Toward integrated DoD biosurveillance : assessment and opportunities
Biosurveillance is a cornerstone of public health. In July 2012, the White House issued the National Strategy for Biosurveillance, which defines the term and sets out key functions and guiding principles. The Department of Defense (DoD) carries out biosurveillance to monitor the health of military and affiliated populations and supports biosurveillance in other countries through a range of programs across the department. The Deputy Secretary of Defense issued interim guidance in June 2013 for implementation of the new National Strategy. This begins to set formal policy for DoD's biosurveillance enterprise. The Office of Management and Budget (OMB) recognized the importance of effective DoD biosurveillance not only for the department itself but also within the context of the National Strategy. With this in mind, OMB tasked DoD to carry out a comprehensive examination of its biosurveillance enterprise to determine priority missions and desired outcomes, the extent to which DoD biosurveillance programs contribute to these missions, and whether the current funding system is appropriate and how it can be improved to ensure stable funding.
"In the context of the 2012 National Strategy for Biosurveillance, the Office of Management and Budget (OMB) asked the Department of Defense (DoD) to review its biosurveillance programs, prioritize missions and desired outcomes, evaluate how DoD programs contribute to these, and assess the appropriateness and stability of the departments funding system for biosurveillance. DoD sought external analytic support through the RAND Arroyo Center. In response to the questions posed by OMB request, this report finds the following: Current DoD biosurveillance supports three strategic missions. Based mostly on existing statute, the highest-priority mission is force health protection, followed by biological weapons defense and global health security. Guidance issued by the White House on June 27, 2013, specified priorities for planning fiscal year 2015 budgets; it includes an explicit global health security priority, which strengthens the case for this as a key DoD biosurveillance strategic mission. DoD biosurveillance also supports four desired outcomes: early warning and early detection, situational awareness, better decision making at all levels, and forecast of impacts. Programs and measures that address priority missions force health protection in particular and desired outcomes should be prioritized over those that do not do so. More near-real-time analysis and better internal and external integration could enhance the performance and value of the biosurveillance enterprise. Improvements are needed in key enablers, including explicit doctrine/policy, efficient organization and governance, and increased staffing and improved facilities for the Armed Forces Health Surveillance Center (AFHSC). AFHSC has requested additional funding to fully implement its current responsibilities under the 2012 Memorandum of Understanding between the Assistant Secretaries of Defense for Health Affairs and for Nuclear, Chemical, and Biological Defense Programs. Additional responsibilities for coordinating the entire DoD biosurveillance enterprise would need concomitant resourcing. There is not a single, unified funding system for the DoD biosurveillance enterprise; the multiple current funding systems would likely benefit from an organizing mechanism with the authority to manage and control funds to meet enterprise goals. Interim guidance issued by the Deputy Secretary of Defense on June 13, 2013, is significant because it is the first policy to explicitly address biosurveillance; it adopts the definition from the National Strategy for Biosurveillance, calls for development of a DoD Directive for biosurveillance, and specifies tasks for DoDs implementation of the Strategy."
"Biosurveillance is a cornerstone of public health. In July 2012, the White House issued the National Strategy for Biosurveillance, which defines the term and sets out key functions and guiding principles. The Department of Defense (DoD) carries out biosurveillance to monitor the health of military and affiliated populations and supports biosurveillance in other countries through a range of programs across the department. The Deputy Secretary of Defense issued interim guidance in June 2013 for implementation of the new National Strategy. This begins to set formal policy for DoD's biosurveillance enterprise. The Office of Management and Budget (OMB) recognized the importance of effective DoD biosurveillance not only for the department itself but also within the context of the National Strategy. With this in mind, OMB tasked DoD to carry out a comprehensive examination of its biosurveillance enterprise to determine priority missions and desired outcomes, the extent to which DoD biosurveillance programs contribute to these missions, and whether the current funding system is appropriate and how it can be improved to ensure stable funding."
"Biosurveillance is a cornerstone of public health. In July 2012, the White House issued the National Strategy for Biosurveillance, which defines the term and sets out key functions and guiding principles. The Department of Defense (DoD) carries out biosurveillance to monitor the health of military and affiliated populations and supports biosurveillance in other countries through a range of programs across the department. The Deputy Secretary of Defense issued interim guidance in June 2013 for implementation of the new National Strategy. This begins to set formal policy for DoD's biosurveillance enterprise. The Office of Management and Budget (OMB) recognized the importance of effective DoD biosurveillance not only for the department itself but also within the context of the National Strategy. With this in mind, OMB tasked DoD to carry out a comprehensive examination of its biosurveillance enterprise to determine priority missions and desired outcomes, the extent to which DoD biosurveillance programs contribute to these missions, and whether the current funding system is appropriate and how it can be improved to ensure stable funding."@en
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