1. DoD Global Health Engagement (GHE): Strategic Perspectives1.
Good afternoon:
I am CDR Joey Piansay from the Office of the Under Secretary of Defense for Policy. I work in the Office of Stability and Humanitarian Affairs.
My presentation will focus on the policy guidance aspects of DoD GHE activities.
Please do not hesitate to interrupt me with any questions or comments.
Office of the Under Secretary of Defense for Policy
Stability and Humanitarian Affairs (SHA)
November 2016

2. Disclosures The presenter has no financial relationships to disclose.
This continuing education activity is managed and accredited by Professional Education Services Group in cooperation with AMSUS.
Neither PESG,AMSUS, nor any accrediting organization support or endorse any product or service mentioned in this activity.
PESG and AMSUS staff has no financial interest to disclose.
Commercial support was not received for this activity.
** REQUIRED ** Slide for AMSUS

3. Learning Objectives / Agenda
Familiarize with GHE key references
Familiarize with OSD Policy and where GHE Policy oversight resides
Discuss GHE’s Role within DoD’s overall strategic mission.
Briefly discuss Aug’16 DoD guidance on Security Cooperation (SC)
Discuss 2016 OSD Policy on Humanitarian Assistance (HA)
Sectors of HA as opportunities for GHE-related activities
Guidance to CCDRs for Assessment, Monitoring and Evaluation (AM&E) for HA
Some Good Practices and Ebola Crisis Experience
Briefly discuss Global Health Security Agenda (GHSA)
** REQUIRED ** Slide for AMSUS
At the conclusion of this activity, the participant will be able to…
Using DoD HA as a GHE activity in focus (and as one of the key areas of Global Health), presenter will:
*Briefly discuss DoD’s role in GHE
*Share best practices
*Guidance to CCDRs or GCCs for Assessment, Monitoring and Evaluation (AM&E)

4. DoD Instructions and Directives
DoDI 2000.ac (Global Health Engagement Activities)
Draft - Formal Coord completed, enters Pre-Sign phase
DoDI (Stability Operations)
DoDI (Military Health Support for Stability Operations)
DoDI (HCA)
DoDD (Foreign Disaster Relief / FDR)
DoDD (Under Secretary of Defense for Policy)
DoDD (Assistant Secretary of Defense for Special Operations and Low Intensity Conflict)
DoDD (Security Cooperation)
DoDD (Assistant Secretary of Defense for Health Affairs)
National Security Strategy 2015
Quadrennial Defense Review (QDR) 2014
Familiarize with GHE key references
In a nutshell, by these DoDIs and DoDDs, shows DoD’s continuous commitment to Global Health and GHE activities.
2006 National Security Strategy:
“The risks [from public health challenges like pandemics that know no borders] to social order are so great that traditional public health approaches may be inadequate, necessitating new strategies and responses…. If left unaddressed, [they] can threaten national security.”
2010 National Security Strategy:
“The threat of contagious disease transcends political boundaries, and the ability to prevent, quickly detect and contain outbreaks with pandemic potential has never been so important….Addressing these transnational risks requires…extensive collaboration with the global community.”
Also refers to “promoting global health security” and calls for a “comprehensive global health strategy”
2015 National Security Strategy:
“America is the world leader in fighting pandemics…and in improving global health security… We will accelerate our work with partners through the Global Health Security Agenda in pursuit of a world that is safer and more secure from infectious disease.”

