carriers/air 

space users, airports, cruise lines, 

and seaports, shall implement 

screening protocols at U.S. ports of 

entry based on disease 

characteristics and availability of 

rapid detection methods and 

equipment. Measure of performance: 

screening implemented within 48 

hours upon notification of an 

outbreak. 

 DHS DOT 

HHS DOS 

DOD USDA 

HA Support 

Agency 

Biosurveillance, 

Disease 

Detection and 

Information 

Sharing 

5.3.1.6. Implement Response/Screening 

Protocols at U.S. Domestic 

Airports 

DHS, in coordination with DOT, HHS, 

USDA, DOD, appropriate State, and 

local authorities, air carriers and 

airports, shall consider implementing 

response or screening protocols at 

domestic airports and other transport 

modes as appropriate, based on 

disease characteristics and 

availability of rapid detection methods 

and equipment. Measure of 

performance: screening protocols in 

place within 24 hours of directive to 

do so. 

 DHS DOT 

HHS USDA 

DOD 

HA Support 

Agency 

Mission 

Assurance: 

Defense 

Industrial Base 

5.3.4.7. Work with Commercial Maritime 

Fleets to Ensure Continuous 

Service 

DHS, in coordination with DOS, DOT, 

DOD, and the Merchant Marine, shall 

work with major commercial shipping 

fleets and the international 

community to ensure continuation of 

maritime transport and commerce, 

including activation of plans, as 

needed, to provide emergency 

medical support to crews of vessels 

that are not capable of safe 

navigation. Measure of performance: 

maritime transportation capacity 

meets demand and vessel mishaps 

remain proportional to number of ship 

movements. 

 DHS DOS 

DOT DOD 

HD Support 

Agency 
42 

Public Affairs 

Support to Civil 

Authorities 

5.3.6.2. Guidance for Personal/Business 

Travel 

DHS and DOT, in coordination with 

DOS, DOD, HHS, USDA, DOI, and 

State, local, and tribal governments, 

shall provide the public and business 

community with relevant travel 

information, including shipping 

advisories, restrictions, and potential 

closing of domestic and international 

transportation hubs. Measure of 

performance: timely, consistent, and 

accurate traveler information provided 

to the media, public, and business 

community. 

 DHS DOT 

DOS DOD 

HHS USDA 

DOI

HA Support 

Agency 

Medical Care to 

U.S. Forces 

6.1.1.3. Emergency Response Training 

DHS, in coordination with HHS, DOJ, 

DOT, and DOD, shall be prepared to 

provide emergency response element 

training (e.g., incident management, 

triage, security, and communications) 

and exercise assistance upon request 

of State, local, and tribal communities 

and public health entities within 6 

months. Measure of performance: 

percentage of requests for training 

and assistance fulfilled. 

6 DHS HHS 

DOJ DOT 

DOD 

HD Support 

Agency 

Surge Medical 

Capability to 

Assist Civil 

Authorities 

6.1.2.2. Develop Interagency Strategy for 

Deployment of Federal Medical 

Personnel 

HHS, in coordination with DHS, DOD, 

and VA, shall develop a joint strategy 

defining the objectives, conditions, 

and mechanisms for deployment 

under which NDMS assets, U.S. 

Public Health Service (PHS) 

Commissioned Corps, Epidemic 

Intelligence Service officers, and 

DOD/VA health care personnel and 

public health officers would be 

deployed during a pandemic, within 9 

months. Measure of performance: 

interagency strategy completed and 

tested for the deployment of Federal 

medical personnel during a 

pandemic. 

9 HHS DHS 

DOD VA 

HA Support 

Agency 
43 

Bulk Transport 

of 

Pharmaceuticals

/Vaccines 

6.1.2.3. Develop Protocols for distribution 

of Critical and non-Critical Medical 

Materiel 

HHS, in coordination with DHS, DOT, 

DOD, and VA, shall work with State, 

local, and tribal governments and 

leverage Emergency Management 

Assistance Compact agreements to 

develop protocols for distribution of 

critical medical materiel (e.g., 

ventilators) in times of medical 

emergency within 6 months. 

Measure of performance: critical 

medical material distribution protocols 

completed and tested. 

6 HHS DHS 

DOT DOD 

VA 

HA Support 

Agency 

Interagency 

Planning 

Support 

6.1.2.4. Guidance for Allocating Scarce 

Medical Resources 

HHS, in coordination with DOD and 

VA, in collaboration with medical 

professional and specialty societies, 

within their domains of expertise, 

shall develop guidance for allocating 

scarce health and medical resources 

during a pandemic, within 6 months. 

Measure of performance: guidance 

developed and disseminated. 

6 HHS DOD 

VA 

HA Support 

Agency 

Surge Medical 

Capability to 

assist Civil 

Authorities (Lab, 

Public Health 

Teams, 

Diagnostics, 

Medical 

Personnel) 

6.1.2.7. Develop Guidance on the role of 

the Medical Reserve Corps 

HHS, in coordination with DHS, DOD, 

VA and the USA Freedom Corps and 

Citizen Corps programs, shall 

prepare guidance for local Medical 

Reserve Corps coordinators 

describing the role of the Medical 

Reserve Corps during a pandemic, 

within 3 months. Measure of 

performance: guidance materials 

developed and published on Medical 

Reserve Corps website 

(www.medicalreservecorps.gov). 

3 HHS DHS 

DOD VA 

HA Support 

Agency 
44 

Public Affairs 

Support to Civil 

Authorities 

6.1.3.1. Test Federal Public Health 

Emergency Communications Plan 

HHS, in coordination with DHS, DOS, 

DOD, VA, and other Federal partners, 

shall develop, test, and implement a 

Federal Government public health 

emergency communications plan 

(describing the government’s strategy 

for responding to a pandemic, 

outlining U.S. international 

commitments and intentions, and 

reviewing containment measures that 

the government believes will be 

effective as well as those it regards 

as likely to be ineffective, excessively 

costly, or harmful) within 6 months. 

Measure of performance: 

containment strategy and emergency 

response materials completed and 

published on www.pandemicflu.gov; 

communications plan implemented. 

6 HHS DHS 

DOS DOD 

VA 

HA Support 

Agency 

Public Affairs 

Support to Civil 

Authorities 

6.1.3.3. Select and Retain Credible Medical 

Spokespersons 

HHS, in coordination with DHS, DOD, 

and the VA, and in collaboration with 

State, local, and tribal health 

agencies and the academic 

community, shall select and retain 

opinion leaders and medical experts 

to serve as credible spokespersons to 

coordinate and effectively 

communicate important and 

informative messages to the public, 

within 6 months. Measure of 

performance: national 

spokespersons engaged in 

communications campaign. 

6 HHS DHS 

DOD VA 

HA Support 

Agency 

Surge Medical 

Capability to 

Assist Civil 

Authorities 

6.1.6.1. Develop Strategic National 

Stockpile Guidance 

HHS, in coordination with DOD, VA, 

and State, local, and tribal partners, 

shall define the mix of antiviral 

medications to include in the 

Strategic National Stockpile (SNS) 

and State stockpiles and develop 

recommendations for how the 

different agents are to be used, within 

6 months. Measure of performance: 

development of policy concerning the 

selection, relative proportions, and 

use of antiviral medications in SNS 

and State stockpiles. 

6 HHS DOD 

VA 

HA Support 

Agency 
45 

Surge Medical 

Capability to 

Assist Civil 

Authorities 

6.1.6.2. Define Medical Materiel Stockpile 

Requirement 

HHS, in coordination with DOD, VA, 

and State, local, and tribal partners, 

shall define critical medical material 

requirements for stockpiling by the 

SNS and States to respond to the 

diversity of needs presented by a 

pandemic, within 9 months. Measure 

of performance: requirements 

defined and guidance provided on 

stockpiling. 

9 HHS DOD 

VA 

HA Support 

Agency 

Surge Medical 

Capability to 

Assist Civil 

Authorities 

6.1.10.2. Assess DoD Authorities for 

Procuring Medical 

Countermeasures Quickly 

HHS, in coordination with DHS, DOD, 

VA, DOC, DOJ, and Treasury, shall 

assess within whether use of the 

Defense Production Act or other 

authorities would provide sustained 

advantages in procuring medical 

countermeasures, within 6 months. 

Measure of performance: analytical 

report completed on the 

advantages/disadvantages of 

invoking the Defense Production Act 

to facilitate medical countermeasure 

production and procurement. 

6 HHS DHS 

DOD VA 

DOC DOJ 

TREASURY 

HD Support 

Agency 

Security in 

Support of 

Pharmaceutical/

Vaccine 

Distribution 

6.1.13.1. Exercise Countermeasure 

Distribution Plans at State/Local 

Level 

HHS, in coordination with DHS, DOD, 

VA, and DOJ, and in collaboration 

with State, local, and tribal partners 

and the private sector, shall ensure 

that States, localities, and tribal 

entities have developed and 

exercised pandemic influenza 

countermeasure distribution plans, 

and can enact security protocols if 

necessary, according to predetermined priorities (see below) 

within 12 months. Measures of 

performance: ability to activate, 

deploy, and begin distributing 

contents of medical stockpiles in 

localities as needed established and 

validated through exercises. 

12 HHS DHS 

DOD VA DOJ 

HA Support 

Agency 
46 

Surge Medical 

Capability to 

Assist Civil 

Authorities 

6.1.13.2. Coordinate Stockpile Asset Use 

HHS, in coordination with DOD, VA, 

States, and other public sector 

entities with antiviral drug stockpiles, 

shall coordinate use of assets 

maintained by different organizations, 

within 12 months. Measure of 

performance: plans developed for 

coordinated use of antiviral 

stockpiles. 

12 HHS DOD 

VA 

HA Support 

Agency 

Bulk Transport 

of 

Pharmaceuticals

/Vaccines 

6.1.13.4. Distribution Plans for 

Countermeasure Stockpiles 

HHS, in coordination with DOD, VA, 

and in collaboration with State, local, 

and tribal governments and private 

sector partners, shall assist in the 

development of distribution plans for 

medical countermeasure stockpiles to 

ensure that delivery and distribution 

algorithms have been planned for 

each locality for antiviral distribution. 

