Security Assistance; and Logistics - Federation of American Scientists

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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
Our ResponseThe Assistant Secretary’s comments were responsive to the intent of therecommendation, and no additional comments are required.21.c.(2) We recommend that the Assistant Secretary of Defense for Health Affairsrecommend to interagency counterparts the establishment of a U.S.-based interagencyhealth sector reach back support office that would coordinate all U.S. Government healthsector reconstruction activities in Iraq.Client CommentsThe Assistant Secretary of Defense for Health Affairs concurred, noting that theInternational Health Division will be the focal point for developing the interagency reachbackcapability, as described in 21.c.(1).Our ResponseThe Assistant Secretary’s comments were responsive to the intent of therecommendation, and no additional comments are required.Added Recommendation. Based on our assessment of DoD health care policyand interagency health care coordination in stability operations as reported in the IG DoDReport, “Assessment of Arms, Ammunition, and Explosives Control and Accountability;Security Assistance; and Sustainment of the Afghan National Security Forces (ReportNo. SPO-2009-001, dated October 24, 2008), and the continued importance of this topicas evidenced in Iraq, we add the following recommendation.21.d. We recommend that the Deputy Secretary of Defense designate the AssistantSecretary of Defense for Health Affairs as the lead to:• Develop policy for all Defense Department stability operations with a medicalcomponent, health-related security and health sector reconstruction activities,medical capacity building, and medical components of humanitarian assistanceand disaster response actions;• Develop policy to form strategic partnerships and cooperative mechanisms withother U.S. Government agencies for stability operations with a medicalcomponent, health-related security and health sector reconstruction activities,medical capacity building, and medical components of humanitarian assistanceand disaster response actions;• Develop, in cooperation with other U.S. Government agencies andnongovernmental organizations, non-kinetic strategies for CombatantCommanders and U.S. Embassy country teams to use medical resources instability operations with a medical component, health-related security and healthsector reconstruction activities, medical capacity building, and medicalcomponents of humanitarian assistance and disaster response actions;• Develop measures of performance and outcomes to meet end state goals;• Identify and program for the resources required to support these tasks.159
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INSPECTOR GENERALDEPARTMENT OF DEFE
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Report No. SPO-2009-002 (Project No
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Report No. SPO-2009-002 (Project No
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Table of ContentsExecutive SummaryR
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IntroductionBackgroundThe DoD Offic
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Appendix A discusses the scope and
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letter to clarify that DoD Instruct
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USCENTCOM guidance for its area of
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1. Describe the mission, roles, and
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Status of Implementation of Recomme
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Management Comments to Recommendati
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. Performing a 10 percent sample in
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94 personnel). The proposed JMD als
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MiTTs. Between February 15 and Marc
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Part II - Arms, Ammunition, and Exp
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Observation 1. Assistance to the Mi
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5, March 25, 2008, 12 addresses DoD
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MNSTC-I personnel made on-the-spot
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1.a. We recommend that the Commande
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Observation 2. Assistance to the Mi
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and procedures for receipt, process
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MNSTC-I and Iraqi military personne
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captured weapons, or if it permanen
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SAO manning has increased approxima
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End-Use Monitoring Compliance PlanT
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Observation 4. Accountability of Ni
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• Corrective actions implemented
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Observation 5. Multi-National Secur
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Observation 6. Multi-National Secur
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elationships with ISF personnel. In
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Originally, personnel filling the n
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FMS shipments to Iraq will sharply
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Client CommentsThe Assistant Secret
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Ministry of Defense and Iraqi Army
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uild 3 rd and 4 th Line maintenance
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Observation 8. Use of Iraq Security
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The Iraqi Government has progressiv
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Observation 9. Request for Forces f
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The IG team concurs with MNSTC-I’
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Taji Location CommandDuring our vis
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• Ministry of Defense Administrat
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Recommendations, Client Comments, a
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The MoD provided an increased alloc
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Recommendations, Client Comments, a
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and KMTB used diesel generators exc
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Observation 14. Location Commander
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The Life-Support Self-Reliance prog
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The Kurdish Minister of Interior (K
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Observation 16. Undistributed ISFF-
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Page 139 and 140: Observation 19. Iraqi Army Heath Ca
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Page 143 and 144: civilian patients. U.S. military me
Page 145 and 146: those deficiencies are many, but th
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Page 149 and 150: Our ResponseCommander, MNSTC-I comm
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Page 153 and 154: While some Iraqi Army mentoring and
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Page 157 and 158: Client CommentsCommander, MNF-I con
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Page 168 and 169: objective will also impact Iraqi ca
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Page 178 and 179: Client CommentsCommander, MNSTC-I c
Page 180 and 181: guidance on stability operations th
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Page 189 and 190: Appendix C. GlossaryThis appendix p
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6. Medical Logistics Status (Author
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Combatant CommandsCommander, U.S. C
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Final ReportReferenceDraftRecommend
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Final ReportReferenceIncorporated a
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Commander, Multi-National Force-Ira
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Commander, Multi-National SecurityT
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Final ReportReferenceRenumbered toR
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Team MembersUnder the guidance of t
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