antidotes to support medical chemical warfare (CW) or biological warfare (BW) defense. Training is currently the most obvious weakness for the Navy in the area of medical defense, and improvements in training will offer the greatest return on investment. Vaccines could provide the most comprehensive defense against BW agents, but the Navy should be under no illusions that a stream of effective approved vaccines will become available in the near term to mid-term. In the absence of adequate supplies of effective vaccines, casualties must be anticipated, but observant sailors, corpsmen, clinicians, and commanders working with modern diagnostic tools will allow early medical interventions to save lives and preserve warfighting strength. Recognition of symptoms and pre-incident intelligence should be the earliest input into efficient, distributed disease reporting and analysis systems to allow effective and timely medical defensive measures to be taken.

In this chapter, the committee presents findings and recommendations that run the spectrum from near-term, nontechnical initiatives, to technical and operational shortfalls, to interdepartmental, policy-level issues that can only be addressed through initiatives by the Secretary of the Navy and above. These findings and recommendations focus on three general areas:

  1. Medical training. Medical training remains a critical determinant of success in medical defense and an area in which senior leadership can be most effectively applied. It is also an area in which Navy medical personnel are significantly lagging behind their counterparts in other Services. Enhanced training of naval personnel, medical and—as noted for operations—non-medical, represents the highest-payoff, near-term investment that can be made by the naval Services, and the committee urges that it be done now. Training is not without costs, but the costs are relatively low. Moreover, without better training, the equipment and medical countermeasures provided by the technology developers cannot provide the levels of effectiveness for which they are designed.

  2. Technical and operational shortfalls. Many of the technical and some of the operational shortfalls in naval medical capabilities are the result of overreliance on the Joint Chemical and Biological Defense (CBD) Program.1 The committee’s leading recommendation for addressing these issues is to define the nature of the shortfalls in terms of naval-specific requirements. This analysis involves the full range of developmental activities, as discussed for operations: doctrine, organization, training, materiel, leadership, personnel, and facilities (commonly referred to as “DOTMLPF” analysis). This kind of analysis and


Due to their expanded scope of chemical and biological defense associated with the war on terrorism, the Department of Homeland Security and the Department of Health and Human Services, especially in the area of vaccines, may impact the Joint CBD Program. The committee believes, however, that its recommendations remain applicable, although the Department of the Navy should follow closely and leverage these activities as much as possible.

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