Security Assistance; and Logistics - Federation of American Scientists

at Recommendation 20.c. on page 146, appropriate right-sizing and repositioning of U.S.forces for the next phase of support to the Iraqi Army requires a holistic reevaluation ofthe U.S. engagement strategy. USCENTCOM should facilitate and resourcecomprehensive, synchronized, integrated, multi-year planning, building strategicpartnerships, and collaboratively engage the MoD and MoH where needed to build asustainable, independent Iraqi Army.USCENTCOM should include these interagency and inter-ministerial engagements in itsrequirements analysis, strategy and theater guidance, and in tasking MNF-I, as part of thedeliberative planning process described in our summary response at Recommendation20.c. on page 146. MNF-I should proactively engage the U.S. Mission-Iraq HealthAttaché to identify resource and authority requirements for this effort. Medical staffelements should elevate issues through command channels to the theater commander, asnecessary, to overcome bureaucratic barriers that cannot be solved at the staff officerlevel. We believe that the USCENTCOM comments highlight the challenges faced byDoD in implementing DoDD 3000.05 and Joint Publication 4-02 in the interagencyenvironment to further develop the Iraqi Army health care system.We request that USCENTCOM and MNF-I jointly and in coordination reconsider theirpositions to Recommendations 21.a.(1), 21.a.(2), 21.a.(3), and 21.b. and providecomments to each in response to the final report.21.c.(1) We recommend that the Assistant Secretary of Defense for Health Affairsestablish a U.S.-based health sector reach back support office within the Department ofDefense, in coordination with the Chairman of the Joint Chiefs of Staff and theCommander, United States Central Command. Use this office to identify, access, andleverage subject matter experts, the assets of the Military Health System, existing andfuture DoD efforts, and those of other U.S. Government (such as the Department of State,the Department 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 promote andimplement:• Development of a sustainable Iraqi Army health care delivery system• Improved Iraqi civilian and military medical education systems that adequatelycomplement the Iraqi Army health care delivery systemClient CommentsThe Assistant Secretary of Defense for Health Affairs concurred, noting that theInternational Health Division within ASD(HA) was developing expertise and staffing forreach back support to the Combatant Commands and was seeking to co-locateinteragency personnel from the Departments of State and Health and Human Services,USAID, and the World Health Organization for complementary strengths and expertise.158