5. OSD Policy’s Role in Humanitarian Assistance
Policy Development (HARO, PKSO and Int’l Hum Policy)
DoD HA policy guidance cable (new, 10 Aug 2016)
DoD Instruction on GHE (Lead: ASD SO-LIC SHA, forthcoming)
DoD Instruction on AM&E Policy (Lead: ASD SPC, forthcoming)
Oversight
Annual CCDR (GCC) strategy and budget submissions
HA projects
Coordination with OSD Policy regional offices, as appropriate
Interagency Coordination
Participate in NSC-led meeting on HA issues
Work with USAID-OFDA and State to address concerns regarding information-sharing, duplication of projects, coordination
Respond to Congressional and GAO inquiries on HA issues
Familiarize with OSD Policy organization and where GHE Policy oversight resides
Discuss GHE’s Role within DoD’s overall strategic mission.
Briefly discuss Aug’16 DoD guidance on Security Cooperation (SC)
Discuss 2016 OSD Policy on Humanitarian Assistance (HA)
Sectors of HA as opportunities for GHE-related activities
Guidance to CCDRs for Assessment, Monitoring and Evaluation (AM&E) for HA
Some Best Practices and Enduring Themes
Briefly discuss Global Health Security Agenda (GHSA)
These are the 3 x steady state OSD-P roles in Humanitarian Assistance
We’ll come back to discussing DoD HA later in this brief
UNCLASSIFIED

6. DoD Policy Guidance for GHE - Basics
Under the authority and direction of OUSD-Policy, the Asst SecDef for SO-LIC will provide guidance and oversight for GHE activities
DoD GHE activities are conducted in support of U.S. national security policy and military strategy. They are a means to partner with other nations to achieve security cooperation and build partner capacity
Each GCC is responsible for issuing specific DoD GHE Policy implementing instructions to subordinate elements. Plan and execute DoD GHE activities in their AOR
DoD GHE activities allow the military health services and PN military or civilian authorities and agencies to build trust and confidence, share information, coordinate activities, maintain influence, and achieve interoperability
DoD GHE uses the full spectrum of health capabilities in Mil-to-Mil, Mil-to-Civ, or multilateral activities
Okay, here is where things get interesting; and I would appreciate your feedback.
See Para.2.B. of May’13 OSD-P cable on “POLICY GUIDANCE FOR DOD GLOBAL HEALTH ENGAGEMENT”
DTG: Z May 13 Precedence: PRIORITY DAC: General
GCCs are, in most cases, the implementing agent for DoD GHE activities; and the GCC Surgeon’s Office needs to have situational awareness, if not direct collaboration, on health or medical related projects in their AOR.
Those activities should synergize with whole of government global health efforts and avoid duplication or overlap.
What we need from you is to ensure Collaboration/awareness of all your GHE activities with the GCC who will be responsible through the new governance to develop AME.

7. DoD Guidance for Security Cooperation – 29Aug16
“The defense strategy emphasizes the importance of enabling partners to address shared security challenges and enhancing the interoperability of its allies and partners with the U.S. joint force. Security Cooperation [SC] must be prioritized and allocated in a strategic manner…”
Provides Additional Strategic Guidance on SC for:
Planning, Assessing, Monitoring & Evaluation (AM&E)
Via “S.M.A.R.T.” Objective Framework (i.e. Specific, Measurable, Achievable, Relevant & results oriented, and Time Bounded)
Prioritization using SC Framework for decision-support
Promote DoD SC Outcomes and Feasibility of Success
Developed by RAND per the OSD-directed study of Dec’15, the S.M.A.R.T. Objective Framework guides CCDRs to ensure that their respective Security Cooperation (SC) activities are appropriately:
*Diversified (i.e. whether a single activity or series of activities geared to HN/PN-sustainable results and outcomes);
*Integrated (i.e. ensuring that the combined impact of prioritized SC activities align to CoM/AMEMB Integrated Country Strategy or ICS) and
*Sequenced (i.e. according to a strategic concept for achieving results)
- Promote DoD SC Outcomes and Feasibility of Success (per DoD SC Framework Tool – see DoD ‘Memo For’ SC Guidance-U/FOUO)

8. DoD GHE as a Security Cooperation Tool
Valuable tool for Geographic Combatant Commands (GCC) to accomplish Theater Campaign Plans and Strategic End States
GHE Activities are intended to:
Build capacity of HN
Improve DoD visibility, access, and influence
Interoperability in a HN or region
Partnering Strategy tool to achieve national security objectives and military end states 7.
DoD is increasingly emphasizing and engaging in GHE activities at the Combatant Command level and within the Services.
Such as, military medical exchanges , humanitarian assistance, medical research and development, and health service delivery.
Plus, as a result of the Ebola outbreak, one recommendation from the JS’s Ebola Red Cell Report is to add language to strategic guidance documents directing COCOMs to increase steady state health activities within their AORs.