Goal is to be able to distribute 

antiviral medications to infected 

patients within 48 hours of the onset 

of symptoms within 12 months. 

Measure of performance: distribution 

plans developed. 

12 HHS DOD 

VA 

HA Support 

Agency 

Bulk Transport 

of 

Pharmaceuticals

/Vaccines 

6.1.13.5. Develop Pre-Pandemic Vaccine 

Plans 

HHS, in coordination with DHS, DOS, 

DOD, DOL, VA, and in collaboration 

with State, local, and tribal 

governments and private sector 

partners, shall develop plans for the 

allocation, distribution, and 

administration of pre-pandemic 

vaccine, within 9 months. Measure of 

performance: department plans 

developed and guidance 

disseminated to State, local, and 

tribal authorities to facilitate 

development of pandemic response 

plans. 

9 HHS DHS 

DOS DOD 

DOL VA 

HA Support 

Agency 
47 

Bulk Transport 

of 

Pharmaceuticals

/Vaccines 

6.1.13.7. Test Medical Materiel Distribution 

Plans 

HHS, in coordination with DHS, DOT, 

DOD, and VA, shall work with State, 

local, and tribal governments and 

private sector partners to develop and 

test plans to allocate and distribute 

critical medical materiel (e.g., 

ventilators with accessories, 

resuscitator bags, gloves, face 

masks, gowns) in a health 

emergency, within 6 months. 

Measure of performance: plans 

developed, tested, and incorporated 

into department plan, and 

disseminated to States and tribes for 

incorporation into their pandemic 

response plans. 

6 HHS DHS 

DOT DOD 

VA 

HA Support 

Agency 

Biosurveillance, 

Disease 

Detection and 

Information 

Sharing 

6.1.13.9. Track Adverse Vaccine Reactions 

HHS, in coordination with DOD, VA, 

and in collaboration with State, 

territorial, tribal, and local partners, 

shall develop/refine mechanisms to: 

(1) track adverse events following 

vaccine and antiviral administration; 

(2) ensure that individuals obtain 

additional doses of vaccine, if 

necessary; and (3) define protocols 

for conducting vaccine- and antiviraleffectiveness studies during a 

pandemic, within 18 months. 

Measure of performance: 

mechanism(s) to track vaccine and 

antiviral medication coverage and 

adverse events developed; vaccineand antiviral-effectiveness study 

protocols developed. 

18 HHS DOD 

VA 

HA Support 

Agency 
48 

Bulk Transport 

of 

Pharmaceuticals

/Vaccines 

6.1.14.1. Develop Objectives for Stockpiles 

Pre-Pandemic and Pandemic 

HHS, in coordination with DHS and 

Sector-Specific Agencies, DOS, 

DOD, DOJ, DOL, VA, Treasury, and 

State/local governments, shall 

develop objectives for the use of, and 

strategy for allocating, vaccine and 

antiviral drug stockpiles during prepandemic and pandemic periods 

under varying conditions of 

countermeasure supply and 

pandemic severity within 3 months. 

Measure of performance: clearly 

articulated statement of objectives for 

use of medical countermeasures 

under varying conditions of supply 

and pandemic severity. 

3 HHS DHS 

DOS DOD 

DOJ DOL 

VA 

TREASURY 

DOT USDA 

DOE DOI 

EPA 

HA Support 

Agency 

Medical Care to 

U.S. Forces 

6.1.14.2. Prioritize Vaccine Distribution to 

Personnel 

HHS, in coordination with DHS and 

Sector-Specific Agencies, DOS, 

DOD, DOL, VA, Treasury, and 

State/local governments, shall identify 

lists of personnel and high-risk 

groups who should be considered for 

priority access to medical 

countermeasures, under various 

pandemic scenarios, according to 

strategy developed in compliance 

with 6.1.14.1, within 9 months. 

Measure of performance: provisional 

recommendations of groups who 

should receive priority access to 

vaccine and antiviral drugs 

established for various scenarios of 

pandemic severity and medical 

countermeasure supply. 

9 HHS DHS 

DOS DOD 

DOL VA 

TREASURY 

DOT USDA 

DOE DOI 

EPA 

HA Support 

Agency 

Bulk Transport 

of 

Pharmaceuticals

/Vaccines 

6.1.14.3. Establish Flexible Countermeasure 

Distribution Processes 

HHS, in coordination with DHS and 

Sector-Specific Agencies, DOS, 

DOD, DOL, and VA, shall establish a 

strategy for shifting priorities based 

on at-risk populations, supplies and 

efficacy of countermeasures against 

the circulating pandemic strain, and 

characteristics of the virus within 9 

months. Measure of performance: 

clearly articulated process in place for 

evaluating and adjusting prepandemic recommendations of 

groups receiving priority access to 

medical countermeasures. 

9 HHS DHS 

DOS DOD 

DOL VA 

TREASURY 

DOT USDA 

DOE DOI 

EPA 

HA Support 

Agency 
49 

Medical Care to 

U.S. Forces 

6.1.14.4. Identify Priority Public Groups for 

Countermeasures 

HHS, in coordination with DHS and 

Sector-Specific Agencies, DOS, 

DOD, DOL, VA, and Treasury, shall 

present recommendations on target 

groups for vaccine and antiviral drugs 

when sustained and efficient humanto-human transmission of a potential 

pandemic influenza strain is 

documented anywhere in the world. 

These recommendations will reflect 

data from the pandemic and available 

supplies of medical countermeasures. 

Measure of performance: provisional 

identification of priority groups for 

various pandemic scenarios through 

interagency process within 2-3 weeks 

of outbreak. 

 HHS DHS 

DOS DOD 

DOL VA 

TREASURY 

DOT USDA 

DOE DOI 

EPA 

HA Support 

Agency 

Surge Medical 

Capability to 

Assist Civil 

Authorities 

6.2.1.3. Be Prepared to Conduct Lab 

Analysis 

HHS, in coordination with DOD, VA, 

USDA, DHS, EPA, and other 

partners, in collaboration with its LRN 

Reference Laboratories, shall be 

prepared within 6 months to conduct 

laboratory analyses to detect 

pandemic subtypes and strains in 

referred specimens and conduct 

confirmatory testing, as requested. 

Measure of performance: initial 

testing and identification of suspect 

pandemic influenza specimens 

completed at LRN Reference and 

National Laboratories within 24 hours. 

6 HHS DOD 

VA USDA 

DHS EPA 

HA Support 

Agency 

Biosurveillance, 

Disease 

Detection and 

Information 

Sharing 

6.2.2.3. Expand Number of Hospitals/Cities 

in BioSense RT Program 

HHS, in coordination with DOD and 

VA, shall expand the number of 

hospitals and cities participating in 

the BioSenseRT program to improve 

the Nation’s capabilities for disease 

detection, monitoring, and situational 

awareness within 12 months. 

Measure of performance: number of 

hospitals (including DOD and VA 

facilities) participating in the 

BioSenseRT program increased to 

350 hospitals in 42 cities. 

12 HHS DOD 

VA 

HA Support 

Agency 
50 

Biosurveillance, 

Disease 

Detection and 

Information 

Sharing 

6.2.2.7. Enhance National Biosurveillance 

Integration System Common 

Operating Picture 

DHS, in collaboration with HHS, 

DOD, VA, USDA and other Federal 

departments and agencies with 

biosurveillance capabilities and realtime data sources, will enhance NBIS 

capabilities to ensure the availability 

of a comprehensive and all-source 

biosurveillance common operating 

picture throughout the Interagency, 

within 12 months. Measure of 

performance: NBIS provides 

integrated surveillance data to DHS, 

HHS, USDA, DOD, VA, and other 

interested interagency customers. 

12 DHS HHS 

DOD VA 

USDA 

HD Support 

Agency 

Biosurveillance, 

Disease 

Detection and 

Information 

Sharing 

6.2.2.8. Collect and Report Health Care 

System Information 

HHS, in coordination with DHS, DOD, 

and VA, and in collaboration with 

State, local, and tribal authorities, 

shall be prepared to collect, analyze, 

integrate, and report information 

about the status of hospitals and 

health care systems, health care 

critical infrastructure, and medical 

materiel requirements, within 12 

months. Measure of performance: 

guidance provided to States and tribal 

entities on the use and modification of 

the components of the National 

Hospital Available Beds for 

Emergencies and Disasters 

(HAvBED) system for implementation 

at the local level. 

12 HHS DHS 

DOD VA 

HA Support 

Agency 

Biosurveillance, 

Disease 

Detection and 

Information 

Sharing 

6.2.3.1. Develop Rapid Diagnostic Tests 

HHS, in coordination with DHS and 

DOD, shall work with pharmaceutical 

and medical device company 

partners to develop and evaluate 

rapid diagnostic tests for novel 

influenza subtypes including H5N1 

within 18 months. Measure of 

performance: new investment in 

research to develop influenza 

diagnostics; new rapid diagnostic 

tests, if found to be useful, are 

available for influenza testing, 

including for novel influenza 

subtypes. 

18 HHS DHS 

DOD 

HA Support 

Agency 
51 

Biosurveillance, 

Disease 

Detection and 

Information 

Sharing 

6.2.3.2. Inventory Research on Rapid 

Diagnostic Testing 

HHS, in coordination with DHS, DOD, 

and VA, shall compile an inventory of 

all research and product development 

work on rapid diagnostic testing for 

influenza and shall reach consensus 

on sets of requirements meeting 

national needs and a common test 

methodology to drive further privatesector investment and product 

development, within 6 months. 

Measure of performance: inventory 

developed and requirements paper 

disseminated. 

6 HHS DHS 

DOD VA 

HA Support 

Agency 

Biosurveillance, 

Disease 

Detection and 

Information 

Sharing 

6.2.3.3. Expedite Private-Sector 

Development of Influenza Testing 

HHS, in coordination with DOD, VA, 

and DHS, shall encourage and 

expedite private-sector development 

of rapid subtype- and strain-specific 

influenza point-of-care tests within 12 

months of the publication of 

requirements. Measure of 

performance: rapid point-of-care test 

available in the marketplace within 18 

months. 

