Governments around the globe are showing a growing willingness to use militaries to support global health, but more comprehensive guidelines and strategies are needed if the world is going to be better prepared for future health emergencies, says a University of Sydney health security expert in The Lancet.
Associate Professor Adam Kamradt-Scott from the Department of Government and International Relations and Charles Perkins Centre is one of 13 contributors to the new report, ‘Militaries and Global Health: Peace, Conflict, and Disaster Response’, part of a series in The Lancet examining important issues in security and global health.
It is the first publication to comprehensively summarise the varied roles, responsibilities and approaches of militaries in delivering global health, drawing on examples and case studies across peacetime, conflict and disaster response environments.
The publication’s authors say military engagement in global health is often driven by defence and security objectives, which can put them at odds with humanitarian principles and run contrary to global health objectives. However, it also points out that in peacetime, militaries are heavily engaged in research and development, and military health scientists and practitioners have been at the forefront of key advances in public health domestically and internationally, since the eighteenth century.
They argue a balance between military and civilian global health capacities is necessary to help build capacity and medical readiness across different countries.
“The involvement of military personnel in health emergencies has traditionally been controversial, but disease outbreaks – such as pandemic flu, cholera, and Ebola and Zika viruses – are legitimate national security threats. In some contexts, military assistance may be the only option where civilian capacity is inadequate,” said Associate Professor Kamradt-Scott.
He said the current Ebola outbreak in the Democratic Republic of the Congo may serve as an example where militaries might potentially support public health objectives.
“Rebel forces have complicated the public health response to the recent outbreak by murdering UN peacekeepers and impeding the contact tracing and vaccination campaign that is underway. Military assistance may prove helpful here in bringing stability to the region so the public health efforts to eradicate Ebola can continue unimpeded, but this again demonstrates the urgent need for understanding how to guide and govern military engagement in global health.
“Disease outbreaks are going to continue to occur, and we need to make sure we have agreed on where the ‘red lines’ are – what are the types of activities militaries can be reasonably asked to perform and what they should not do.”
The publication proposes potential strategies for more effective engagement of militaries in global health, including developing mechanisms for communication, coordination, and joint action across relevant entities at national and global levels.
These strategies and more will be just one of the topics to be discussed at the Global Health Security 2019 conference in June, which will bring together stakeholders working in global health security to measure progress, determine gaps, and identify new opportunities to enhance national, regional and global health security.
Associate Professor Kamradt-Scott is also currently working on research seeking to better understand the roles, functions, responsibilities and limits of military assistance in health emergencies to inform future practice. Funding for the project is provided to Associate Professor Kamradt-Scott through the Australian Research Council’s Discovery Projects scheme.
He is also leading a collaboration with the World Health Organisation to identify potential disease outbreak-related trade and travel sanctions. Together, they launched a tool in February 2018 to monitor compliance with the International Health Regulations (2005) (IHR 2005) requirements regarding additional health measures.
Top image: 3D representation of a Zika virus. Image credit: Manuel Almagro Rivas/Wikimedia Commons.