able supporting evidence and a description of the committee’s reasoning that led to each recommendation.

CONCLUSION

Partly because of the past success of DoD research programs, the public and even DoD personnel outside of the medical sphere know little about the contributions of the military’s infectious disease programs or the threats that its products have ameliorated. By creating a single vaccine authority with a credible advisory board and with budgetary authority and responsibility extending across the broad continuum of the vaccine acquisition cycle, from setting priorities to stockpiling of licensed products, DoD would enhance not only the effectiveness but also the visibility of its vaccine program. The creation of such an authority would also improve the likelihood that the vaccine acquisition process would be provided with a budget that is sufficient to accomplish its mission. It is a mission of enormous importance. Immunization is often the most effective means of preventing infectious diseases, in either civilian or military populations, and whether caused by naturally encountered infectious agents or purposeful exposures related to bioterrorism or biological warfare.

In summary, DoD’s vaccine acquisition program, despite its distinguished history, diffuses responsibility and is inadequately funded; therefore, it cannot produce the effort required to respond to a task that has been made more urgent by the continuing emergence of new natural infectious disease threats and growing recognition of the risks of bioterrorism and biological warfare.

The committee urges DoD to work more aggressively with decision makers in the U.S. Congress and in the executive branch to recognize that infectious disease agents—whether they occur naturally or are weaponized as agents of biological warfare or terror—threaten military operations and, therefore and implicitly, the welfare of the nation. Decision makers must recognize (1) the past, imminent, and possible future successes of vaccines in minimizing those threats; (2) the strong track records and reputations of military research programs in developing vaccines used by the U.S. military as well as in civilian settings; (3) the contributions that DoD’s medical research efforts make to foreign policy and national security; (4) the threats to continued vaccine development and the ultimate availability of vaccines that are posed by organizational and fiscal limits; and, consequently, (5) the need for adequate, stable funding and strong management authority. Such changes would allow DoD to optimally advance and exploit the technology available for vaccine development, and to provide the best possible protection of the nation’s armed forces against infectious diseases.



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