18 HHS DOD 

VA DHS 

HA Support 

Agency 

Biosurveillance, 

Disease 

Detection and 

Information 

Sharing 

6.2.4.1. Evaluate Disease Reporting as 

Pandemics Evolve 

HHS, in coordination with DHS, DOD, 

VA, USDA, and DOS, shall be 

prepared, within 12 months, to 

continuously evaluate surveillance 

and disease reporting data to 

determine whether ongoing disease 

containment and medical 

countermeasure distribution and 

allocation strategies need to be 

altered as a pandemic evolves. 

Measure of performance: analyses of 

surveillance data performed at least 

weekly during an outbreak with timely 

adjustment of strategic and tactical 

goals, as required. 

12 HHS DHS 

DOD VA 

USDA DOS 

HA Support 

Agency 
52 

Mission 

Assurance: 

Defense 

Industrial Base 

6.2.4.2. Track Integrity of Critical 

Infrastructure/Health Care 

Facilities 

DHS, in coordination with SectorSpecific Agencies, HHS, DOD, DOJ, 

and VA and in collaboration with the 

private sector, shall be prepared to 

track integrity of critical infrastructure 

function, including the health care 

sector, to determine whether ongoing 

strategies of ensuring workplace 

safety and operational continuity 

need to be altered as a pandemic 

evolves, within 6 months. Measure of 

performance: tracking system in 

place to monitor integrity of critical 

infrastructure function and operational 

continuity in near real time. 

6 DHS HHS 

DOD DOJ VA 

DOL 

TREASURY 

DOT USDA 

DOE DOI 

EPA 

HD Support 

Agency 

Biosurveillance, 

Disease 

Detection and 

Information 

Sharing 

6.2.5.1. Support Epidemic and Modeling 

Hub/Center 

HHS, in coordination with DOD and 

DHS, shall develop and maintain a 

real-time epidemic analysis and 

modeling hub that will explore and 

characterize response options as a 

support to policy and decision makers 

within 6 months. Measure of 

performance: modeling center with 

real-time epidemic analysis 

capabilities established. 

6 HHS DOD 

DHS 

HA Support 

Agency 

Interagency 

Planning 

Support 

6.3.2.1. Guidance on Community 

Containment Strategies 

HHS, in coordination with DHS, DOT, 

Education, DOC, DOD, and Treasury, 

shall provide State, local, and tribal 

entities with guidance on the 

combination, timing, evaluation, and 

sequencing of community 

containment strategies (including 

travel restrictions, school closings, 

snow days, self-shielding, and 

quarantine during a pandemic) based 

on currently available data, within 6 

months, and update this guidance as 

additional data becomes available. 

Measure of performance: guidance 

provided on community influenza 

containment measures. 

6 HHS DHS 

DOT 

EDUCATION 

DOC DOD 

TREASURY 

HA Support 

Agency 
53 

Biosurveillance, 

Disease 

Detection and 

Information 

Sharing 

6.3.2.3. Research Voluntary 

Home/Community Quarantine 

Measures 

HHS, in coordination with DHS and 

DOD and in collaboration with 

mathematical modelers, shall 

complete research identifying optimal 

strategies for using voluntary home 

quarantine, school closure, snow day 

restrictions, and other community 

infection control measures, within 12 

months. Measure of performance: 

guidance developed and 

disseminated on the use of 

community control. 

12 HHS DHS 

DOD 

HA Support 

Agency 

Interagency 

Planning 

Support 

6.3.3.1. Guidance for Individuals to Reduce 

Exposure Risk 

HHS, in coordination with DHS, VA, 

and DOD, shall develop and 

disseminate guidance that explains 

steps individuals can take to 

decrease their risk of acquiring or 

transmitting influenza infection during 

a pandemic, within 3 months. 

Measure of performance: guidance 

disseminated on 

www.pandemicflu.gov and through 

VA and DOD channels. 

3 HHS DHS VA 

DOD 

HA Support 

Agency 

Public Affairs 

Support to Civil 

Authorities 

6.3.3.2. Disseminate Social Distancing 

Behavior Guidance 

HHS, in coordination with DHS, DOD, 

VA, and DOT and in collaboration 

with State, local, and tribal partners, 

shall develop and disseminate lists of 

social distancing behaviors that 

individuals may adopt within 6 

months and update guidance as 

additional data becomes available. 

Measure of performance: guidance 

disseminated on 

www.pandemicflu.gov and through 

other channels. 

6 HHS DHS 

DOD VA 

DOT 

HA Support 

Agency 

Medical Care to 

U.S. Forces 

6.3.4.1. Optimize Care Under Medical 

Surge Conditions 

Major medical societies and 

organizations, in collaboration with 

HHS, DHS, DOD, and VA, should 

develop and disseminate protocols 

for changing clinical care algorithms 

in settings of severe medical surge. 

Measure of performance: evidencebased protocols developed to 

optimize care that can be provided in 

conditions of severe medical surge. 

 HHS DHS 

DOD VA 

HA Support 

Agency 
54 

Surge Medical 

Capability to 

Assist Civil 

Authorities 

6.3.4.2. Develop Protocols for Expanded 

Hospital/Home Care 

HHS, in coordination with DHS, DOD, 

and VA, and in collaboration with 

States, localities, tribal entities, and 

private sector health care facilities, 

shall develop strategies and protocols 

for expanding hospital and home 

health care delivery capacity in order 

to provide care as effectively and 

equitably as possible, within 6 

months. Measure of performance: 

guidance and protocols developed 

and disseminated. 

6 HHS DHS 

DOD VA 

HA Support 

Agency 

Public Affairs 

Support to Civil 

Authorities 

6.3.5.1. Education Tools to Reduce 

Individual Risk 

HHS, in coordination with DHS, DOL, 

Education, VA, and DOD, shall 

develop and disseminate guidance 

and educational tools that explain 

steps individuals can take to 

decrease their risk of acquiring or 

transmitting influenza infection during 

a pandemic, within 6 months. 

Measure of performance: interim 

guidance disseminated on 

www.pandemicflu.gov and through 

VA, DOD, and other channels within 

3 months; complementary 

educational tools on social distancing, 

personal hygiene, mask use, and 

other infection control precautions 

developed within 6 months. 

6 HHS DHS 

DOL 

Education VA 

DOD 

HA Support 

Agency 

Surge Medical 

Capability to 

Assist Civil 

Authorities 

6.3.7.1. Identify Medical Capabilities Under 

ESF #8 

HHS, in coordination with DHS, DOD, 

VA, and DOT, and as the lead for 

ESF #8, shall identify public health 

and medical capabilities required to 

support a pandemic response and 

work with other supporting agencies 

to identify and deploy or otherwise 

deliver the required capability or 

asset, if available. Measure of 

performance: inventory of public 

health and medical capabilities within 

6 months; available public health or 

medical capabilities or assets 

deployed or delivered during a 

pandemic. 

6 HHS DHS 

DOD VA 

DOT 

HA Support 

Agency 
55 

Public Affairs 

Support to Civil 

Authorities 

6.3.8.1. Risk Communication Strategy 

HHS, in coordination with DHS, DOD, 

and VA, shall develop and 

disseminate a risk communication 

strategy within 6 months, updating it 

as required. Measure of 

performance: implementation of risk 

communication strategy on 

www.pandemicflu.gov and elsewhere. 

6 HHS DHS 

DOD VA 

HA Support 

Agency 

Support to 

International 

Allies and NGOs 

7.1.1.1. Develop Response Plans with 

Canada and Mexico 

USDA, in coordination with DHS, 

HHS, DOD, and DOI, and in 

partnership with State and tribal 

entities, animal industry groups, and 

(as appropriate) the animal health 

authorities of Canada and Mexico, 

shall establish and exercise animal 

influenza response plans within 6 

months. Measure of performance: 

plans in place at specified Federal 

agencies and exercised in 

collaboration with States believed to 

be at highest risk for an introduction 

into animals of an influenza virus with 

human pandemic potential. 

6 USDA DHS 

HHS DOD 

DOI 

HD Support 

Agency 

Surge Medical 

Capability to 

Assist Civil 

Authorities 

7.1.2.2. Ensure Veterinary Lab Surge 

Capacity 

USDA, in coordination with DOD, 

HHS, DHS, and DOI, shall partner 

with States and tribal entities to 

ensure sufficient veterinary diagnostic 

laboratory surge capacity for 

response to an outbreak of avian or 

other influenza virus with human 

pandemic potential, within 6 months. 

Measure of performance: plans and 

necessary agreements to meet 

laboratory capacity needs for a worst 

case scenario influenza outbreak in 

animals validated by utilization in 

exercises. 

6 USDA DOD 

HHS DHS 

DOI 

HA Support 

Agency 

Biosurveillance, 

Disease 

Detection and 

Information 

Sharing 

7.1.5.6. Refine Disease Mitigation 

Strategies for Animal Outbreaks 

USDA, in coordination with DHS, 

DOI, and DOD, shall partner with 

State and tribal authorities to refine 

disease mitigation strategies for avian 

influenza in poultry or other animals 

through outbreak simulation 

modeling, within 6 months. Measure 

of performance: simulation models 

produced and reports issued on the 

results of influenza outbreak scenario 

modeling. 

6 USDA DHS 

DOI DOD 

HA Support 

Agency 
56 

Surge Medical 

Capability to 

Assist Civil 

Authorities 

7.3.4.1. Assess Animal Health Outbreak 

Response Capability 

USDA shall assess the outbreak 

response surge capacity activities 

that other Federal partners, including 

the DOD, may be able to support 

during an outbreak of influenza in 

animals and ensure that mechanisms 

are in place to request such support, 

within 6 months. Measure of 

performance: written assessment 

completed and all necessary 

activation mechanisms in place. 

6 USDA DOD HA Support 

Agency 

Interagency 

Planning 

Support 

8.1.1.2. Develop Pandemic Influenza 

Tabletop Exercise 

DHS, in coordination with DOJ, HHS, 

DOL, and DOD, shall develop a 

pandemic influenza tabletop exercise 

for State, local, and tribal law 

enforcement/public safety officials 

that they can conduct in concert with 

public health and medical partners, 

and ensure it is distributed nationwide 

within 4 months. Measure of 

performance: percent of State, local, 

and tribal law enforcement/public 

safety agencies that have received 

the pandemic influenza tabletop 

exercise. 

