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U.S. Military Assistance to International Health Emergency Response: Examining Frameworks for an Ebola-Like Disaster in the Asia

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U.S. Military Assistance to International Health Emergency Response: Examining Frameworks for an Ebola-Like Disaster in the Asia U.S. Military Assistance to International Health Emergency Response: Examining Frameworks for an Ebola‑like Disaster in the Asia‑Pacific After-Action Report 28-29 January 2015 Honolulu, Hawaii Informing Decisions that Shape the Nation’s Role in the Asia-Pacific Banyan Analytics is an institute focused on the Asia-Pacific region. The institute uses analysis to inform decisions that shape the Nation’s role in the Asia-Pacific, aiding the U.S. government with the implementation of programs and initiatives involved in regional engagement efforts. The institute is a valuable partner to government offices and other organizations that operate in the Asia-Pacific, leveraging over five decades of ANSER experience supporting the U.S. government with objective research and analysis in addressing challenges that are inherent in coordinating and executing complex initiatives. The research described in this report was produced by Banyan Analytics, and results from the investment of Analytic Services Inc. in research related to Informing Decisions that Shape the Nation’s Future. The views expressed herein are those of the authors and do not necessarily represent the opinions of Analytic Services Inc., or its research clients and sponsors. You may copy these materials free of charge for educational, noncommercial use if you retain all copyright notices included on them; appropriate citation of the source is requested. In accordance with Title 17 (USC), Section 107, this material is distributed without profit or payment and is intended for nonprofit research and educational purposes only. Analytic Services Inc. DMCA Copyright Copyright © 2015 Banyan Analytics, Analytic Services Inc., All rights reserved. Cover photo source: U.S. Army Sgt. 1st Class Brien Vorhees / DVIDS Contents Executive Summary ............................................................................................ 1 Key Findings Summary ...................................................................................................... 1 Key Challenges .................................................................................................................. 2 Action Items ...................................................................................................................... 2 Areas for Further Research ................................................................................................ 2 Exercise Overview ............................................................................................... 3 Findings and Analysis ......................................................................................... 7 International Resources to Support Health Emergencies in the Asia-Pacific ........................ 7 International Health Regulations ................................................................................................................................ 7 Association of Southeast Asian Nations ...................................................................................................................11 Bilateral and Multilateral Support ............................................................................................................................. 12 Nongovernmental and Intergovernmental Organizations ........................................................................................ 13 Private-Sector Integration .......................................................................................................................................... 16 Existing Resources for Public Health Response.........................................................................................................17 Financial Support .......................................................................................................................................................21 Slow Response Timeline for Health Emergencies ..................................................................................................... 23 Controlling Spread of Infectious Diseases ................................................................................................................ 25 Request for U.S. Assistance ...............................................................................................25 Process to Request U.S. Assistance ........................................................................................................................... 25 Assessments to Determine the Scope and Scale of Required Support ................................................................... 26 Coordination Mechanisms ................................................................................................29 Host Nation Role ....................................................................................................................................................... 29 United Nations Office for the Coordination of Humanitarian Affairs .................................................................. 29 Coordination of U.S. Assets .......................................................................................................................................31 Coordination Challenges for International Disaster Response ................................................................................31 Relationship Building ................................................................................................................................................ 35 Capacity Building ....................................................................................................................................................... 37 Use of U.S. Military Capabilities for Health Emergency Response .....................................39 Concerns, Perception, and Expectations for Use of U.S. Military Resources ......................................................... 39 Appropriate Type and Level of Support ....................................................................................................................40 Push Versus Pull Strategy .......................................................................................................................................... 43 Mission Evolution ...................................................................................................................................................... 45 Transition Back to Steady-State ................................................................................................................................. 45 www.anser.org/banyan_analytics i Contents Protection of U.S. Forces ...................................................................................................46 Arming Orders ...........................................................................................................................................................46 U.S. Military Involvement in Security ....................................................................................................................... 47 Personal Protective Equipment .................................................................................................................................. 47 Risk Communication ........................................................................................................48 Risk Communication Resources ............................................................................................................................... 48 Curbing Fear Mongering ........................................................................................................................................... 49 Social Mobilization .....................................................................................................................................................51 Public Messaging ........................................................................................................................................................51 Balancing Hope and Reality ...................................................................................................................................... 53 Outcomes ..........................................................................................................55 Summary of Challenges ....................................................................................................55 Action Items .....................................................................................................................58 Areas for Further Research ...............................................................................................58 Appendix A: Participant List .............................................................................59 Appendix B: Quarantine and Isolation as Tools of Disease Prevention ...............65 Background .....................................................................................................................65 Historical Perspectives in America ....................................................................................67 Use of Quarantine in Modern Times—Lessons from Ebola ................................................67 Appendix C: Types and Use of Personal Protective Equipment in Healthcare Settings..............................................................................................................69 Background .....................................................................................................................69
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