Medical Aspects of Chemical Warfare (2008) - The Black Vault

Medical Aspects of Chemical Warfaretended proliferation risk. 10 Further details about theglobal stockpile and demilitarization are presentedin Chapter 4.The Terrorist ThreatIt is well known that terrorists have a strong interestin chemical weapons. For example, in 1995 severalfollowers of the Aum Shinrikyo cult carried out anerve agent attack with sarin in the Tokyo subwaysystem. The media has reported that Al Qaeda and itsoperatives have also had a fascination with weaponsof mass destruction, including chemical weapons. Ofparticular concern are revelations that Al Qaeda hadplans to employ cyanide devices against civilians inNew York City subways. 11 Several cyanide plots havebeen thwarted prior to execution, yet plans for a crudebut potentially effective cyanide dispersal device havebeen posted on jihadist Web sites since 2005. 12 Becausethe next chemical attack may occur in the civilianarena, there are implications for both the civilian firstresponder and for the armed forces. The military maybe called upon for consultation or response in sucha situation, making it necessary for it to work withcivilian populations.The Future Chemical ThreatThere are myriad toxic chemicals that could beconsidered agents of concern for the future chemicalthreat. Also, the possibility that existing classes ofagents may be enhanced for more lethal effects mustalways be considered so that countermeasures aredeveloped. The potential future chemical threat isas wide ranging as an adversary’s imagination andbudget allow.JOINT MEDICAL LIFECYCLE MANAGEMENTIn 2003 the US Army was made the executive agentfor the chemical/biological program to coordinate andintegrate all research, development, and acquisitionprograms for all the services. As of 2007 the programincludes the Joint Program Executive Office (JPEO), theJoint Science and Technology Office, the Joint Test andEvaluation Executive Office, the Joint Combat Developer,and the Joint Requirements Office. These officesare dedicated to delivering joint fighting capabilities,including medical treatment.To counter the chemical threat, sustain combatpower, and maintain a healthy force, the military establishedthe JPEO in April 2003. The JPEO integratesa systems approach to address agent delivery, doseson target, downwind dispersal, dose absorbed, andsymptoms. The Chemical Biological Medical SystemsJoint Project Management Office is specifically responsiblefor medical systems. It addresses chemical casualtymedical pretreatment and posttreatment, medicalsurveillance, and medical diagnostics to counter thethreat and leverage the joint services research anddevelopment programs for combat personnel.The Chemical Biological Medical Systems Joint ProjectManagement Office is responsible for developing,procuring, fielding, and sustaining premier medicalprotection and treatment capabilities against chemicaland biological warfare agents. Medical products aresubmitted through the US Food and Drug Administrationfor licensing or approval. The management officeis composed of a headquarters and support elementand two joint product management offices: the JointVaccine Acquisition Program (which focuses on developing,testing, producing, and storing vaccines) andMedical Identification and Treatment Systems.Medical Identification and Treatment Systemsmanages the development, acquisition, and fieldingof products used for the prophylaxis, treatment, anddiagnosis of chemical and biological warfare agent exposurein US service members. Medical Identificationand Treatment Systems products range from specifichardware devices that enable medical personnel todiagnose biological warfare agent exposure to drugsthat prevent or mitigate the actions of chemical orbiological agents.Science and technology (research and development)is overseen by the Defense Threat ReductionAgency chemical/biological directorate. The DefenseThreat Reduction Agency must interact at many levels,including with the executive agent or the Armyacquisition executive (who takes direction from thedefense acquisition executive), the Joint RequirementsOffice (which addresses user community needs andrequirements), the deputy assistant to the secretary ofdefense for chemical and biological programs (whichprovides program oversight), the Joint Staff, the USArmy Chemical School, the joint program managers,and the JPEO. The medical mission of the DefenseThreat Reduction Agency is to safeguard America andits allies from weapons of mass destruction (chemical,biological, radiological, nuclear, and high-yield explosives)by providing medical capabilities to reduce,eliminate, and counter the threat and mitigate its effects.The Defense Threat Reduction Agency managesthe medical research and development programs andfunding, including the Department of Defense medicalmissions at the US Army Medical Research Institute ofInfectious Diseases and the US Army Medical ResearchInstitute of Chemical Defense (USAMRICD).4