1. USPACOM Global Health Engagement Strategy
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USPACOM Global Health Engagement Strategy
RADM Colin Chinn
USPACOM Command Surgeon
28 August 2014
Overall classification of this brief is:
UNCLASSIFIED//FOUO

2. CDRUSPACOM Priorities
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CDRUSPACOM Priorities
Maintain the Momentum of the Rebalance to the Asia-Pacific Region
Enhance and Align Strategy, Resources, Capabilities, Posture and Plans
Strengthen Relationships with Allies and Partners
Optimize Staff Performance and Command Climate
Complete Operationalization of the Theater C2 and PACOM Staffs
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3. Regional Threats to Health
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Regional Threats to Health
Emerging Infectious Diseases
Antimicrobial Resistance
Counterfeit Pharmaceuticals
Water Quality
Human Trafficking
Animal Trafficking
Non-Communicable Diseases
PACOM
There are many threats to health in the Asia-Pacific region, most are transnational and require collaborative approaches to address. These health security issues impact overall security within the region; working together to address these issues will improve security and stability.
Natural Disasters
Climate Issues
High Population Densities
Territorial Disputes
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4. Maturation of USPACOM Health Engagements
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Maturation of USPACOM Health Engagements
PAST:
Uncoordinated, unsynchronized events focused on direct patient care; components executing without COCOM oversight.
PRESENT:
Focus has shifted away from MEDCAPs/DENCAPs/VETCAPs & towards capacity building.
Interoperability between our components and with the interagency in a whole of government approach.
Health TSC is part of USPACOM TCP & provides guidance for planning and execution of health engagements.
Health engagements are a strategic enabler that cuts across TCP sub-campaigns and contributes to national and regional security and stability.

5. USPACOM Command Surgeon Priorities
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USPACOM Command Surgeon Priorities
Health Engagement with Partner Nations
Malaria Elimination Efforts in Mekong Region
Health Response to Disaster
Emerging Infectious Disease and Biosurveillance
The overarching TSC goals of J07 are:
Complement host/partner nation health systems strengthening.
Align medical activities with the Theater Campaign Plan (TCP) and Intermediate Military Objectives (IMO) to achieve Guidance for Employment of the Force (GEF) end-states. Health is one cog, albeit an important one, in the overall PACOM effort to achieve our GEF End-states.
Synchronize PACOM health strategy with DoS, USG and international interagencies with DoD and Service efforts.
Assess host/partner nation baseline health status and disease burden for engagement opportunities. By conducting valid and effective assessments and establishing healthcare baselines, we can identify shortfalls in healthcare capability, capacity and regional interoperability and conduct follow up engagement assessment to determine effectiveness and follow on sequential engagements.
Create enduring regional health security by enhancing whole-of-society resiliency and interoperability. The end state is to increase theater health security by building whole-of-nation resiliency to handle crises on its own.
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6. USPACOM Health Lines of Effort
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USPACOM Health Lines of Effort
Operational Medicine
First Responder Training/Trauma Casualty Care
Medical Support to HA/DR
Naval / Undersea Medicine
Aerospace Medicine
Patient Movement: CASEVAC, MEDEVAC, AIREVAC
Public Health / Force Health Protection
Malaria/Dengue
Emerging Infectious Disease
Biosurveillance/Lab Capacity Building
One Health (Animal, Human, Environmental)
Unique Health Needs of the Female Servicemember
Health System Strengthening
Blood Safety Program
Medical Education Support
Maternal & Child Health
Operational Medicine line of effort encompasses our mil-to-mil engagement on military health topics.
Public Health / Force Health Protection may include mil-to-mil as well as mil-civ and whole of government. Addressing these issues in our partner nations will improve US Force Health Protection, as well as that of our partner nations.
Health System Strengthening may be mil-mil or mil-civ, and focuses on building partner nations’ health systems.
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7. USPACOM Partners for Health
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USPACOM Partners for Health
Whole of Government
Regional
Allies & Partners
Australia
Philippines
Thailand
Japan
S. Korea
New Zealand
Indonesia
Laos
Singapore
Cambodia
Vietnam
Malaysia
China
Nepal
India
Bangladesh
Sri Lanka
Maldives
Brunei
Tonga
Regional Partners:
1st Row: Allies: Australia, Philippines, Thailand, Japan, S.Korea
2nd Row: New Zealand, Indonesia, Laos, Singapore, Cambodia
3rd Row: Vietnam, Shri Lanka, Maldives, Brunei, Tonga
We work with a wide array of organizations in DoD, the USG Interagency, international organizations like the WHO, and NGOs.
HHS-Office of the Secretary
Support of LMI sub-regional LMI workshops on IHRs
Strategic partnership with Institute Pasteur-Lao
Food and Drug Administration
No country program. Routine food and supply monitoring
Centers for Disease Control
Country Lead, Dr. Andy Corwin at Embassy as CDC Influenza assignee
FETP supported by CDC influenza and GDD Regional Centre in Thailand
National Institutes of Health
Research through multiple third party research entities on influenza, Non-Communicable Diseases and population health
US Department of Agriculture
Food for Education Program; in-country teams assess food, nutrition and farming
Department of State
Cook stove program, Bio-engagement Program on surveillance and lab
Environmental Protection Agency
Multilateral environmental performance enhancement projects

