Kate Almquist Knopf, blogging for the Center for Global Development, notes several problems that could result from the Department of Defense (DoD) getting involved in global health. Her main argument states that the DoD’s priority should be to protect U.S. national security. She goes on to say, if providing humanitarian aid and promoting development is in the United States’ national interest, then it should be done by those best-suited to do the job — civilian development experts. She argues that the DoD should instead focus on the value its participation could add to development practice through providing security so that civilian practitioners can do their jobs.
While there is no single DoD “global health budget” line item, a 2012 report by the Kaiser Family Foundation estimates the DoD budget for such activities was more than half a billion dollars in fiscal year (FY) 2012 – at least $579.7 million. In comparison, this estimated funding “floor” ranks higher than the global health budgets for either the Centers for Disease Control and Prevention or the National Institutes of Health in FY 2012. For FY 2014, the DoD requests $526.6 billion to protect and advance security interests at home and abroad.
Although this substantial amount of money is being funneled through the DoD towards global health efforts, Knopf argues that the DoD is not the ideal leader for global health initiatives. The DoD does its health projects like its military actions – only for the short-term. Additionally, the DoD health-related activities are often not evaluated for effectiveness, defying the accepted principles of development work. These principles understand that a long-term approach with regular evaluation is more sustainable and effective. Yet the agencies that follow these principles, like the USAID and the Department of State, get less funding for global health than does the DoD. In fact, only one percent of the federal budget goes to these two agencies.
When a military group is present, mixed messages are not uncommon. Knopf stresses that the delivery of health services to civilian populations is a civilian role, not a military one. The appropriate time for the military to step in is when there is an extreme emergency like a natural disaster.
Knopf also points out that more needs to be done to get the different agencies to collaborate. The DoD should not act in isolation from USAID and the State Department. Given the vast budget and influence of the DoD, improved coordination with U.S. government civilian partners in global health may promote more effective use of resources and ensure U.S. government efforts in national security and in global health are not contradicting one another. Given the nature of the organization, the DoD’s national security objectives will at times take precedent over the objectives of the global health and development community, hindering progress toward improving health.
– Maria Caluag