9. Global Health Engagement Definition
“Health preparedness and response to threats; such as infectious and non-communicable diseases, that are not controlled, prevented, or deterred by territorial boundaries of states, and thus require global coordination.” 1
Key principles of GHE
Health equity.
Preference to address health issues in poor, vulnerable, and underserved population. 4.
Health preparedness and response to threats; such as infectious and non-communicable diseases, that are not controlled, prevented, or deterred by territorial boundaries of states, and thus require global coordination.”
Key principles of GHE
Health equity.
Preference to address health issues in poor, vulnerable, and underserved population.
1This definition is quoted from the OSD-Policy Guidance cable on GHE published per DTG152052Z May 13

10. Draft DoDI 2000.ac GHE Activities as of 31Oct16
DRAFT ** PRE-DECISIONAL **
Draft DoDI 2000.ac GHE Activities as of 31Oct16
DoD Global Health Engagement (GHE)1. Interaction between individuals or elements of the Armed Forces of the United States and those of a PN’s [Partner Nations] armed forces and/or civilian authorities, in coordination with other USG departments and agencies, to build trust and confidence, share information, coordinate mutual activities, maintain influence, and achieve interoperability in health related activities which support national security policy and military strategy. GHE activities establish, reconstitute, maintain, or improve the capabilities or capacities of the PN’s military or civilian health sector, and/or those of DoD.
OSD-Policy Guidance on GHE published (established) on DTG152052Z May 13
EXPANDS and UPDATES the GHE definition from the previous GHE WG of Jan’14.
“DoD GHE comprises health and medical related actions and programs undertaken by the DoD to improve foreign armed forces’ or foreign civilian authorities’ health system capacity; and to promote and strengthen their human and/or animal health systems in support of national security objectives.”
On GHE Council Charter, OSD Policy ASD HD&GS concurred on 23 Jan 2016 and GHE DoDI drafted entering informal coord from Feb’16 through Jul’16.
Formal coord took place between Aug’16 through Oct’16 – Formal Coord (Stage 3 of DoDI issuance phase) was completed as of 31 Oct 2016.
* As of 26 Sept 2016, expanded definition, to clarify the endstate of DoD GHE activities, was achieved concurred by GHE Council AO Group, to include CJCS JS J5 and JS Surgeon
* Current DoDI draft expanded the GHE Council Charter with specification/detailed roles & responsibilities of GHE Council Members, Services & GCCs; added Procedures Section; and updated Glossary & key References
* The essence of the 15 May 2013 GHE definition is [not] lost since this orig cable remains a [primary] and foundation reference for the pilot DoDI 2000.ac for DoD Policy Guidance for GHE activities.
* Updated definition also complements DoD’s current focus on improving PN capacity through GCC’s TSC Program HA and HCA (mil-to-mil and mil-to-civ), to include alignment to the recently signed (4Nov16) Executive Order on Global Health Security Agenda (GHSA)
This new definition complements and improves upon GHE as initially defined / described in Para.2.A. of the pilot OSD-Policy GHE Cable DTG152052Z May 13 (See previous slide):
1This definition to be submitted for inclusion into JP 1-02
UNCLASSIFIED

11. Requirements for DoD GHE Plans and Activities
DoD priorities – what is OSD Policy doing for GHE
Funding DoD GHE activities (legal authorities)
Internal and external coordination (GCC, interagency, NGOs, IGOs)
Identify gaps / Work and Implement Solutions
Synchronize and integrate efforts
Improve efficiency
Identify opportunities for project cooperation
Promote HN long-term project sustainability
12.
The GCC set Requirements based on his/her Theater Campaign Plan.
You as the planners need to take in consideration the legal authorities Include LT to discuss the approval of HAP projects
It is a partnering strategy tool to achieve national security objectives and military endstates.