8. Thailand Health Engagement
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Thailand Health Engagement
Med Support to HA/DR
Aerospace Medicine/ Aeromedical Evacuation
Shipboard Medicine
First Responder/Trauma Casualty Care
Malaria / EID (AFRIMS)
Educational Exchanges (MoU with USUHS)
International Health Regulations (IHR)
Regional Leader
ADMM-Plus EWG on Mil Med Co-chair
Opportunities for Trilateral and Multilateral Engagement (Burma and China)
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9. Vietnam Health Engagement Overview
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Vietnam Health Engagement Overview
Dive/Undersea Medicine
Aerospace Medicine
PKO Level 2 Hospital
First Responder / Trauma Casualty Care
Med support to HA/DR
Humanitarian Mine Action
PAC PARTNERSHIP / PAC ANGEL
Research Collaboration
Blood Safety Program
HIV – DoD PEPFAR
Tropical Medicine / EID
Burn Medicine
Malaria
International Health Regulations (IHR)
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10. Vietnam: Interventional Burn Management SMEE
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Vietnam: Interventional Burn Management SMEE
Program developed from PACIFIC PARTNERSHIP 2012 SMEE
Dermatology, Plastic Surgery, Orthopedics and Pulmonary/Critical Care educational exchanges and patient care
Working with National Institute of Burns in Hanoi
Phase I-III in 2013
I: Planning/initial SMEE
II: Advanced SMEE in Vietnam
III: Vietnamese staff visited Navy Medical Center San Diego
PACIFIC PARTNERSHIP 2014: continued care by US and Vietnamese specialists for young patient originally seen in 2012, skin-resurfacing laser to decrease scars
Building partner nation capacity, capability & building strong relationships

11. China Health Engagement
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China Health Engagement
Lines of Effort
Pandemic Response
Joint Pandemic Response Exercises
Pandemic Data Sharing
Infectious Diseases
HIV/AIDS Prevention
Malaria Eradication
Scientific Educational Exchanges
Medical Support to HA/DR
Exercises and Exchanges
Soldier Care
Medical Education Exchanges
Traditional Chinese Medicine
Our China engagement is slightly different than our strategic framework with other countries in the AOR.
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12. Singapore Health Engagement
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Singapore Health Engagement
NMRC-A Research Collaboration
Shipboard & Undersea Medicine
HA/DR Collaboration
Combined Exercises
Aerospace Medicine
Amputee Care
Disease Surveillance/ Outbreak Response
Regional Leader
Past ADMM-Plus EWG Mil Med Co-chair
Opportunities for trilateral/multilateral engagements
Medical Educational Exchanges
Dengue Expertise
Key leader engagement is another important part of our engagements in the theater. Building strong relationships for ongoing partnership.
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13. Japan Health Engagement
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Japan Health Engagement
Operational Planning
Cooperation on PACIFIC PARTNERSHIP & other HA missions
Educational Exchanges (MoU with USUHS)
HA/DR Collaboration
Combined Exercises
Aerospace Medicine/ Aeromedical Evacuation
Shipboard Medicine
Undersea Medicine

