Department of Defense (DoD)

The Department of Defense (DoD) implements PEPFAR programs by supporting HIV/AIDS prevention, treatment, and care, strategic information, human capacity development, and program and policy development in host militaries and civilian communities of 73 countries around the world. These activities are accomplished through direct military-to-military assistance, support to nongovernmental organizations and universities, and collaboration with other U.S. Government agencies in country. Members of the defense forces in 13 PEPFAR focus countries have been the recipients of DoD military-specific HIV/AIDS prevention programs designed to address their unique risk factors, in addition to treatment and care programs for their personnel. In these 13 countries alone, military programs have the potential to make an impact on more than 1.2 million people, including active-duty troops, their dependents, employees, and surrounding civilian communities. The DoD supports a broad spectrum of military-specific HIV prevention programs, infrastructure development and support (including laboratory, clinic and hospital facility renovation, equipment, and training), and treatment and care activities.

The DoD HIV/AIDS Prevention Program (DHAPP), based at the Naval Health Research Center (NHRC) in San Diego, California, is the DoD Executive Agent for the technical assistance, management, and administrative support of the global HIV/AIDS prevention, care, and treatment for foreign militaries. DHAPP administers funding, directly conducts training, and provides technical assistance for focus countries and other bilateral countries, and has staff actively serving on most of the Technical Working Groups and Core Teams through the Office of the U.S. Global AIDS Coordinator. DHAPP oversees the contributions to PEPFAR of a variety of DoD organizations, which fall under the various regional military commands, as well as specialized DoD institutions whose primary mission falls within the continental United States.

PEPFAR contributions from some of these DoD organizations are listed below:

  • The U.S. European Command (EUCOM) vision is to eliminate HIV/AIDS as a threat to regional stability through partnerships and interagency collaboration. EUCOM works closely with DHAPP to support partner nation militaries in developing sustainable programs. EUCOM efforts emphasize senior leadership advocacy, specifically in supporting partner nation policy development in the field of HIV/AIDS. EUCOM efforts in this realm include counseling and testing to obtain HIV/AIDS status and planning appropriate intervention techniques for military members. Additionally, EUCOM uses data collected to obtain baseline prevalence rates in the militaries. Other initiatives include in-country program management support, and development of program effectiveness measures. EUCOM is committed to providing seamless support to PEPFAR as missions in African countries transition to the U.S. Africa Command.
  • The U.S. Africa Command (AFRICOM) is the result of an internal reorganization of the U.S. military command structure, creating one administrative headquarters that answers to the Secretary of Defense and is responsible for U.S. military relations with 53 African countries. AFRICOM is consolidating the efforts of three existing headquarters commands into one that is focused solely on Africa and helping to coordinate U.S. Government contributions on the continent. Unlike traditional Unified Commands, AFRICOM will focus on war prevention rather than warfighting. AFRICOM intends to work with African nations and African organizations to build regional security and crisis-response capacity in support of U.S. Government efforts in Africa. Through October 2008, AFRICOM will gradually assume control over existing U.S. Government programs, currently administered by the U.S. Central Command, U.S. European Command, and U.S. Pacific Command. AFRICOM recognizes that HIV/AIDS has an enormous impact on economic and political stability across the continent, and, by degrading military medical readiness, weakens the national security of individual countries. HIV/AIDS programming will be a key component of AFRICOM's security cooperation and humanitarian assistance activities.
  • The U.S. Pacific Command (PACOM) has been working to prevent the spread of HIV among the military personnel in several Asian countries, including East Timor, India, Indonesia, Madagascar, Papua New Guinea, Thailand, and Vietnam. The Center of Excellence in Disaster Management and Humanitarian Assistance (COE) has been the primary PACOM organization implementing PEPFAR HIV efforts for militaries in the region. Most notably, their partnership with the Royal Thai Army has led to the development of the HIV/AIDS Regional Training Center, Bangkok Thailand, which provides education and training in HIV prevention, laboratory capacity building, and policy to military officers in the region.
  • The U.S. Central Command (CENTCOM) defines its mission as conducting operations to attack, disrupt and defeat terrorism, deter and defeat adversaries, deny access to weapons of mass destruction, assure regional access, strengthen regional stability, build the self-reliance of partner nations' security forces, and protect the vital interests of the United States within the area of responsibility. Most recently expended efforts in these areas by CENTCOM have included the collection and dispersion of nearly $250,000 in medical supplies and educational and training materials to health clinics and hospitals in Anbar province in Iraq.
  • The U.S. Southern Command (SOUTHCOM) primary mission objectives include ensuring security of the United States from any threats, enhancing hemispheric security, increasing stability through U.S. partner nation relationships, and improving consequence management and disaster response capabilities of our partner nations. Furthermore, SOUTHCOM objectives also include ensuring favorable security conditions by enabling effective sovereignty in addition to ensuring political and economic freedom with respect for human dignity. SOUTHCOM has exercised these mission points in the field of HIV/AIDS prevention and treatment recently through employment of the hospital ship USNS Comfort (T-AH 20). Medical staff associated with Comfort conducted training and education for Haitian doctors, nurses and medical technicians in Port-au-Prince, Haiti. Navy and U.S. Public Health Service doctors provided classes on control of infection, AIDS/HIV prevention, and nursing skills using a "train-the-trainer" approach at the Hospital de l'Universite d'Etat d'Haiti.
  • The U.S. Military HIV Research Program (MHRP) is dedicated to HIV vaccine development, prevention, disease surveillance, and care and treatment for HIV. Working under PEPFAR since 2004, MHRP has developed comprehensive prevention, and care and treatment programs in Kenya, Nigeria, Tanzania, and Uganda. These programs expand beyond research and are a critical complement to the vaccine research activities in these countries. In order to execute an ethical, sustainable, and noncoercive research program in resource-limited environments, there must be a link between care and treatment and HIV vaccine research, providing powerful synergy between research and clinical programs.
  • The Uniformed Services University of the Health Sciences (USUHS) defines its missionary goals as enhancing DoD and national security by providing health support for the full range of military operations and sustaining the health of all those entrusted to our care. USUHS strives to provide a world-class health system that supports the military mission by fostering, protecting, sustaining, and restoring health. Currently, USUHS is accomplishing this goal in the area of HIV/AIDS prevention and treatment through the establishment of policies regarding pre- and post-travel health assessments. Such assessments include HIV/AIDS testing for active duty service personnel and immediate contact and provision of the necessary medical care and psychosocial counseling upon receipt of an indeterminate or positive test. This is in accordance with the DoD Office of Health Affairs.
  • Defense Institute for Medical Operations (DIMO) defines its primary mission as strengthening global medical capabilities in disaster response and health care management through education and training. In the context of PEPFAR, DIMO has provided HIV policy development and medical capacity development training to the military medical communities of Russia, Mauritania, and Senegal, among other countries. DIMO provides training in country as well as at its facility in San Antonio, Texas.