4 DHS DOJ 

HHS DOD 

DOL 

HD Support 

Agency 

Military 

Assistance for 

Civil 

Disturbances 

8.1.2.3. Advise State Governors on 

Insurrection Act Procedures 

DOJ shall advise State Governors of 

the processes for requesting Federal 

military assistance under the 

Insurrection Act within 3 months. 

DOD, after coordination with DOJ, 

shall publish updated policy guidance 

on Military Assistance during Civil 

Disturbances, within 6 months. 

Measure of performance: all State 

Governors advised and guidance 

published. 

3 DOJ DOD HD Support 

Agency 
57 

Interagency 

Planning 

Support 

8.1.2.7. Develop Best Practices and Model 

Protocols for Pandemic Influenza 

Outbreak 

DHS, in coordination with DOJ, DOD, 

DOT, HHS, and other appropriate 

Federal Sector-Specific Agencies, 

shall convene a forum for selected 

Federal, State, local, and tribal 

personnel to discuss EMS, fire, 

emergency management, public 

works, and other emergency 

response issues they will face in a 

pandemic influenza outbreak and 

then publish the results in the form of 

best practices and model protocols 

within 4 months. Measure of 

performance: best practices and 

model protocols published and 

distributed. 

4 DHS DOJ 

DOD DOT 

HHS 

HD Support 

Agency 

Interagency 

Planning 

Support 

8.3.2.2. Planning for the Conduct of 

Essential Emergency Services 

During a Pandemic Outbreak 

DHS, in coordination with DOJ, DOD, 

DOT, HHS, and other appropriate 

Federal Sector-Specific Agencies, 

shall engage in contingency planning 

and related exercises to ensure they 

are prepared to sustain EMS, fire, 

emergency management, public 

works, and other emergency 

response functions during a 

pandemic, within 6 months. Measure 

of performance: completed plans 

(validated by exercise(s)) for 

supporting EMS, fire, emergency 

management, public works, and other 

emergency response functions. 

6 DHS DOJ 

DOD DOT 

HHS 

HD Support 

Agency 

COOP/COG 9.1.1.1. Provide Pandemic Influenza COOP 

Guidance 

DHS, in coordination with HHS, DOD, 

and DOL shall provide pandemic 

influenza COOP guidance to the 

Federal departments and agencies 

within 6 months. Measure of 

performance: COOP planning and 

personnel protection guidance 

provided to all departments for use, 

as necessary, in updating 

departmental pandemic influenza 

response plans. 

6 DHS HHS 

DOD DOL 

HD Support 

Agency 
58 

COOP/COG 9.1.1.2. Provide Personnel Guidance 

Related to COOP 

The Office of Personnel Management 

(OPM), in coordination with DHS, 

HHS, DOD, and DOL, shall provide 

guidance to the Federal departments 

and agencies on human capital 

management and COOP planning 

criteria related to pandemic influenza, 

within 3 months. Measure of 

performance: guidance provided to 

all departments for use, as 

necessary, in adjusting departmental 

COOP plans related to pandemic 

influenza. 

3 OPM DHS 

HHS DOD 

DOL 

HD Support 

Agency 

COOP/COG 9.1.1.3. Guidance for Workplace Options 

OPM, in coordination with DHS, HHS, 

DOD, and DOL, shall update the 

guides Telework: A Management 

Priority, A Guide for Managers, 

Supervisors, and Telework 

Coordinators; Telework 101 for 

Managers: Making Telework Work 

for You; and, Telework 101 for 

Employees: Making Telework Work 

for You, to provide guidance to 

Federal departments regarding 

workplace options during a pandemic, 

within 3 months. Measure of 

performance: updated telework 

guidance provided to all departments 

for use, as necessary, in updating 

departmental COOP plans related to 

pandemic influenza. 

3 OPM DHS 

HHS DOD 

DOL 

HA/ 

P&R 

Support 

Agency 

COOP/COG 9.1.2.1. Identify Critical Infrastructure 

Dependencies 

DHS, in coordination with SectorSpecific Agencies, critical 

infrastructure owners and operators, 

and States, localities and tribal 

entities, shall develop sector-specific 

planning guidelines focused on 

sector-specific requirements and 

cross-sector dependencies, within 6 

months. Measure of performance: 

planning guidelines developed for 

each sector. 

6 DHS HHS 

DOT USDA 

EPA DOE 

Treasury DOI 

DOD 

HD Support 

Agency 
59 

COOP/COG 9.1.3.1. Conduct Critical Infrastructure 

Conferences and Exercises 

DHS, in coordination with all the 

Sector-Specific Agencies, shall 

conduct forums, conferences, and 

exercises with key critical 

infrastructure private sector entities 

and international partners to identify 

essential functions and critical 

planning, response and mitigation 

needs within and across sectors, and 

validate planning guidelines, within 6 

months. Measure of performance: 

planning guidelines validated by 

collaborative exercises that test 

essential functions and critical 

planning, response, and mitigation 

needs. 

6 DHS HHS 

DOT USDA 

EPA DOE 

Treasury DOI 

DOD 

HD Support 

Agency 

COOP/COG 9.1.3.2. Business/Defense Industrial Base 

Continuity Planning 

DHS, in coordination with all the 

Sector-Specific Agencies, shall 

develop and coordinate guidance 

regarding business continuity 

planning and preparedness with the 

owners/operators of critical 

infrastructure and develop a Critical 

Infrastructure Influenza Pandemic 

Preparedness, Response, and 

Recovery Guide tailored to national 

goals and capabilities and to the 

specific needs identified by the 

private sector, within 6 months. 

Measure of performance: Critical 

Infrastructure Influenza Pandemic 

Preparedness, Response, and 

Recovery Guide developed and 

published (www.pandemicflu.gov). 

6 DHS HHS 

DOT USDA 

EPA DOE 

Treasury DOI 

DOD 

HD Support 

Agency 

Interagency 

Planning 

Support 

9.1.4.1. Provide Infections Control 

Guidance 

HHS, in coordination with DHS, DOL, 

OPM, Department of Education, VA, 

and DOD, shall develop sectorspecific infection control guidance to 

protect personnel, governmental and 

public entities, private sector 

businesses, and CBOs and FBOs, 

within 6 months. Measure of 

performance: sector-specific 

guidance and checklists developed 

and disseminated on 

www.pandemicflu.gov. 

6 HHS DHS 

DOL OPM 

EDUCATION 

VA DOD 

HA Support 

Agency 
60 

Interagency 

Planning 

Support 

9.1.4.2. Guidance on Environmental 

Cleaning for Waste Material 

HHS, in coordination with DHS, DOL, 

EPA, Department of Education, VA, 

and DOD, shall develop interim 

guidance regarding environmental 

management and cleaning practices 

including the handling of potentially 

contaminated waste material, within 3 

months, and revise as additional data 

becomes available. Measure of 

performance: development and 

publication of guidance and checklists 

on www.pandemicflu.gov and 

disseminated through other channels. 

3 HHS DHS 

DOL EPA 

EDUCATION 

VA DOD 

HA Support 

Agency 
61 

ANNEX B, INTELLIGENCE 

Annex B, Intelligence is classified and has been published separately. 
62 

ANNEX C, FORCE HEALTH AND PROTECTION 

PURPOSE 

This section provides specific policy and planning guidance for health service support operations 

in both CONUS and OCONUS locations in the event of pandemic influenza (PI). Detailed and 

updated information on clinical guidelines, laboratory diagnostics, containment measures, 

immunization guidance, and additional references can be found in the Department of Defense 

Influenza Pandemic Preparation and Response Health Policy Guidance, posted on the Assistant 

Secretary of Defense (Health Affairs) website at http://www.dod.mil/pandemicflu. DoD's first 

priority, in the event of a pandemic, will be to ensure sufficient personnel, equipment, facilities, 

materials, and pharmaceuticals to provide the highest possible level of health support to DoD 

forces, civilian personnel, and beneficiaries as well as to protect and preserve DoD's worldwide 

operational effectiveness. DoD sets policies for deployed forces working abroad under 

Geographic Combatant Commands as outlined in the Unified Command Plan. As resources 

permit, DoD will provide clinical and logistical support to other Federal, State, or local agencies 

as described in this Annex; and when requested, provide emergency support to local civilian 

authorities to save life, limb, or eyesight. 

ADDITIONAL ASSUMPTIONS 

• A pandemic in the United States could result in 20-35% of the population becoming ill, 

3% being hospitalized, and a fatality rate of 1%. 

• A pandemic in the United States could result in up to 40% absenteeism rate that will 

exacerbate personnel shortfalls resulting from hospitalization. 

• In a pandemic, anticipate a 25% increase in requirements for all categories of medical 

support. 

• Civilian commercial air carriers will be impacted seriously and cannot be relied upon to 

provide support to DoD. The civil reserve air fleet (CRAF) will not be activated by DoD. 

• DoD will not be required to evacuate large numbers of infected patients from OCONUS 

locations; however, DoD may be directed to deploy medical personnel to forward 

locations to deliver care to U.S. citizens. 

• DoD may, under applicable authorities, be requested to provide logistical support for 

international containment efforts including transport of WHO and other International 

Agency supplies, response teams, and assets to OCONUS locations. 
63 

EMERGENCY HEALTH POWERS 

CONUS installation commanders are authorized, upon the recommendation of the military 

treatment facility (MTF) commander and/or the Public Health Emergency Officer (PHEO), to 

implement emergency health powers on their installations in order to protect military and civilian 

personnel and property (reference k). These powers include restriction of movement and use of 

containment strategies (isolation, quarantine, social distancing) as well as medical evaluation and 

treatment. 

 

Commanders of Reserve component facilities not located on an active military installation are 

authorized, upon the recommendation of the closest MTF commander or the senior military 

medical advisor in that geographic region, to implement emergency health powers in their 

facility in order to protect military personnel and property. These powers include restriction of 

movement and use of containment strategies as appropriate. 

Installation commanders at OCONUS locations may be restricted in implementation of 

emergency health powers by host nation law and applicable international agreements. 

