1. a response mechanism to provide feedback to reporting agencies and individuals and, if necessary, to mobilize investigative and control efforts of local and international agencies.

Overseas laboratories, the military health system (MHS) infrastructure, and the GEIS Central Hub provide the basic framework necessary for GEIS to conform to this ideal type. Because GEIS supports activities at DoD overseas laboratories, it is also, in a sense, responsive to IOM recommendations calling for sustained support of these resources (IOM, 1992).

GEIS in Context

Within the DoD

GEIS is a new mission that has been added to operations carried out at existing DoD facilities within the United States and abroad. GEIS does not and cannot sustain these facilities alone. The success of GEIS is predicated on the availability of resources at overseas research laboratories and supporting MHS capabilities sufficient to maintain an appropriate base for GEIS operations. DoD laboratory resources, particularly overseas medical research laboratories, have been and continue to be imperiled.

In 1992, the IOM noted that (IOM, 1992, p. 149):

The [Committee on Emerging Microbial Threats to Health] is concerned that some of these [DoD overseas medical research] laboratories have been closed in the past, for reasons related both to insufficient funding and changes in mission priorities, and that further closings could jeopardize the United States’ ability to detect and respond to emerging infectious disease threats.

A new DoD research facility, the ninth largest biomedical research facility in the country, was recently completed in Maryland (Walter Reed Army Institute of Research, 1998). The facility houses Army and Navy medical research and development command headquarters, as well as the GEIS Central Hub. This facility is an outstanding resource domestically. It reflects an important investment in DoD laboratory infrastructure. Other DoD laboratories are also in need of revitalization. GEIS would benefit from increased capacity within existing laboratories and the introduction of additional DoD laboratories overseas, particularly in areas of high biodiversity and other locations where the potential for the emergence of infectious diseases is high. At a minimum, it is important to GEIS that existing laboratory facilities be maintained.

At the time of preparation of the 1992 IOM report, seven overseas laboratories were in existence (IOM, 1992). By the time that Presidential Decision Directive NSTC-7 was released in 1996, there were six laborato-



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