14. Malaria Elimination Efforts in the Mekong Region
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Malaria Elimination Efforts in the Mekong Region
Artemisinin-Resistant Malaria increasing in Greater Mekong Area of SE Asia
Focused in border areas, migrant and military populations
USPACOM Surgeon working with international organizations (WHO, Global Fund, Gates Foundation, Presidential Malaria Initiative) to ensure programming & funds reach military health systems
Speaker at June 2014 Global Fund “Malaria Control and Elimination in the Armed Forces” meeting in Vietnam
Regional military malaria meetings, in partnership with AFHSC-GEIS and US military overseas labs in June 2013 (Thailand) and August 2014 (Cambodia)
Working to establish pre-deployment screening for drug-resistant malaria before Peacekeeping Operations
A priority for PACOM Surgeon is working to eliminate drug-resistant malaria in the Greater Mekong Subregion; this is critical because this drug resistant strain of malaria is currently limited to this region but the risk of spread elsewhere in the world is substantial, and would significantly reverse world-wide gains in malaria control. This issue impacts global health security.
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15. USPACOM Blood Safety Program
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USPACOM Blood Safety Program
Enduring program of Blood Safety in Lao PDR, Vietnam and Cambodia since 2009
Purpose:
Builds host nation biosecurity and a sustainable blood program capacity in support of disaster response
Brings together civilian and military blood program stakeholders in Partner Nations, paving the way for further civilian and military coordination
Program progression to include frozen blood products, nursing training, and link with Blood Bank construction
Partners
Additional Points:
1-2 Blood Safety Workshops per year in each country program
Funded through OHDACA HA for Laos and Cambodia, DoD PEPFAR in Vietnam
In Cambodia and Laos primary partner is civilian (i.e. Red Cross); in Vietnam primary partner is MoD – invitations extended for civ-mil participation in all events in all countries
Cambodian and Lao participants have attended events in both countries
These programs have been lauded by country teams as model of interagency/international/civ-mil coordination
Building blood banking/transfusion/testing capability enhances national preparedness for disasters
In Lao PDR, this is one of the most successful programs in a country where engagement (especially mil-mil) is significantly limited; based on the success of the Blood Safety Program other opportunities are arising for more health and mil-mil engagement
Partners: DoS, US CDC, USAID, National Blood Transfusion Center, Ministry of Health, US PEPFAR, Australian Red Cross, Laos Red Cross, World Health Organization, US Army Corps of Engineers and Armed Services Blood Program

16. Regional Disaster Response Capacity Building
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Regional Disaster Response Capacity Building
RIMPAC 2014 MILMED: Conduct Mil-Mil Health Engagements through exercises (HA/DR) and Medical / Health Subject Matter Expert Exchanges in order to increase capacity, capability, and interoperability with 23 participating nations.
I’d like to highlight some of the regional engagements that have happened this year and perhaps some of you were involved with. The ASEAN Defense Ministers’ Meeting Plus Expert Working Groups on HA/DR and Military Medicine conducted a large, multi-national exercise on HA/DR and Military Medicine in Brunei in June. This was an excellent opportunity for military personnel from 17 countries to come together and exercise, share experiences and lessons learned, and prepare for future disasters.
Photos include Chinese Peace Ark Ship and a Philippine Air force C-130.
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17. PACIFIC PARTNERSHIP 2014 UNCLASSIFIED Vietnam (6-15 Jun 2014)
Restorative Medicine Summit, Burn Management,
Blood Safety Workshop, Cardiac Life Support
Cambodia (19-28 Jun 2014)
Rheumatic Heart Disease Symposium, Surgery, Cardiology, Undersea Medicine, Dental, Veterinary
Philippines (4-15 Jul 2014)
Surgery, Cardiology, Women/Children Health, Care for the Caregiver
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Vietnam-(June 10, 2014) A Navy team, led by Cmdr. Peter Shumaker, the chairman of dermatology at Naval Medical Center San Diego, used laser-resurfacing technology to treat a severely burned mother and her daughter at the Da Nang General Hospital. The mother and her daughter are both being treated by an advanced skin-resurfacing laser, a skin substitute and surgery to treat the residual effects of the burn as well as alleviate the skin contractures. Phan Nguyen Thanh Thao was burned at the age of three along with her mother. Over 70 percent of her body was burned which left her unable to walk. Navy medical staff first saw Thao and her mother aboard the USNS Mercy as part of Pacific Partnership This treatment at the Da Nang General Hospital has been the fourth interaction since then. The exchange was with the Department of Plastic and Reconstructive Surgery of Da Nang General Hospital along with three surgeons from the National Institute of Burns in Hanoi.
Indonesia (26 May-9 Jun 2014)
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Helping Babies Breathe, Nursing Skills, Dental,
Ophthalmology, Veterinary, Infectious Diseases
Timor Leste (11-25 Jun 2014
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Safe Motherhood Course, Newborn Care, Basic
Life Support, Emergency Medicine, Dental

18. UNCLASSIFIED
Conclusion
USPACOM Health Engagements have evolved over the last 5 years from largely direct patient care to enhanced focus on building capacity, capability and interoperability
USPACOM Command Surgeon coordination with USG Interagency has expanded greatly
USPACOM Health TSC Activities directly support the USPACOM Theater Campaign Plan
USPACOM Health TSC contributes to achievement of National Security End States
Global Health Engagement: Strategic Enabler for Security Cooperation

19. UNCLASSIFIED
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