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# Global Health Engagement Strengthens Partnerships 

By Military Health System Communications Office

Health and Human Services Secretary Alex Azar describes the work of the international crew of the USNS Comfort as “near miraculous.” He was aboard the U.S. Navy hospital ship during its deployment to South America earlier this year and saw firsthand the impact of forward deployed health and humanitarian assistance missions. 

On board, he met a man who had been blind for several years. The Comfort and its staff performed cataract surgery, restoring the man’s sight. After the procedure, “he actually looked up and the first thing he saw was a clock on the wall and pointed to it,” Azar recalled. “He said he hadn’t seen a clock in a decade.”

Azar recounted this story Dec. 3 at the 2019 annual meeting of the Society of Federal Health Professionals, calling it and the mission of the Comfort as “perfect examples of international humanitarian cooperation and the great American generosity made possible by our men and women in uniform and our medical professionals and civilian servants throughout the U.S. government.”

In all, the Comfort’s deployment touched the lives of nearly 69,000 people in 12 countries in South America, Central America, and the Caribbean through dental work, surgeries, family medicine, and eye exams. Medics also distributed nearly 31,000 pairs of prescription eyeglasses.

The Comfort deployment underscores the Department of Defense’s commitment to its role in Global Health Engagement, a critical driver to advance U.S. national security interests around the world.

The U.S. military has long recognized the close link between health and security – and the operational and strategic importance of Global Health. In the early 1900s, U.S. Army surgeon Major Walter Reed discovered the causes of yellow fever, which claimed the lives of more U.S. soldiers than combat during the Spanish-American War. Since then, the Department’s role in global health builds upon the foundation of readiness, recognizing that U.S. forces could be deployed anywhere in the world, and on a moment’s notice – and that they must be prepared for any health threats they might face. In recent years, the strategic focus on the linkage of global health and security has been increasingly reflected in the National Security Strategy, the National Defense Strategy, the National Biodefense Strategy, and the Global Health Security Strategy.

Beyond protecting U.S. forces, the Department recognizes that by enhancing readiness, increasing interoperability, and strengthening partnerships, Global Health Engagement activities serve as key enablers of the National Defense Strategy.

**Advancing readiness of the force**

The Military Health System carries out its mission to prepare military medical teams to provide the best possible health care on the battlefield and ensure service members are medically ready to deploy. Global Health Engagement activities advance this readiness, providing critical training opportunities to enhance military medical capabilities.

The U.S. remains at the global forefront for infectious disease prevention. The Military Health System’s cutting-edge research and development program continues to develop vaccines and countermeasures for infectious disease to enhance global health security – from Zika to dengue fever. These capabilities are important not only to protect U.S. and partner forces, but to combat health threats that can destabilize societies and create conditions where conflict is likely to emerge.

Contributing to the overall effort, as part of the Defense Health Agency’s combat support capabilities, the Health Surveillance Explorer communicates disease outbreak surveillance through immediate reporting and monthly surveillance summaries, providing critical information to inform Force Health Protection priorities and monitor threats to global stability. The U.S. military’s research labs in South America, Africa, Southeast Asia, and the Middle East serve on the front lines with partner nations to improve disease surveillance and outbreak response assistance.

The first goal of the U.S. Government Global Health Security Strategy calls for strengthening partner country global health security capacities. “Achieving global health security requires all nation-states to be capable of preventing, detecting, and responding promptly and effectively to health security risks and public health emergencies of international concern,” according to the strategy published earlier this year. “To help those in need while protecting Americans at home and abroad, the United States will help partners achieve international global health security standards.”

One example supporting this strategy occurred in March 2019 when U.S. Africa Command and the Ugandan Ministry of Defense co-hosted the African Malaria Task Force. Experts from 18 African partner nations, nongovernmental organizations, nonprofit organizations, and the U.S. gathered to share best practices and lessons learned in combating the primary disease that kills in Africa.

“The purpose [of AFMT] is to bring together scientists and policymakers in order to strengthen and expand effective, sustainable malaria control programs, provide support to African partner nations, and to assist national and regional malarial programs,” said U.S. Air Force Lt. Col. Edward Kosterman, public health officer, Office of the Command Surgeon, AFRICOM, in an AFRICOM news release. “We want to encourage our partners to take a whole-of-government approach to combat malaria, by sharing resources, strategies, and expertise while leveraging their ministries of defense as key assets in resource-constrained environments.”

AFMT has grown since its inception in 2011 to include 21 African partner nations, testament to the benefits of strengthening collaboration to combat a disease that the Centers for Disease Control and Prevention says in 2016 claimed 90 percent of reported deaths worldwide in Africa.

**Building partnerships and interoperability**

Global Health Engagement activities also build interoperability through subject matter expert exchanges with partners and allies and joint exercises to improve response to disasters or outbreaks, contributions to globally integrated health services, and partnerships to advance shared interests and maintain regional stability and security.

Earlier this year, the Department of Defense partnered with the United Arab Emirates to create a dedicated trauma, burn, and rehabilitative medicine capability in Abu Dhabi – an effort that will both sustain and enhance wartime surgical skills while building interoperability with U.S. partners across the region.

Military health education and training exchanges, including sharing advances in military trauma care and patient movement, promote mutual awareness, familiarity, and confidence in military medicine and enhancing Partner Nation military medical capabilities.

As part of the Comfort’s deployment this year, the ship’s medical staff collaborated with Colombian military and civilian medical experts to exchange treatment techniques and best practices.

“It’s an event of supreme importance because the U.S. military is teaching us many ways to prevent epidemic illnesses that all under-developed countries, like Colombia, have to confront,” said Lt. Col. Janeth Rosero Reyes, Colombian army director of general medicine at Battalion Cordoba. “My entire team learned a lot of techniques and we will begin to share them with the goal to generate an impact in our foundation.”

**Enhancing Security Cooperation**

Global Health Engagement enhances security cooperation, fostering critical relationships and cooperation so that when health or other security threats arise, the U.S. is ready and able to partner to advance shared interests.

The Defense HIV/AIDS Prevention Program, for example, partners with 55 other countries’ militaries to curb the global HIV/AIDS epidemic. Over the past nearly two decades of work, DHAPP has provided direct military-to-military cooperation and support to partner nations through activities like training health care workers to provide clinical services, equipping laboratories and clinics for testing and diagnostics, promoting health education, linking individuals with treatment, and more. This long-standing singular focus on a disease continues to leverage critical partnerships while addressing a global epidemic, reflecting the unique and powerful capabilities behind Global Health Engagement. 

“As the Military Health System works to deliver on the National Defense Strategy’s priorities to advance readiness and strategic partnerships and alliances, Global Health Engagement remains a strategic tool for combatant commands,” said assistant secretary of Defense for Health Affairs Tom McCaffery, “and the Military Health System remains committed to leveraging the vast repository of Global Health Engagement assets to support operational readiness, recognizing the U.S. military is better prepared, better protected and stronger through partnership as a result.”

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