TASKS 

 

The following is a summary of DoD medical support tasks assigned to: 

• The Office of the Secretary of Defense 

o Coordinates PI planning and response with all involved government and nongovernment agencies, including but not limited to, the World Health Organization 

(WHO), the White House, the Departments of State, Health and Human Services 

(HHS), Transportation, Homeland Security, and the U.S. Centers for Disease 

Control and Prevention (CDC). 

o Publishes policy guidance on providing health service support to DoD 

contractors. 

o Provides direction for prioritization of limited resources such as antiviral 

medicines and vaccines. 

o Ensures interoperability with the interagency Joint Operations Center, as 

established by either DHS or HHS as the Primary Federal Agency. 

o Acquires and maintains stockpiles of DoD-controlled medications and vaccines. 
64 

o Release of vaccine and antiviral medications will be at the direction of the 

Assistant Secretary of Defense/Health Affairs (ASD(HA)). Priorities for 

distribution will be provided in separate guidance. 

o Authorizes DoD forces to provide civil support (reference i) and support of 

emergency functions identified in the National Strategy for Pandemic Influenza 

Implementation Plan. 

o In conjunction with HHS, the Joint Staff, and the Combatant Commands, consider 

restricting movement of DoD assets to or from specific regions as conditions 

warrant. 

o Develop, in coordination with the Office of the Assistant Secretary of Defense 

(Public Affairs), an active Public Affairs program to provide service members and 

their families, and the civilian workforce, the latest information covering 

pandemic fundamentals (e.g., signs and symptoms of influenza, modes of 

transmission), DoD policies regarding distribution of anti-viral medication, 

personal and family protection, national response strategies, and changes in access 

to medical care. 

• Under Secretary of Defense for Intelligence (USD(I)) 

o Serves as the principal staff advisor to the Secretary of Defense regarding 

intelligence, counterintelligence, security, sensitive activities, and other 

intelligence-related matters. In this capacity, the USD(I) exercises the Secretary 

of Defense’s authority, direction and control over the Defense Agencies and DoD 

Field Activities that are Defense intelligence, counterintelligence, or security 

components and exercises planning, policy and strategic guidance over all DoD 

intelligence, counterintelligence, and security policy, plans, and programs.

o The USD(I) serves as the primary representative of the Secretary of Defense to 

the Office of the Director of National Intelligence and other members of the 

Intelligence Community.

• Under Secretary of Defense for Acquisition, Technology, and Logistics 

(USD(AT&L)) 

o Will incorporate policy described in this plan into relevant directives and 

applicable joint doctrine and training as appropriate. 

o Notify the key DoD logistics agencies, and in collaboration with the ASD(HA), 

locate and coordinate the release of required DoD contingency medical materiel; 

this excludes medical materiel under the direct control of the ASD(HA). 
65 

o In coordination with ASD(HD) and ASD(HA), obtain through the Chairman of 

the Joint Chiefs of Staff, information regarding the status of critical medical 

materiel needed to support the Combatant Command(s) and Service priorities. 

o When appropriate, obtain through the Chairman of the Joint Chiefs of Staff, in 

coordination with ASD(HA), information regarding the availability of Military 

Department-owned medical materiel that could be provided to HHS in support of 

international containment and in response to DSCA requests. 

o As required, coordinate the delivery and transfer of DoD contingency medical 

materiel with appropriate Federal agencies. Coordination will continue until 

transferred materiel is delivered. 

• Assistant Secretary of Defense for Health Affairs (ASD(HA)) 

o Serves as the principal staff advisor to the Secretary of Defense for all DoD health 

policies, programs, and activities. Collaborates with ASD(HD) on the health 

service support aspects of disasters, public health emergencies, and, after the 

Secretary and Deputy Secretary of Defense, serves as the principal official within 

the DoD responsible for health service support recommendations for populations 

impacted by these events. 

o Coordinate the release of required DoD contingency medical materiel such as 

anti-virals. 

• Assistant Secretary of Defense for Reserve Affairs (ASD(RA)) 

o Monitor Military Department Reserve Components' readiness, training, and 

exercise policies, equipment, and funding for emergency response preparedness. 

• Assistant Secretary of Defense for Networks and Information Integration 

(ASD(NII)) 

o Coordinate, develop, and implement command and control policies, requirements, 

plans, procedures, and standards for DoD responses to disasters, public health 

emergencies and pandemic disease outbreak events. 

• Assistant Secretary of Defense for Public Affairs (ASD(PA)) 

o Provide the public affairs guidance interface with other Government Agencies and 

shall provide public affairs guidance to the Military Departments and Combatant 

Commands. 
66 

• Office of General Counsel 

o Ensure that military commanders' actions regarding isolation and quarantine on a 

military installation of infected or possibly infected DoD or non-DoD personnel 

are determined by the nature of the outbreak and the laws, regulations, and 

policies concerning those types of situations, especially regarding non-military 

personnel. Commanders must obtain legal and medical advice on individual 

situations from their legal and medical staffs. Local legal advice will reflect State 

law and coordination with civilian authorities. 

• Joint Chiefs of Staff 

o Assist ASD(HA) in allocation decisions concerning vaccine and antiviral 

medications to the Military Departments and Combatant Commands in 

accordance with DoD prioritization guidelines. 

o Ensure Combatant Commands have established liaison with appropriate host 

nation civilian and military public health and medical logistical support elements 

within their respective area of responsibility. 

 

o Ensure both ASD(HD) and ASD(HA) are included in reports Combatant 

Commands provide to CJCS or to the Secretary of Defense. 

 

o Identify and advise the Combatant Commands of critical medical capabilities that 

may not be readily deployable in the event of a domestic pandemic outbreak. 

Allocate DoD resources between competing domestic and OCONUS 

requirements. 

 

o Direct Combatant Command review of host nation support agreements, and if 

resources permit and upon request, augment host nation surveillance and 

containment capabilities. In conjunction with the Department of State, determine 

OCONUS locations where contingency plans should be developed to expand host 

nation health support capabilities for DoD beneficiaries. 

o Ensure Combatant Commands review their policies and capabilities for providing 

health service support to non-US personnel. For allied and coalition military 

personnel, DoD will deliver stabilization treatment in its facilities with return to 

national control as soon as feasible, and in accordance with existing treaties and 

agreements. DoD facilities will provide health service support to host nation 

civilians who are directly supporting US forces consistent with host nation law 

and policy. Host nation civilians will be returned to national control when 

medically indicated and in accordance with existing treaties and agreements. 

o Ensure Combatant Commands, in conjunction with the Department of State and 

as part of their security cooperation planning responsibilities, include host nation 
67 

and regional alliance nations in their PI preparedness, response, and mitigation 

planning. 

o Ensure Combatant Commands, in conjunction with the Department of State and 

as part of their security cooperation planning, develop and execute bilateral and 

multilateral military-to-military and/or civilian-to-military PI response exercises 

with the host and regional alliance nations. 

o Ensure Combatant Commands, in conjunction with the Department of State and 

as part of their security cooperation planning, provide enhanced medical and 

veterinary training in infection control and case management capabilities with the 

host and regional alliance nations. 

• Combatant Commands 

o Through the Joint Chiefs of Staff, implement this policy within respective Area of 

Responsibilities (AORs) to include addressing integration of pandemic influenza 

prevention, preparedness, response, and recovery in appropriate OPLANs, 

CONPLANS, OPORDS, and theater security cooperation planning. 

• Military Departments and Defense Agencies 

o In coordination with ASD(HA) and the TRICARE Management Activity, develop 

contingency plans to enable CONUS MTFs to respond to an outbreak that fully 

implements the recommendations of the Implementation Plan for the National 

Strategy for Pandemic Influenza. Ensure plans include provisions for 

prioritization of services in the event of reduced staffing, conduct of, and support 

to, epidemiological investigations, surge training requirements (for example, 

ventilator use), and support to civilian authorities. 

o Ensure that public health and disease outbreak emergency response policies, 

plans, procedures, and guidelines are supported by sufficient command and 

control capabilities and other equipment to respond properly to disasters, public 

health emergencies, and disease outbreaks. 

o Ensure installation and MTF commanders develop comprehensive preparedness, 

prevention, response, exercise, and training activities for preparation and response 

to a pandemic influenza outbreak. A complete discussion of the list of tasks to be 

undertaken can be found in the Department of Defense Influenza Pandemic 

Preparation and Response Health Policy Guidance, posted on the ASD(HA) 

website at http://www.dod.mil/pandemicflu.

o Institute, as appropriate, emergency response programs for public health and 

disease outbreaks on military installations including active and Reserve 

component installations, Reserve Centers, and armories in CONUS. 
68 

o Ensure preparation of MTFs to provide mass distribution of medications to care 

for potentially large numbers of patients. 

o Ensure installation commanders designate a PHEO (reference k). This individual 

has experience and training in functions essential to effective public health 

emergency management. Specific responsibilities of the PHEO are described in 

the Department of Defense Influenza Pandemic Preparation and Response Health 

Policy Guidance, posted on the ASD(HA) website at 

http://www.dod.mil/pandemicflu. 

o Distribute vaccines and anti-viral medications in accordance with ASD(HA) and 

Joint Staff guidance. 

o Ensure installations participate in pandemic influenza planning, training, and 

exercise activities with co-located Federal, State, and local agencies. Where the 

operational mission permits, encourage Combatant Command components to 

participate in similar operations with the host nation as requested. 

o Provide daily situation reports as directed by the Joint Staff. 

o Establish reporting procedures for Combatant Command components as required. 

o Identify personnel, equipment, or logistical shortfalls immediately to the Joint 

Staff; components should report through both Combatant Command and Military 

Department channels. 

o Where operationally feasible, establish policies for adopting flexible worksites 

(e.g., telecommuting) and flexible work hours (e.g., staggered shifts) in the event 

of a pandemic. 

o Ensure development of active and passive systems to monitor outpatient and 

inpatient disease surveillance on their installations worldwide with an emphasis 

on index case and cluster identification, and develop mechanisms for using DoD 

epidemiological investigation experts in international support efforts. 

o Ensure appropriate systems are in place to monitor the health of overseas military 

forces (CONUS and OCONUS bases, deployed operational forces, exercises, 

units, etc.) and for coordination with Department of State, HHS, allied, coalition, 

and host nation public health communities to investigate and respond to 

confirmed infectious disease outbreaks on DoD installations and units. 

o For both CONUS and OCONUS installations, ensure Military Department-level 

and facility-level public health education programs are established consistent with 

the respective patient population. 
69 

o Ensure installation commanders receive additional support as buildings other than 

medical treatment facilities are pressed into service. Incorporate provisions for 

increased staff or emergency training of volunteer staff. Education, training, and 

risk communication, before and during an outbreak, will be critical for prompt, 

disciplined, and effective response. 

o Ensure installation commanders identify facilities, other than hospital or clinic 

locations, where mass vaccinations, antivirals and patient care, can be delivered. 

o Ensure installation commanders plan for mental health and chaplain support for 

emergency workers. 

