Security Assistance; and Logistics - Federation of American Scientists

21.a.(2) We recommend that the Commander, U.S. Central Command identify, access,and leverage subject matter experts, the assets of the Military Health System, existingDoD efforts, and those of other U.S. Government (such as the Department of State, theDepartment of Health and Human Services, and the U.S. Agency for InternationalDevelopment), international, and private sector organizations to assist the U.S. Mission–Iraq and the Multi-National Force-Iraq Command Surgeon efforts to coordinate andimplement:• Development of a sustainable Iraqi Army health care delivery system• Improved civilian and military medical education systems that adequatelycomplement the Iraqi Army health care delivery systemClient CommentsCommander, USCENTCOM partially concurred. USCENTCOM agreed with using andleveraging subject matter experts and assets of the U.S. Government and others to assistdevelopment of the Iraqi Army health care system. The Commander stated that similar toprevious recommendations, the USCENTCOM SGO must maintain a level of awarenessof ongoing development strategy and activities and seek to facilitate support of thoseactivities. The Commander stated that the U.S. Mission-Iraq Health Attaché, MNF-I, andMNSTC-I were best positioned and staffed to identify development strategies andmethodologies and to carry those out. Finally, USCENTCOM suggested that theUSCENTCOM SGO should provide strategic oversight, facilitate the matching ofresources to the development strategies, and ensure continuity between deployed forces.Our ResponseAlthough USCENTCOM partially concurred, its comments were not responsive to theintent of the recommendation. USCENTCOM did not explain the planning and process itwould use to identify, access, and leverage the U.S. and Iraqi government organizationsto develop the Iraqi Army health care delivery systems or to improve education systems.We believe that unity of effort between DoD elements and with all U.S. Governmentagencies is essential if effective synchronization is to occur in support of Iraqi nationalhealth sector reconstruction. While capacity is developing within the U.S. Mission-IraqHealth Attaché’s office, the core competency for strategic planning continues to restwithin DoD. Neither MNF-I nor MNSTC-I have sufficient manpower or expertise onstaff to plan and implement the needed development strategies, as described in clientcomments to Recommendations 20.a. and 20.b. on pages 143 and 145. See our responseat Recommendation 21.b. on page 157 for a more extensive discussion of this issue.21.a.(3) We recommend that the Commander, U.S. Central Command establish, insupport of the U.S. Mission–Iraq and the Multi-National Force-Iraq, an interagencyforum to plan and coordinate the implementation of U.S. Government health sectormentoring of the Ministry of Health and accomplish other support activities on behalf ofthe Ministry of Defense and the Iraqi Army.156