12. Prioritization of GHE Activities11
The key is to “build capacity and capability” of [not only] the PN’s (partner nation’s) personnel but of our own.
And as with everything else we do these days, we must be able to provide metrics demonstrating effectiveness and efficiency.

13. What OSD Policy is doing for DoD GHE
Coordinating DoD GHE activities within DoD:
Global Health Engagement Council (GHEC)
Member of Health Affairs/JS Surgeon General’s Global Health Working Group (GHWG)
Success depends upon integrated and coordinated efforts within the DoD and the Interagency
Develop policy guidance for DoD GHE:
DoD GHE Policy Guidance Cable issued May 2013
GHE DoDI 2000.ac (draft) enters Pre-Signature Phase Dec 2016
Working with CJCS J-5 [and] Surgeon’s Office with Service GHE representatives on strategic guidance for DoD GHE
Way Ahead: Include DoD GHE language in strategic guidance documents (e.g. Guidance for Employment of the Force or GEF; JP 4-0 HSS, etc.) and also for future DoDI or DoDD references’ updates
The GHEC is made up of the representatives from the major stockholders for DoD GHE.
Joint Staff Surgeon Office for strategic oversight and guidance and coordination with GCC Surgeon Offices.
Defense Health Agency and Health Affairs to enable the conduct of GHE through education and training and standards of care guidance.
The services provide coordination with their respective Surgeon Generals’ Offices as well as providing the personnel for implementation.
A DODI on DoD GHE is in the works. It does not limit who can do DoD GHE projects but encourages coordination and collaboration within the DoD and interagency.

14. Funding DoD GHE Activities
BLUF: There are various funding authorities for which DoD GHE qualifies under. The below is a samples and more common funding authorities used for DoD GHE.
GHE under Title 10 USC 401 (Humanitarian Civic Assistance) – MILDEPs Operation & Maintenance accounts
GHE under Defense Threat Reduction Agency’s Cooperative Biological Engagement Program or CBEP
Cooperative Threat Reduction Program accounts
Overseas Humanitarian, Disaster, and Civic Aid (OHDACA) – Humanitarian Assistance (HA) or Foreign Disaster Relief (FDR) 10
As I mentioned earlier, DoD GHE are those DoD health or medical related activities conducted with a foreign nation.
Activities with their armed forces, foreign civilian authorities, or other agencies to establish, reconstitute, maintain, or improve the health sector of the FN.
DoD GHE can be funded with different DoD appropriations such as O&M funds and OHDACA.

15. Baseline GHE Activities (1 of 2)
Military-to-Military (HCA)
Expeditionary capability, peacekeeping operations, counter CBRN, disaster response, or per additional GCC guidance
Military-to-Civilian (HA)
Disaster preparation and response; public health, disease surveillance and prevention; health-related engineering projects (water, sanitation, and vector control; and clinic) construction and equipping.
8. DoD GHE activities may take the form of Mil to Mil, Mil to Civ.
There is no question that Mil-Civ activities are a significant part of the GCC’s HA and HCA programs. These activities play an important role in achieving strategic objectives and military end states not reachable by other means.
It is a partnering strategy tool to achieve national security objectives and military endstates.
And by the way, over 50-percent of DoD HA and HCA projects are health-related.