• Logistics Considerations 

o The principal medical materiel requirements for an influenza pandemic include 

specially formulated influenza vaccine, antiviral drugs, ventilators, and personal 

protective equipment. 

o Coordinate purchases of antiviral drugs and influenza vaccine through the 

Defense Supply Center, Philadelphia. 

o Combatant Command logisticians should place their orders for Tamiflu® bottles 

in multiples of 48. Unit of issue prescribed to the patient is one bottle; there are 

48 bottles per case. 

o Considerable demand for ventilators is likely, especially in the event that the 

pandemic occurs before a vaccine is available. Where feasible, consideration 

should be given to stockpiling instead of “just-in-time” acquisition of adequate 

numbers of ventilators, antiviral drugs, and other medical supplies including 

Personal Protective Equipment (PPE). 
70 

ANNEX D, CONTINUITY OF OPERATIONS/CONTINUITY OF 

GOVERNMENT

PURPOSE 

National policy requires a comprehensive and effective program to ensure the survival of our 

constitutional form of government and continuity of national essential functions. The policy 

requires DoD to support its own departmental mission requirements, as well as those of other 

government institutions, when directed by the President or the Secretary of Defense, with plans 

and capabilities to help preserve the continuity of government. To accomplish this, DoD must 

insure that the capability exists to continue essential functions in the event of a disruption to 

operations. 

An influenza pandemic may degrade seriously the capability of DoD to continue its mission 

essential functions and services due to significant and sustained absenteeism. This annex 

provides substantive guidance on continuity of operations (COOP) and continuity of government 

(COG) for the Office of the Secretary of Defense (OSD), the Military Departments, the 

Chairman of the Joint Chiefs of Staff, the Combatant Commands, the Office of the Inspector 

General of the Department of Defense, the Defense Agencies, the DoD Field Activities, and all 

other DoD Components to develop or revise their respective COOP plans in preparation for a 

pandemic influenza event.

GENERAL GUIDANCE

In addition to this annex, additional Continuity of Operations (COOP) and Continuity of 

Government (COG) documents can be found in Annex G to provide guidance on specific 

operational approaches and methodologies for mitigating threats to national security. 

Departmental plans should apply similar operational approaches and methodologies for 

mitigating the threat of pandemic influenza. 

In accordance with the Department of Defense Continuity Strategy, national policy requires a 

comprehensive and effective program to ensure the survival of our constitutional form of 

government and continuity of national essential functions under all circumstances. The policy 

requires DoD to support its own departmental mission requirements, as well as those of many 

other government institutions, when directed by the President or the Secretary of Defense, with 

plans and capabilities to help preserve the ability to govern, continue the nation’s leadership, to 

perform functions and services required to meet defense and civilian needs through the entire 

range of threats, and if necessary, to help reconstitute governmental functions.

Department plans should be operational documents. They should first articulate the manner in 

which the department will discharge its responsibilities as defined in the Implementation Plan. 
71 

In addition, plans should address the operational approach to employee safety, continuity of 

operations, and the manner in which the department will communicate to its stakeholders. 

SPECIFIC GUIDANCE 

Unlike other catastrophic events, a pandemic will not be geographically or temporally bounded, 

and will not affect directly the physical infrastructure of an organization. These facts lead to 

unique planning considerations. Institutional planning efforts should build upon existing 

continuity of operations planning by the organization, but be expanded to address the following 

questions: 

• How will the department protect the health and safety of its employees, especially those 

critical to mission essential functions? 

• What are the department’s essential functions and services, and how will these be 

maintained in the event of significant and sustained absenteeism? 

• How will the department support the Federal response to a pandemic, and States and 

communities? 

• How, when and what will the department communicate to its stakeholders during a 

pandemic? 

ELEMENTS OF A VIABLE COOP CAPABILITY 

It is estimated that 40 percent of the staff may be absent from work for extended periods of time. 

These absences may be the result of personnel being ill, taking care of family members who have 

contracted the virus, or simply because they feel safer at home and less likely to be exposed to 

the virus. Therefore, a viable COOP plan must include a health focus. Each of the following 

elements of a COOP plan includes specific guidance in the event of an influenza pandemic. 

Plans and Procedures 

In accordance with DoDD 3020.26, the Department of Defense shall have a comprehensive and 

effective Defense Continuity Program that ensures DoD Component Mission Essential Functions 

(MEF) continue under all circumstances across the spectrum of threats. In order to reduce the 

pandemic threat, a portion of the COOP plan’s objective should be to minimize the health, social, 

and economic impact of a pandemic on the United States. Additionally, all plans and procedures 

should be developed to correlate to the organization, its personnel, and mission. Plans must 

include: 
72 

• The ability to maintain sustained operations until normal business activity can be 

reconstituted, which may be longer than 30 days (six to eight weeks is recommended). 

• Procedures to ensure essential services can be provided if employee absenteeism reaches 

40 percent. 

• Activation phases based on pandemic alert levels, the proximity of outbreak to 

organization’s offices/facilities, and reoccurring outbreaks. 

• Appointment of a senior manager and Influenza Team consisting of essential 

stakeholders capable of addressing issues related to pandemic influenza planning. 

• A health focus to minimize the effects of a pandemic on staff and operations.

Essential Functions 

Essential functions are those functions that enable organizations to provide vital services, 

exercise civil authority, maintain the safety and well being of the general populace, and sustain 

the industrial/economic base in an emergency. During a pandemic, or any other emergency, 

these essential functions must be continued in order to facilitate emergency management and 

overall national recovery. To effectively identify essential functions, organizations must: 

• Select essential functions considering the dynamic nature of a pandemic. 

• Reexamine prioritization of essential functions resulting from duration and personnel 

impact. 

• Identify essential functions that cannot be performed from home or other locations. 

• Identify critical systems and operations that can be redistributed and supported from other 

offices. 

• Consider additional business services critical to meeting organizational missions. 

• Review the effect of a pandemic on essential contract and support services and 

organizational operations, and develop mitigation strategies. 

• Consider the need for cross-training to ensure essential staffs are available to perform 

functions. 

• Continue to perform essential functions beyond the existing 30 day requirement. 
73 

Delegation of Authority 

Clearly pre-established delegations of authority are vital to ensuring all organizational personnel 

know who has authority to make key decisions in a COOP situation. Because absenteeism may 

reach a peak of 40 percent at the height of a pandemic wave, delegations of authority are critical. 

These delegations of authority must: 

• Be at least three deep per responsibility to take into account the expected rate of 

absenteeism. 

• Plan for geographical dispersion, taking into account the regional nature of an outbreak. 

Orders of Succession 

Just as important as Delegations of Authority, Orders of Succession are essential to an 

organization’s COOP plan to ensure personnel know who has authority and responsibility if the 

leadership is incapacitated or unavailable in a COOP situation. Since influenza pandemic may 

affect regions of the United States differently in terms of timing, severity and duration, 

geographical dispersion is encouraged for purposes of Orders of Succession development. 

Orders of succession must: 

• Be at least three deep per position to take into account the expected rate of absenteeism. 

• Plan for geographical dispersion, taking into account the regional nature and possibility 

of different orders of succession depending on the spread of the pandemic. 

• Establish an order of succession to other key leadership positions. 

• Identify the orders of succession by positions or titles, rather than by name. 

• Establish rules and procedures for successors. 

• Ensure all successors are trained to assume the lead position. 

• Ensure plans incorporate rules pertaining to the succession of command of military 

organizations. 

Alternate Operating Facilities 

The identification and preparation of Alternate Operating Facilities and the preparation of 

personnel for the possibility of an unannounced relocation of essential functions and COOP 

personnel to these facilities is part of COOP planning. During an influenza pandemic, however, 

special consideration must be given to “social distancing” in the workplace through 
74 

telecommuting, or other means, as an alternative to staff relocation/co-location. Identifying and 

acquiring alternate operating facilities should include consideration of the following: 

• The geographical location: 

o Initiate distributed or dispersed DoD operations. 

o Make use of existing department or agency field, branch or satellite locations. 

o Ensure accessibility for handicapped employees. 

o Telecommuting locations. 

o Telecommuting from home. 

o Virtual offices. 

o Joint or Shared facilities. 

• Determine which essential functions can be conducted from a remote location (e.g., 

home) and those that need to be performed at a designated department or agency facility. 

• Consider reliable logistical support, services, and infrastructure systems at facilities that 

remain open, including alternate operating facilities. 

o Prioritization/determination of accessible facilities/buildings (as alternative to 

relocating to remote facility) 

o Necessary support staff 

o Social distancing policies 

o Medical screening of employees 

o Health/medical units 

o Sanitation 

o Essential services 

o Food/water. 

• Consider the impact local quarantines may have on open/accessible facilities and 

operating plans. 

• Perform a risk assessment to determine the risk to personnel of moving them to an 

alternate facility if there is a potential for exposing the COOP personnel to infected 

individuals. 

• Ensure the health, safety and security of relocated personnel including medical screening 

and health monitoring, if available and sustainable at the alternate facility. 

• Ensure a timely and orderly recovery from the alternate facility only after it has been 

verified that the pandemic influenza threat has been neutralized at the pre-deployment 

site. 

