Truman Series: Health by DoD

This is the latest in our series by fellows in the Truman National Security Project.  Harley Feldbaum writes:

Late last week, Chairman of the Joint Chiefs Mike Mullen gave a talk at Princeton calling for a “whole of government” approach to national security and expressing concern about a “militarization of foreign policy.” Most startling was that Mullen pointed out the typically unstated issue of when this approach would be implemented: “in my opinion… we are a good decade away from creating a capability in our other departments.” Bottom line: it will be years before State, USAID and other civilian agencies are re-staffed and organized to conduct soft power missions.

Since DoD will remain the principle soft power player for the near future, let’s take a look at four DoD soft power missions, in this case in the health field:

First, I give two DoD health missions a “C”, for both their benefit to U.S. strategic interests and impact on improving global health. The last two years have seen increasing deployments of the hospital ships USS Comfort and USS Mercy on humanitarian missions to Latin America and West Africa. Touted as voyages of healing that win heart and minds, these ships provide randomly selected populations a brief 72 hours of access to first-rate medical care, but with no plan for return visits or follow-up care.   By NGO standards, these missions are expensive joke with little long-term impact on health; what’s more, their public diplomacy impact likely pales in comparison to Cuban health diplomacy efforts that place doctors in poor neighborhoods for years at a time.

Then there’s “medical civil-assistance programs” (or MEDCAPS), essentially temporary medical clinics used recently in Iraq and Afghanistan to win support of local populations, gather intelligence, and reward communities for cooperation with the U.S..  Like the hospital ship missions, MEDCAPS offer little in terms of sustainable health improvement. Worse, however, is their potentially counter-productive strategic impact. Major Jay Baker describes MEDCAPS as “tailgate medicine” that detracts from Iraqi health systems and undermines the American strategic objective of building Iraqi government legitimacy.

Can DoD “do” soft power right in the health arena?  Yes. DoD’s overseas medical laboratories and its HIV/AIDS Prevention Program (DHAPP) and are examples where it does. Haven’t heard of these programs? Perhaps that is because they are not designed to meet only short-term U.S. strategic objectives or provide photo-ops for the American public. Rather, they’re operated in concert with foreign governments to address areas of mutual concern. The overseas laboratories employ foreign nationals and address local health needs, while supporting America’s interest of detecting and responding to new infectious disease outbreaks. DHAPP leverages the military’s experience dealing with HIV/AIDS to assist foreign militaries reducing the impact of the disease on their forces. This is something many foreign militaries want and need, and providing this service facilitates greater cooperation on other areas of strategic U.S. concern.

Humanitarian impact, partnership and sustainability are good principles to incorporate into DoD soft power missions. The overseas medical labs and DHAPP show that DoD can do soft power right, let’s hope we see more of this while we rebuild our civilian soft power capabilities.

Harley Feldbaum is a professorial lecturer of International Policy at Johns Hopkins SAIS, the Associate Director of SAIS’s Global Health and Foreign Policy Initiative, and a Truman National Security Project fellow.  The views expressed here are his own.