At the intersection of public health and national defense: DoD labs

There’s a new CSIS report out on the effectiveness of overseas labs functioning under the Department of Defense. General findings include more-frequent than expected interaction with regional offices, and an unexpected focus on diseases relevant to the endemic population. This is natural, if you think about it: DoD labs function at the interest of the US military, and members of the service on the ground are (ignoring the effects of malnutrition and resistance) just as susceptible to malaria or cryptosporidiosis or what have you as anyone in the area as a function of birth. The primary goal of these infectious disease units is, consequently, to protect first-world soldiers from third-world diseases.

These labs are important for a few reasons:
– Proximity to location of interest. A permanently funded station abroad to conduct research is an invaluable resource, and allows for longer-term projects.
– Funding is through the defense department rather than general research grants. Though intradepartmental funding is free to shift from year to year, this session of Congress (as with many other sessions of congress) has demonstrated greater reluctance to cut defense budgets than allocated funds for medical research.
– Staffed by military personnel rather than civilian researchers, they stand at the interface of aid and security, and are fit to work with the intricate relationship between the two. More on that sometime later.

This got me thinking:
Health technologies for combat situations in the US are identical in need to those abroad: point-of-care diagnosis is critical in a high-speed situation, no freeze chain may be available, and disposable or reusable technologies may save lives. This represents an alternate path to funding : develop appropriate technologies for and through the US military, cut costs subsequently to re-appropriate technologies for use in resource-poor environments. Implement through existing labs that have established relationships with locals in disease-ridden locations, and with flexible personnel available to monitor program effectiveness.

And put it under “defense funding.”

Why? Because there is no greater source of goodwill than saving lives at the community level. I’m beginning to firmly believe that one of the most firmly IGNORED issues is health in the backwaters(mountains?) of the Middle East. The region lacks instant recognition, the celebrity appeal of sub-saharan Africa, and is of course known for a plethora of other problems. But the concerns, particularly in overall security, are MUCH more high-risk (if less high-profile) with regard to US interests – and where terrorist organizations recruit out of poverty and desperation as a result of illness, where women in childbirth are occasionally not taken to a hospital to be given a caesarian by a man, where operations may be postponed until a family can pay, there can be fewer more substantial security investments.

At the intersection of public health and national defense: DoD labs

Goal 8: Develop a global partnership for development

Here is The Thing from this week that will stick with me:

At Princess Haya Al Hussein’s talk on world hunger at the Baker Institute, she brought up the Millennium Development Goals and general lack of dedication most signatories have shown with regards to their fulfillment by 2015. Of course, there is a general lack of awareness about such things. Though the MDGs represent a significant commitment on behalf of UN member-states, the plan began as long-term and the details belong to a relatively obscure field – neither condition makes for a compelling news feature (I mean, this is a field I want to pursue as a career – I can name four things I know are on the list, rattle off some sub-goals, guess well at the others, and know there are eight). Her most telling anecdote, however, involved talking with two children in a less-than-developed are of Nairobi who discussed the directive in detail, and who were intimately aware of the promises the United Nations had made to the very broad group of people – those experiencing poverty in a global, crippling sense – that they belonged to. They discussed these points as if they were things that were actually going to happen, as though we were not failing massively, because they outlined a commitment those in power had made to pulling them out of an awful situation.

I’d like to relate this sort of commitment to expectations of government in the United States. This is a nation where people are consistently vocal about their lack of expectations for the president and congress, and where we in general have an unyielding lack of faith in the ability of elected officials to accomplish productive tasks – and yet we feel cheated, disappointed, betrayed when an elected official who otherwise upholds his duty does so much as tweet out a picture of his dick. I don’t intend to undermine the seriousness of that act – quite the opposite. My point is that that wasn’t even in the job description; we became enraged at an unwritten expectation of good conduct. And yet we do not flinch at the very serious prospect of abandoning a clearly outlined agreement to millions. We don’t expect the UN to accomplish anything, because they’ve failed at so much? Is that a good excuse? I don’t expect attractive male congressmen to act like anything other than horny sixteen year olds, but I still cringe when they do.

Can’t afford it? Great. Don’t sign it. Don’t make the promise in the first place, and save on failing floods of people later, on causing potentially very serious social unrest due to hunger or disease or disappointment – don’t provide detailed steps on alleviating hunger, concrete approaches to slicing child mortality in half (sterile razors!), on providing legitimate ways to counter the spread of HIV. But if a country vows and falters without anything resembling a worthy national effort, it should be prepared for the hostility that will follow.

A major step here would be to educate Americans on the issues of global development and foreign aid – to counter the ridiculously inflated statistics people throw out when told to guess what percentage of our GNP goes to other countries (10%? 20? More like less than 1 [CGD]). This would, ideally, reduce calls to cut developmental aid and allow the masses to refocus on other questionable portions of the national budget. A national election would be an excellent platform for this if the economy were back in full swing – I’m betting on 2016 for a decent post-failure examination.

Goal 8: Develop a global partnership for development