DeFraites BMC Public Health 2011, 11(Suppl 2):S1 http://www.biomedcentral.com/1471-2458/11/S2/S1 R E V I E W Open Access The Armed Forces Health Surveillance Center: enhancing the Military Health System’s public health capabilities Robert F DeFraites Abstract Since its establishment in February 2008, the Armed Forces Health Surveillance Center (AFHSC) has embarked on a number of initiatives and projects in collaboration with a variety of agencies in the Department of Defense (DoD), other organizations within the federal government, and non-governmental partners. In 2009, the outbreak of pandemic H1N1 influenza attracted the major focus of the center, although notable advances were accomplished in other areas of interest, such as deployment health, mental health and traumatic brain injury surveillance. Introduction The center was established by the Deputy Secretary of Defense in February 2008 [1]. The center’s mission is to promote, maintain and enhance the health of United States (U.S.) military and military-associated populations by providing relevant, timely, actionable and comprehen- sive health surveillance information. The center is intended to become the central epidemiological resource for DoD. To achieve that aim, AFHSC combined the resources of the Army Medical Surveillance Activity (AMSA), the DoD Global Emerging Infectious Disease Surveillance and Response System (DoD-GEIS), and the Global Health Surveillance Activity supporting the Force Health Protection Directorate in the Office of the Assis- tant Secretary of Defense for Health Affairs. This paper outlines the diverse and unique capabilities of the center. As AFHSC matures, evolves and grows, the capabilities and support provided by its legacy agencies are expanding to meet DoD’s needs. The center plays a key role in the collective understanding of infectious dis- ease threats throughout the world, and the impact of these threats on U.S. uniformed and military-associated populations. Today, more than ever, DoD has a more complete picture of the health of American men and women in uniform. Correspondence: Robert.DeFraites@us.army.mil Armed Forces Health Surveillance Center, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA Background The center traces its founding to two major policy devel- opments in the 1990s. In the wake of the Persian Gulf War in 1990-91, DoD lacked the ability to address health-related issues in any comprehensive or cohesive manner. Among other initiatives, DoD designated AMSA at the U.S. Army Center for Health Promotion and Pre- ventive Medicine as the department’s Center for Deploy- ment Health Surveillance [2]. AMSA operated and maintained a longitudinal relational database that tracked soldiers’ health-related events throughout their military careers. The effort later evolved into the Defense Medical Surveillance System (DMSS) [3] as an Army Medical Department DoD Executive Agency. The Defense Department established requirements for documentation of the health status of servicemembers immediately before and following deployment on major operations [4-10]. DMSS was designated as the reposi- tory for this information. The Defense Medical Epide- miological Database, a subset of DMSS, is intended for remote user analysis. The database allows authorized users to access de-identified aggregate data on ambula- tory visits, hospitalizations and reportable events of active-duty military personnel spanning the previous 10 years. Meanwhile, the DoD Serum Repository con- tains more than 56 million serum specimens drawn from individuals serving on active duty since the late 1980s [3]. The specimens, maintained at -25 degrees Celsius, are linked with individual DMSS data, as well as augmented by epidemiological studies of military and © 2011 DeFraites; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.