Shedding light on the Department of Defense’s little-known contributions to global health

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Col. Kent E. Kester, MD (left), a former commander at Walter Reed Army Institute of Research, and Peter Hotez, MD, PhD, at a briefing on the DoD’s Essential Contributions to Global Health.

The U.S. Department of Defense might not incite thoughts of contributions to global health, but a briefing Thursday on Capitol Hill – hosted by The American Society of Tropical Medicine and Hygiene (ASTMH), Center for Strategic & International Studies (CSIS), Research! America and the Sabin Vaccine Institute (SVI) – shed new light on that thinking.

“The Walter Reed Army Institute of Research (WRAIR) is one of the largest developers of vaccines in the non-private sector,” said Peter Hotez, MD, PhD, president of the SVI and ASTMH, and a presenter at the briefing on DoD’s Essential Contributions to Global Health.  “Most of the interventions that we have that we can use to fight neglected diseases in low- to middle-income countries are because of WRAIR.”

There are many reasons for that, according to fellow panelist Col. Kent E. Kester, MD – a former commander at WRAIR and a malaria vaccine researcher, scientist and soldier. “Our primary mission is force health protection – developing medical solutions to protect our deployed service members. If you have health threats that don’t discriminate between someone living in a small village in Kenya or an Army Corps of Engineers building bridges in country X, it has much broader implications and force health protection means much more,” Kester said.

What is more, “sick nations are dangerous nations – that’s a truism,” he said.

Hotez agreed, noting the “very intimate” relationship between tropical infections and conflict.  “We can actually show that if you go to the countries with the highest rates of neglected tropical diseases, they were most likely involved in conflicts at some point over the past 20 years. Is it because these are places where there has been a lot of conflict and a breakdown of the public health infrastructure? That’s certainly true, but we think tropical infectious diseases have been shown to be highly destabilizing,” Hotez said.

The annual budget of the DoD is approximately $630 billion, .05 percent of which is going to produce some of the “most extraordinary interventions that are making a huge difference for bottom billion people who make no money, and at the same time they are having a huge potential impact on reducing poverty and conflict in low-income countries,” Hotez said. 

The next challenge, panelists agreed, is to educate the public and the Congress about what we’re getting for that approximately $130 million annual investment. “The intimate relationship between disease and national security interests is an argument that needs to be better articulated than it has been to date,” Hotez said, and include how we are working to meet all the goals of the president’s Global Health Initiative, and take infectious disease research at WRAIR and link it to overseas labs.

J. Stephen Morrison, PhD, director of the Global Health Policy Center at CSIS.

“There’s no question that our U.S. servicemen and women rely on the work these laboratories perform,” said panelist J. Stephen Morrison, PhD, director of the Global Health Policy Center at CSIS, who issued a new report entitled The Defense Department’s Enduring Contributions to Global Health in late June. The global health benefits that are spread beyond the immediate target client base – diagnostics, vaccines, therapies, new knowledge – they’re a best buy… There’s not a lot of money going into these laboratories relative to the output, he said.

Some examples in the CSIS report of DoD contributions to global health include:

  • in Thailand, the first successful HIV/AIDS vaccine trial,
  • the demonstrated efficacy of Malorane, primaquine, and weekly tafenoquine to treat and prevent malaria,
  • lab research that resulted in the first vaccine for Japanese encephalitis virus (JE),
  • the first identification of new strains of dengue fever in Peru.

However, “The labs are under-resourced and under-acknowledged, within the DoD, on the Hill and in broader society,” Morrison said. He then outlined what is needed moving forward, including recommendations for modest adjustments in funding levels to create a balance where core research can be fulfilled, much better communication between levels [of government], better outreach to Congress and core constituencies, and cultivating champions to speak in support of them.

“All those steps can be achieved in the near and immediate term,” Morrison said.

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