16. DoD GHE Activities (2 of 2)
Mil-Civ activities are an integral part of DoD’s HA & HCA Programs – they are “Security Cooperation” tools that further defense strategy and objectives
In general, 50-percent of DoD HA & HCA projects are health-related (i.e. medical/dental/veterinary, SMEEs, etc.) 9.
They are funded through the Oversea Humanitarian Disaster and Civic Assistance Fund, know as OHDACA. (You’ll being hearing more about this in a few minutes)

17. OSD Policy Guidance for DoD Humanitarian Assistance Programs
Switching gears… this is your updated on latest DoD Policy Guidance on HA.
Source: Most of the content in the following slides are “direct lift” from the 2016 OSD Policy HA Guidance Cable (DTG Z Aug 16).
HA is [one] of the major Security Cooperation tools used by DoD GHE to advance U.S. national security and defense strategy objectives; and they (along with HCA) comprise the ‘steady state’ CCDR (GCC) activities for partnering and enabling development of PN/HN interoperability, capacity and capability.
Deputy Assistant Secretary of Defense,
Stability and Humanitarian Assistance (SHA)
Directorate for Humanitarian Assistance and Response Operations (HARO)
24 October 2016
UNCLASSIFIED

18. Importance of HA in National Security Strategy
REFERENCES from latest DoD HA Cable released (IAW DTG Z Aug 16):
A. TITLE 10, UNITED STATES CODE, SECTIONS , 404, 2557, AND 2561
B NATIONAL SECURITY STRATEGY
C QUADRENNIAL DEFENSE REVIEW
D GUIDANCE FOR EMPLOYMENT OF THE FORCE
E DOD DIRECTIVE , FOREIGN DISASTER RELIEF
F JOINT PUBLICATION 3-29, FOREIGN HUMANITARIAN ASSISTANCE
G DOD DIRECTIVE CLIMATE CHANGE ADAPTATION AND RESILIENCE
H UNITED STATES NATIONAL ACTION PLAN ON WOMEN, PEACE, AND SECURITY
I. DSCA MANUAL M, "SECURITY ASSISTANCE MANAGEMENT MANUAL" (SAMM), CHAPTER 12
J. POLICY GUIDANCE FOR DOD HUMANITARIAN ASSISTANCE FUNDED BY THE OVERSEAS HUMANITARIAN,DISASTER, AND CIVIC AID APPROPRIATION, ASD SOLIC, ZJUN12
UNCLASSIFIED

19. Why does DoD conduct HA?
USAID is the Lead Federal Agency for development, HA (Humanitarian Assistance), and Foreign Disaster Relief (FDR)
DoD HA activities are conducted under Title 10 codes to advance both stabilization and Security Cooperation (SC) objectives
Coordinated with the Country Team, including USAID and State/DoS
2016 OSD Policy HA Guidance Cable (DTG Z Aug 16) :
Updated / Reissued 2012 OSD Policy HA Guidance Cable and directed ASD SO-LIC / SHA (under the direction and authority of OUSD-Policy) to provide policy oversight & guidance of the DoD HA program
DSCA Security Assistance Management Manual (SAMM), Chapter 12
CCDR Implementation Instructions
Sectors of Engagement
Disaster Risk Reduction, Mitigation, and Preparedness (DP)
(training, equipment, shelter/operations center construction, etc.)
Health (training, clinic/facility improvements, equipment, etc.)
Education (school construction/improvements)
Basic Infrastructure (wells, orphanage construction, etc.)
“Stability operations are a core U.S. military mission that DoD shall be prepared to conduct with proficiency equivalent to combat operations.”
DoD Instruction , Stability Operations
UNCLASSIFIED

20. Overview - DoD HA (Humanitarian Assistance)
HA falls under the purview of the Department of Defense and includes activities designed to relieve or reduce endemic conditions such as human suffering, disease, hunger, and privation, particularly in regions where humanitarian needs may pose major challenges to stability, prosperity, and respect for universal human values. HA activities may also bolster a host nations (HN) capacity to reduce the risk of, prepare for, mitigate the consequences of, or respond to humanitarian disasters…
A quick review…The above stipulations are “direct lift” from Para.3.A. the 2016 OSD Policy HA Guidance Cable (DTG Z Aug 16)
Para.3.A OSD Policy HA Guidance Cable (DTG Z Aug 16)
UNCLASSIFIED