Interoperable Communications 
75 

The success of a viable COOP capability from alternate facilities or telecommuting from home is 

dependent upon the identification, availability and redundancy of critical communication 

systems to support connectivity to internal organizations, external partners, critical customers, 

and the public. Pandemic plans should carefully consider the use of portable computers, high 

speed telecommunications links, personal communication devices and other systems to minimize 

illness among essential employees and restrict workplace entry of people with influenza 

symptoms. Elements of an interoperable communications capability should include: 

• Planning that carefully considers the use of laptops, high-speed telecommunications 

links, Personal Digital Assistants (PDAs), and other systems that enable employees to 

perform essential functions while teleworking. This includes the identification, 

availability, redundancy, and testing of critical communications systems that support 

connectivity to internal organizations, external partners, critical customers, and other key 

stakeholders. 

• Test and exercise telework impact on internal networks as well as impact of governmentwide mandated telework. 

• Backup plans to use if communications infrastructure fails as a result of surge in demand. 

Vital Records and Databases 

The identification, protection, and ready availability of electronic and hardcopy documents, 

references, records, and information systems needed to support essential functions during a 

COOP situation is another critical COOP planning requirement. Along with the ability to access 

vital records and databases, pandemic influenza planning must include the identification and 

maintenance of vital systems that rely on periodic physical intervention by essential individuals. 

An effective vital records program must also include: 

• Identification of records needed to sustain operations for 30 days or longer because vital 

records at alternate facilities may not be accessible. Determine whether files be accessed 

electronically from a remote location (e.g., an employees home). 

• A plan for, the maintenance of vital systems that rely on periodic physical 

intervention/servicing by essential individuals. 

• The assignment of responsibility of the vital records program, including identifying 

alternates with sufficient training to assume the role. 

• The identification and acquisition of the appropriate medium for accessing vital records, 

ensuring the primary and alternates are sufficiently trained to include required clearances, 

passwords and/or access codes. 
76 

Human Capital 

Each organization is responsible to design, update and carry out comprehensive plans to take into 

account and respond to the threats that its employees are most likely to face. Local management 

officials should ensure that union notification and bargaining obligations have been met prior to 

implementation of the plan. Human resources staff should be contacted to assist in determining 

management’s bargaining obligations. These plans interact with and impact on human capital 

management during a pandemic, and should consider organizational policies that encourage sick 

employees to stay home; and, enable staff to utilize telecommuting. Considering the 

impact/implications of pandemic influenza on employees, plans must include: 

• Updating human capital and organizational policies for: 

o Compensation for nonessential and essential employees 

o Sick leave 

o Mandatory sick leave 

o Family medical leave 

o Processing grievances 

o Telework policy 

o Family Assistance Programs. 

• Coordinating modifications to human capital policies and plans with labor relations. 

• Reviewing of terms and conditions of contract work to ensure contractor responsibility 

for essential functions (where relevant) and to suspend non-essential work. 

• Evaluating the need for hygiene supplies, medicines, and other medical necessities to 

promote the health and wellness of healthy essential personnel and plan for distributing 

such supplies. 

• Procedures for medically screening and clearing essential personnel. 

• Developing and/or modifying an employee accountability system. 

• Developing guidance and awareness plans and materials for employees, including 

o Occupational risk reduction strategies 

o Infection control 

o Personal hygiene 

o Social distancing techniques 

o Travel restrictions 

• The provision of relevant information and advisories about the pandemic to employees, 

via 

o Hotlines 

o Web sites 

o Voice Messaging System Alerts 

o All Hands Messages 
77 

• An ability to provide employees with cross-training to ensure essential staffs are available 

to perform functions 

• For further information on Human Capital Planning for Pandemic Influenza, please see 

the Office of Personnel Management (OPM) guide, same subject. The guide can be 

found at www.opm.gov/pandemic. 

Test, Training and Exercises 

Testing, training, and exercising of COOP capabilities are essential to assessing, demonstrating 

and improving the ability of organizations to execute their COOP plans and programs. Pandemic 

influenza COOP Plans must also test, train, and exercise “social distancing” techniques, 

including telecommuting, to help minimize contact with others and reduce the spread of 

infection. Additional requirements include: 

• Testing of established triggers and procedures for activating and terminating the 

organization’s COOP and emergency response plan in the event of a pandemic influenza. 

• Annual awareness briefings on pandemic influenza. 

• Testing of plans through tabletop, functional and full-scale exercises activating the COOP 

in the event of a pandemic influenza. 

• Testing, training, and exercising should include social distancing techniques, including 

telework capabilities and impacts of a skeleton staff on facilities and essential functions 

and services. 

 

Devolution of Control and Direction 

The devolution option of COOP must be developed to address how an organization will identify 

and conduct its essential functions during an emergency that renders the organization’s 

leadership and staff incapable or unavailable to execute those functions either from its primary or 

alternate operating facilities. Because an influenza pandemic may hit earlier, longer, or harder in 

various parts of the country, devolution planning may need to consider rotating operations 

between regional offices as the pandemic wave moves throughout the United States. Additional 

considerations include: 

• Taking into account how an organization will conduct essential functions if pandemic 

influenza renders leadership and essential staff incapable or unavailable to execute those 

functions. Full or partial devolution of essential functions may be necessary to ensure 

continuation. 

• Developing detailed guidance for devolution, including 

o Essential functions 
78 

o Rotating operations geographically as applicable 

o Supporting tasks 

o Points of contacts 

o Resources and phone numbers. 

• Ensuring that the devolution site has the capability to provide for the health, safety and 

security of the personnel. This includes the provision of vaccines and anti-virals. 

Reconstitution 

Reconstitution embodies the ability of an organization to recover from a catastrophic event and 

consolidate the necessary resources that allow it to return to a fully functional entity of the 

Federal government. The objective during this recovery and reconstitution phase during a 

pandemic is to expedite the return of normal services to the nation. Additional considerations 

include: 

• A method to acquire verification that the pandemic influenza threat has passed and that it 

is safe to return to the point of embarkation. 

• Developing plans for the replacement of employees unable to return to work and 

prioritizing hiring effort. 

• In conjunction with public health authorities, developing plans and procedures to ensure 

the facilities/buildings are safe for employees to return to normal operations. 

• Recognition that facilities may require decontamination before they can be reoccupied 

with a return to normal operations. 

• The need to consider providing counseling and other mental health and social services 

resources. 

Additional Actions 

Additional actions must be considered in developing a COOP plan in the event of a pandemic 

influenza. 

 

• Appointment of a COOP Influenza Manager. Appointing a COOP Influenza Manager 

and alternate is critical to provide a point of contact for all issues related to pandemic 

influenza, including plans, procedures, intelligence, and other information pertinent to 

providing for the health, safety and security of personnel and facilities. 

• Identification of “Social Distancing/Shelter-in-Place Techniques. The Office of 

Personnel Management shall provide interim pandemic influenza guidance through 

Telework: A Management Priority, A Guide for Managers, Supervisors, and Telework 

Coordinators; Telework 101 for Managers: Making Telework Work for You; and 
79 

Telework 101 for Employees: Making Telework Work for You. Shelter-in-Place guidance 

and plans are available through the American Red Cross. 

• Development of a Pandemic Internal Communications Plan. The development of a 

Pandemic Internal Communications Plan is critical to prepare the personnel for a 

pandemic by keeping them informed of the status of current outbreaks, symptomology, 

available vaccines and anti-virals and activation of COOP and emergency response plans. 

• Ensure Adequate Availability of Essential Supplies, Services, and Contracts. Plans 

must anticipate and plan for the requirement for additional resources in the event of a 

pandemic, including: 

o Providing sufficient and available infection control supplies (e.g., hand sanitizers, 

environmental cleaning supplies and educational materials). 

o Enhancing communications and infrastructure as needed to support personnel 

telecommuting and remote customer access. 

o Ensuring availability of medical consultation and advice for medical response. 

o Cleaning of facilities and equipment, which may require new or modifying 

current housekeeping contracts. 

• Management of Staff Who Become Ill in the Workplace. Management of staff who 

become ill in the workplace requires the development of plans and procedures for: 

o Infection control procedures to prevent further spread of the virus. 

o Protection of the remaining staff. 

o Decontamination/cleaning of areas the staff member may have infected. 

o Identification of other staff members that have or may have been in contact with 

the staff member(s) that became ill. 

o Contact procedures for requesting internal or external medical support. 

CONCLUSION 

Continuity of operations in the event of a pandemic influenza requires additional considerations 

beyond the traditional COOP concept. COOP planning facilitates the performance of department 

and agency essential functions during any emergency or event that may disrupt normal 

operations, including moving COOP personnel to an alternate site, if the primary location is no 

longer available. Unlike other emergencies, a pandemic influenza will not directly affect the 
80 

infrastructure of an organization. Its impact is on the organization’s human resources resulting 

in 40 percent staff absences. The loss of personnel has a direct impact on the ability of an 

organization to perform their essential functions if preventive and mitigating action is not taken 

in a timely manner. Therefore, COOP in a pandemic influenza must focus on preventive 

countermeasures, such as staff education, vaccine and pre-positioning of mission essential 

functions prior to local threat. After exposure, COOP will be reliant on supportive care and antiviral medication. Protecting staff from contracting the virus must be the focus of planning in 

order to ensure the continuation of essential functions and the continuity of government. 
81 

ANNEX E, PUBLIC AFFAIRS

PURPOSE 

 

The purpose of this annex is to outline the Public Affairs efforts of the Department of Defense 

(DoD) to prepare for, and if necessary respond to, the threat of a Pandemic Influenza outbreak. 

SITUATION 

The current pandemic threat is primarily restricted to the poultry industry in Asia and Europe, as 

the result of the H5N1 Influenza A virus. While there have not been any reported cases of 

sustained human-to-human transmission of the H5N1 virus, the current widespread outbreaks in 

birds and the potential of the virus to mutate have raised concern that the virus will possibly 

become transmissible between humans with catastrophic results worldwide. 

Although the threat of an Influenza Pandemic is global, the focus of media attention will be upon 

the messages we are sending and what the U.S. Government (USG) is doing to prevent the 

spread of disease. It will be crucial to maintain constant and consistent messages and information 

with our primary audiences during these periods. These messages may be in conjunction with or 

in coordination with the Center for Disease Control (CDC), the Department of Health and 

Human Services (DHHS), the Department of State (DOS), or other applicable U.S. Government 

agencies. 