21. 2016 HA Policy Guidance (Key Updates)
Clarifies:
“Why DoD does HA”, HA Sectors and Program Goals
Guidance to CCDR for Assessment, Monitoring and Evaluation (AM&E)
Prioritizes Policy Project Review based on Annual CCDR strategy submissions, for adherence to policy guidance
Coordination with USAID and Embassy Country Teams
Expanded or Added focus on:
Disaster Prep, Risk Redux & Health-focused projects
Areas with greatest humanitarian need
USG National Action Plan on Women, Peace and Security Agenda (WPSA)
References from 2016 OSD Policy HA Guidance Cable (DTG Z Aug 16)
2016 DOD DIRECTIVE CLIMATE CHANGE ADAPTATION AND RESILIENCE
2016 U.S. NATIONAL ACTION PLAN ON WOMEN, PEACE, AND SECURITY AGENDA (WPSA)
The DoDI on Assessment, Monitoring and Evaluation (AM&E) is forthcoming – lead coordinator is DSCA for this initiative
2012 GAO Report on DoD HA Activities
Findings:
Good linkage of COCOM HA programs to strategic objectives
Risk of duplication with USAID activities
Insufficient/incomplete data in OHASIS on HA projects
Lack of assessments data prevented review of project effectiveness in meeting objectives
Lack of interagency information-sharing on HA
Recommendations:
Update policy guidance on using OHDACA for assessments
Capture all HA and HCA project data in OHASIS
Use risk-based assessments to evaluate projects (DSCA and JS)
Work with State and USAID to improve information-sharing and use of different terminology for humanitarian activities
That Congress relook DoD’s HA authorities
UNCLASSIFIED

22. Women, Peace and Security Agenda (WPSA)
UNCLASSIFIED
Women, Peace and Security Agenda (WPSA)
Women and girls are particularly affected by disasters and, crises, and are especially affected by conflicts, comprising the vast majority of forcibly displaced persons around the world.
When developing HA Projects, DoD activities should consider the distinct needs of women and girls for crises and conflict-affected disasters, including by providing safe, equitable access to education, health services, shelter, water, sanitation and humanitarian assistance services.
“direct lift” from Para.3.E. of the 2016 OSD Policy HA Guidance Cable (DTG Z Aug 16)
Para.3.E OSD Policy HA Guidance Cable (DTG Z Aug 16), REF H (2016 U.S. NATIONAL ACTION PLAN ON WOMEN, PEACE, AND SECURITY AGENDA or WPSA)

23. DoD HA Program Goals (updated Aug’16)
Improve the basic living conditions of the civilian populace in a country or region that is strategically important to the U.S.
Enhance the legitimacy of the host nation (HN) by improving its capacity to provide essential services to its populace
Promote interoperability and coalition-building with foreign military and civilian counterparts
Generate long-term positive perceptions of DoD and the USG with HN civilian and military institutions
Enhance security and promote enduring stability in the HN or region
Below is “direct lift” from the 2016 OSD Policy HA Guidance Cable (DTG Z Aug 16)
C. DOD HA PROGRAM GOALS: CONSISTENT WITH REFERENCES A THROUGH J (where Ref J was 2012 DoD Cable on HA), AND TO THE EXTENT PERMITTED BY LAW, THE DOD HA PROGRAM WILL BE USED TO PROMOTE THE FOLLOWING OBJECTIVES GLOBALLY:
IMPROVE THE BASIC LIVING CONDITIONS OF THE CIVILIAN POPULACE IN A COUNTRY OR REGION THAT IS STRATEGICALLY IMPORTANT TO THE UNITED STATES;
ENHANCE THE LEGITIMACY OF THE HN BY IMPROVING ITS CAPACITY TO PROVIDE ESSENTIAL SERVICES TO ITS POPULACE;
PROMOTE INTEROPERABILITY AND COALITION-BUILDING WITH FOREIGN MILITARY AND CIVILIAN COUNTERPARTS;
GENERATE LONG-TERM POSITIVE PERCEPTIONS OF DOD AND THE USG WITH HN CIVILIAN AND MILITARY INSTITUTIONS; AND
ENHANCE SECURITY AND PROMOTE ENDURING STABILITY IN THE HN OR REGION.
As a Security Cooperation tool, HA is intended to build partner nation capacity and to improve DoD visibility, access, and influence in support of broader DoD and USG objectives
UNCLASSIFIED

24. Good Practices for DoD GHE (1 of 3)
GHE-related projects and activities must be coordinated through the CCDR; and its Surgeon’s office ICW planners (e.g. POMIs, IHPs, GHE representatives) office should collaborate with, or at least have knowledge of CCDR SC operational design (i.e. LOEs/IMOs) through execution.
DoD GHE activities must ensure they do not significantly exceed HN standards of care
Providing care or medications that exceed local standards may have a negative effect on the local health care infrastructure
Whenever possible, DoD GHE activities should be coordinated with a whole of government global health effort and avoid duplication or overlap. Activities MUST complement and align to CCDR Theater Campaign Plan
Okay, here is where things get interesting; and I would appreciate your feedback.
GCCs are, in most cases, the implementing agent for DoD GHE activities; and the GCC Surgeon’s Office needs to have situational awareness, if not direct collaboration, on health or medical related projects in their AOR.
Those activities should synergize with whole of government global health efforts and avoid duplication or overlap.
What we need from you is to ensure Collaboration/awareness of all your GHE activities with the GCC who will be responsible through the new governance to develop AME.

25. Good Practices for DoD GHE (2 of 3)
During the Ebola Crisis in West Africa:
OSD Policy’s ASD for SO/LIC was DoD’s overall lead for the response. The DoD GHE Council was established for the first time for enable interagency
Via DASD SHA, coordinated the response within the DoD components (internal) and Interagency (e.g., DoS, USAID & HHS)
Other OSD Policy offices provided policy oversight for their specific area
African Affairs lead the DoD’s issues concerning international military and civilian response efforts.
HD&GS/HDI&DSCA, which has the PI&ID portfolio for DoD, lead on Aeromedical Evacuation and domestic issues.
HD&GS/CWMD has the GHSA portfolio, provided policy oversight to the DoD’s biosurveillance and diagnostic activities.
14.

26. Good Practices for DoD GHE (3 of 3)
During the Ebola Crisis in West Africa:
Global Health Engagement Council started; its charter and functions were developed (folded into DoDI GHE)
Joint Staff: J3, J5, and the Surgeon offices were the “bridge” to make policy work
Execution by the Services, AFRICOM, TRANSCOM and NORTHCOM was remarkable in its scope and breadth, which will lead to better response to future disasters.
ASD HA (OUSD-P&R) was the lead for Force Health Protection and Readiness issues. They were the go-to SMEs for DoD
Each DoD entity was invaluable to the overall DoD response and reflects that no one office owns DoD GHE but that it is a team effort
HD/GS Spell out at work

27. Global Health Engagement – Advancements in Policy & Coordination
DoD GHE Council
Global Health Engagement – Advancements in Policy & Coordination
Membership
Joint Staff, Director for Strategic Plans and Policy (J-5)
ASD Health Affairs
ASD Homeland Defense and Global Security
ASD Nuclear, Chemical and Biological Defense Programs
ASD Special Operations and Low-Intensity Conflict
(Chair)
Structure
The Global Health Engagement Council consists of three groups:
Senior Group – meets at least annually (met 25 Aug 2016, Aug / Sep 2017)
Deputy Group – meets at least semi-annually (Apr / Mar 2017)
Action Officers Group – meets regularly (met 22 Nov 2016, next mtg Feb 2017)
On GHE Council Charter, OSD Policy ASD HD&GS concurred on 23 Jan 2016 and GHE DoDI drafted entering informal coord from Feb’16 through Jul’16.
Formal coord took place between Aug’16 through Oct’16, delays due to optempo as well as summer PCS and personnel turnover
OSD-Policy Guidance on GHE DTG152052Z May 13
Functions
Collaborate and coordinate on GHE strategic advice to the Secretary of Defense
Effectively coordinate GHE within the DoD at the strategic policy level
Understand DoD GHE objectives and evaluate and improve DoD’s ability to meet its GHE objectives
Advocate for GHE inclusion in appropriate strategic policy and guidance documents
Improve awareness of GHE across the DoD and among other agencies
Promote GHE collaboration and partnering activities with Federal Government and NGOs
Support, as appropriate, the U.S. Government response to international health emergencies