Mission 

When directed by the President or the Secretary of Defense, DoD will conduct Public Affairs 

operations to contribute to the overall communication goals of DoD and the USG to minimize 

the spread and effect of Pandemic Influenza and to maintain the conditions of confidence and 

readiness in the U.S. Armed Forces to conduct global operations. 

Execution 

• Concept of PA Operations. OASD(PA) will provide USG-approved overarching 

themes and messages as well as Public Affairs Guidance (PAG) for Combatant 

Commands, and will coordinate Combatant Command Proposed PAG (PPAG) with the 

Joint Staff, DOS, DHHS, CDC and other USG agencies as appropriate. 
82 

• Posture. Each Combatant Command should develop active PPAG that addresses the 

following issues as they relate to the pillars of the National Strategy (Preparedness and 

Communication, Surveillance and Detection, and Response and Containment): 

o Health protection and safety of personnel and resources. 

o Maintenance of essential functions and services (mission). 

o Support to the Federal response (and/or DoS overseas) to a pandemic. 

o Communication between Combatant Command stakeholders and higher 

headquarters as well as other DoD elements. 

COORDINATING INSTRUCTIONS 

• There will be no initial release of information about any disease outbreak, or response 

operations by any command, until after the initial release is made by White House, DOS 

or DoD spokesperson, or until directed by higher authority. 

• If an outbreak occurs, DoD may play supporting roles, consistent with existing 

agreements and legal authorities, in implementation of movement controls, 

transportation, logistics and medical support. In this situation, DoD communication 

efforts would also provide support to the lead Federal agency. 

• Geographic and Unified Combatant Command information campaigns should include 

building awareness of the potential threat specific to their area, encouraging stakeholder 

audiences to develop individual preparedness skills, (e.g., social distancing, personal 

hygiene, mask use, and other infection control precautions individuals should employ 

during a pandemic) and communicating our capacity to respond within their own area of 

responsibility as well as assisting to coordinate response efforts within an international 

framework. 

• Pandemic influenza information message maps developed in coordination with other 

Federal agencies will be used to ensure consistency, assuage anxiety, and promote 

realistic expectations about the pandemic. Risk communication materials will be current 

and updated as conditions change and circumstances warrant. 

• Combatant Commands shall also develop additional materials unique to their Area of 

Responsibility (AOR), tailored for their respective military members to be made available 

through established DoD channels. 

PUBLIC AFFAIRS MESSAGES 

 

The following messages are approved for initial use. Subsequent Public Affairs Guidance may 

alter or add to these messages: 
83 

• The primary goal of DoD in combating the spread of pandemic influenza in the U.S. 

military population and civilian population is to preserve the ability of our military and 

civilian workforce to provide for national defense. 

• While there is no current pandemic influenza outbreak, there is still reason to be 

concerned. We aren't going to wait for a crisis to develop before we take steps to educate 

and safeguard the American people. 

• Individuals should stay informed about pandemic influenza and prepare as they would for 

any emergency. 

• Preparing now can limit the effects of a pandemic. Informed public participation and 

cooperation will be needed for effective public health efforts. 

• The United States has been working with the World Health Organization and other 

countries to strengthen detection and response to outbreaks. 

• If the new virus starts in Asia, limitations on travel, such as those used for SARS, may 

delay entry into the United States. 

• It is unlikely that control measures will prevent pandemic influenza from entering the 

United States, but preparing now can limit the spread and effects of pandemic influenza. 

• Domestically, the Department of Health and Human Services would be the lead Federal 

agency in charge of responding to a pandemic and DoD would act in a supporting role. 

• While we are a supporting agency DoD must also focus on the health and well-being of 

U.S. military and civilian personnel. 

ADDITIONAL INFORMATION 

http://www.pandemicflu.gov

http://www.dod.mil/pandemicflu 

http://www.hhs.gov/emergency/mediaguide/PDF/

http://www.who.int/entity/csr/don/Handbook_influenza_pandemic_dec05.pdf
84 

ANNEX F, REFERENCES

a. Armed Forces Epidemiological Board, “Vaccines in the Military: A Department of 

Defense-Wide Review of Vaccine Policy and Practice,” Recommendation 11, 

August 1999, web site http://www.ha.osd.mil/afeb/reports/vaccines.pdf/ (as of 

December 15, 2005). 

b. Assistant Secretary of Defense (Health Affairs) Memorandum, Subject: “Department of 

Defense Influenza Pandemic Preparation and Response Health Policy Guidance,” January 

25, 2006. 

c. Assistant Secretary of Defense (Health Affairs) Policy 05-022, “Policy for the Use of 

Influenza Vaccine for 2005-2006 Influenza Season,” November 8, 2005, web site 

http://www.ha.osd.mil/policies/2005/05-022.pdf (as of December 21, 2005). 

d. Assistant Secretary of Defense (Health Affairs) Policy 99-008, “Policy for DoD Global, 

Laboratory-Based Influenza Surveillance,” February 3, 1999, web site 

http://www.ha.osd.mil/policies/1999/clin9908.htm (as of December 21, 2005). 

e. Assistant Secretary of Defense (Health Affairs) Policy, “Policy for Release of Antiviral 

(Tamiflu®) Stockpile During an Influenza Pandemic,” (January 10, 2006). 

f. Centers for Disease Control and Prevention, “Prevention and Control of Influenza: 

Recommendations of the Advisory Committee on Immunization Practices (ACIP),” 

Morbidity and Mortality Weekly Report, Vol. 23, May 28, 2004, web site 

http://www.cdc.gov/mmwr/PDF/rr/rr5306.pdf (as of December 15, 2005). 

g. Centers for Disease Control and Prevention, “Vaccine Information Statements,” 

http://www.cdc.gov/nip/publications/VIS/default.htm. 

h. Department of Defense Directive (DoDD) 3020.26, Defense Continuity Program, 

(September 8, 2004). 

i. Department of Defense Directive 3025.15, “Military Assistance to Civil Authorities,” 

February 18, 1997, web site 

http://www.dtic.mil/whs/directives/corres/pdf/d302515_021897/d302515p.pdf (as of 

December 15, 2005). 

j. Department of Defense Directive 6200.2, “Use of Investigational New Drugs for Force 

Health Protection,” August 1, 2000, web site 

http://www.dtic.mil/whs/directives/corres/xml/d62002x.xml (as of December 14, 2005). 

k. Department of Defense Directive 6200.3, “Emergency Health Powers on Military 

Installations,” May 12, 2003, web site 

http://www.dtic.mil/whs/directives/corres/xml/d62003x.xml (as of December 14, 2005). 
85 

l. Department of Defense Instruction 6205.2, "Immunization Requirements," October 9, 

1986, web site http://www.dtic.mil/whs/directives/corres/html/62052.htm.

m. Department of Defense, Joint Staff Planning Order, Subject: Pandemic Influenza (PI) 

PLANORD, November 14, 2005 and DJS GENADMIN Message Pandemic Influenza 

Planning Efforts, February 6, 2006. 

n. Department of Defense, Strategy for Homeland Defense and Civil Support, (June 2005). 

o. Department of Defense, National Defense Strategy of the United States of America, 

(March 2005). 

p. Department of Health and Human Services, “HHS Pandemic Influenza Plan,” November 

2005, web site 

http://www.hhs.gov/pandemicflu/plan/pdf/HHSPandemicInfluenzaPlan.pdf (as of 

December 15, 2005). 

q. Department of Homeland Security, “National Response Plan,” December 2004, web site 

http://www.dhs.gov/interweb/assetlibrary/NRP_FullText.pdf (as of December 15, 2005). 

r. Executive Order 13295: Revised List of Quarantinable Communicable Diseases, (April 4, 

2003). 

s. Executive Order 13375 – Amendment to Executive Order 13295 relating to certain 

influenza viruses and quarantinable communicable diseases, (April 1, 2005). 

t. Federal Preparedness Circular (FPC) 60, Continuity of the Executive Branch of the 

Federal Government during National Security Emergencies, (November 2005). 

u. Federal Preparedness Circular (FPC) 65, Federal Executive Branch Continuity of 

Operations (COOP), (June 15, 2004). 

v. Homeland Security Council, “National Strategy for Pandemic Influenza,” November 

2005, web site http://www.whitehouse.gov/homeland/nspi.pdf (as of 

December 16, 2005). 

w. Homeland Security Council, National Strategy for Pandemic Influenza Implementation 

Plan, (May 2006). 

x. Homeland Security Presidential Directive (HSPD) - 10: BioDefense for the 21st Century, 

(April 28, 2004). 

y. Joint Publication 3-07.5, “Joint Tactics, Techniques, and Procedures for Noncombatant 

Evacuation Operations,” September 30, 1997, web site 

www.dtic.mil/doctrine/jel/new_pubs/jp3_07_5.pdf. 
86 

z. National Communication System (NCS) Directive 3-10, Telecommunication Operations: 

Required Minimum Continuity Communications Capabilities, (June 7, 2005). 

aa. National Security Council, National Strategy to Combat Weapons of Mass Destruction, 

(December 2002). 

bb. Office of Personnel Management, “Human Capital Management Policy for a Pandemic 

Influenza,” June 9, 2006, web site www.opm.gov/pandemic. 

cc. U.S. Army Medical Surveillance Activity, “Tri-Service Reportable Events: Guidelines & 

Case Definitions,” version 1.0, July 1998, web site: 

http://amsa.army.mil/documents/DoD_PDFs/Jul98TriServREGuide.pdf (as of 

December 16, 2005). 

dd. U.S. Army Regulation 40-562/BUMEDINST 6230.15/AFJI 48-110/CG COMDTINST 

M6230.4E, “Immunizations and Chemoprophylaxis,” (November 1, 1995). 

ee. United States Code Title 21, Code of Federal Regulations, Parts 50, “Informed Consent 

of Human Subjects,” and 312, “Investigational New Drug Application,” current edition. 

ff. World Health Organization, “WHO Global Influenza Preparedness Plan, 2005,” web site 

http://www.who.int/csr/resources/publications/influenza/WHO_CDS_CSR_GIP_2005_5.

pdf (as of December 15, 2005).