28. Global Health Security Agenda (GHSA) EO
Executive Order (EO) signed by POTUS 4Nov16 established a policy coordination mechanism for USG to continue, strengthen, and institutionalize GHSA.
Initiative arose from combined response to Ebola epidemic in West Africa. 55 countries signed on to GHSA, resulted from commitments from G-7, Nordic, and key G-20 partners to assist 76 countries; USG partnering with 31 countries and Caribbean Community to provide assistance to create, for the first time, a step-by-step plan to get prepared.
Established the GHSA Interagency Review Council1, chaired by a member of NSC staff and will include senior officials from at least 12 departments and agencies for health security matters across the federal government.
See White House BLOG at:
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The White House 
Office of the Press Secretary
For Immediate Release 
November 04, 2016
Statement by National Security Advisor Susan E. Rice on the Executive Order on Advancing the Global Health Security Agenda
American leadership is essential for advancing global health security and for ensuring that all countries are prepared to prevent, detect, and respond to threats posed by infectious diseases. But America can't do it alone, and the time for action is now. It's up to all countries to do their part and help their neighbors. That's why we launched the Global Health Security Agenda in to empower the global community to step up, bolstered by American leadership, and secure a world that is safe from epidemic threats. Today, President Obama signed an Executive Order to further advance the Global Health Security Agenda.
Already, we've seen historic success: Working with partners in Guinea, Liberia, Sierra Leone, and from around the world, we led the way in ending the Ebola epidemic in West Africa - and we are leading the way on the Zika response here at home. Fifty-five countries, as well as stakeholders from across nongovernmental and private sectors and next generation leaders in global health security have signed on to the Agenda. The effort has resulted in commitments from G-7, Nordic, and key G-20 partners to assist at least 76 countries and regions that will make a real difference in communities around the world. The Global Health Security Agenda has also led to the creation of a new way to identify gaps through external evaluation, which 22 countries - including the United States - have now undergone. As part of our own commitment to this Agenda, the United States is partnering with 31 countries and the Caribbean Community to provide assistance to create, for the first time, a step-by-step plan to get prepared.
The Executive Order signed today builds on this progress by establishing long-term policy objectives and memorializing a comprehensive framework for the United States to continue, strengthen, and institutionalize our achievements and use common targets to measure progress. The Executive Order will save lives by further leveraging the full power and leadership of the United States Government and is an important step toward a safer, more resilient future.
1Provides a direct interface for DoD GHE Council via ASD HA (USD P&R) and ASD HD&GS (USD-P) for coord of GHE equities in GHSA
UNCLASSIFIED

29. Obtaining CME/CE Credit
If you would like to receive continuing education credit for this activity, please visit:

30. QUESTIONS and COMMENTS
POC Info, OSD-P HARO GHE:
Mr. John Trigilio,
OSD Policy / SO-LIC / Stability and Humanitarian Affairs (SHA)
Director for Humanitarian Assistance and Response Operations (HARO)
☎ (W) (703)
NIPR:
CDR Joseph Edward F. Piansay, MSC, USN
GHE and MILMED (Rm 5C685)
HARO AO for SOUTHCOM & NORTHCOM portfolios
OSD(P) SO-LIC/ Stability and Humanitarian Affairs (SHA)
2100 Defense Pentagon, Washington DC 20301
☎ (W) (703)
NIPR: