10. Medical Research
In light of the large investment of the civilian sector in basic biomedical sciences, the Army postures its basic medical programs to exploit rather than sustain the medical technology base. To effectively leverage the national and international investment in civilian biomedical research into a meaningful contribution to military specific requirements, the Army's in-house and extramural basic medical research programs are intensively managed by the U.S. Army Medical Research and Materiel Command (USAMRMC) as integral components of the four medical functional research areas:
(1) Infectious Diseases of Military Significance
(2) Combat Casualty Care
(3) Army Operational Medicine
(4) Medical Chemical/Biological Defense
The Army basic medical research program is effectively integrated into the DoD biomedical research program through the Armed Services Biomedical Research and Evaluation Management (ASBREM) Committee. This coordination committee and the subordinate Joint Technology Coordinating Groups provide oversight and assurance that there is no unnecessary duplication of research efforts between the respective Services. This functionally aligned research investment ensures against technological surprises, which could overwhelm medical countermeasures to the health and performance of our Armed Forces. Both the leveraging of civilian investment and coordination within DoD allow the program to be focused on those specific technologies that will support the DoD mission to preserve soldiers' health and mission capabilities despite the extraordinary battle and non-battle threats to their health and well-being. Figure V-19 illustrates the impact that medical research can have on warfighting capability.
Figure V-19. Basic Research in Military Medicine Basic Research produces breakthroughs in medical technology.
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b. Major Research Areas
Infectious Diseases of Military Significance Basic research in infectious diseases of military significance concentrates on prevention, diagnosis, and treatment of infectious diseases affecting readiness and deployment. Molecular biology will facilitate development of vaccines and prophylactic drugs to prevent illness, new vaccine delivery systems, and rapid diagnostic tests based on genetic probes. Special emphasis will be placed on alternative drug delivery systems or vaccines that can be administered infrequently, so that continual protection can be provided with minimal or no sustaining treatments. The Army is designated DoD Executive agent for this program and supports basic research efforts at Walter Reed Army Institute of Research (WRAIR), the U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), and the Navy, in addition, to numerous research contracts at universities and other research institutions.
Combat Casualty Care Basic research in combat casualty care is directed toward enhanced survivability (control of bleeding and field infusion devices), recovery from combat trauma, and the ability to provide intensive treatment during the evacuation process. Physiological research is performed to explore mechanisms of preventing secondary damage from acute injury and to determine approaches to managing casualty care during delayed evacuation. This includes work on biological interventions related to the induction of a hibernation like state. Basic research in combat casualty care is performed at WRAIR and the U.S. Army Institute of Surgical Research (USAISR).
Army Operational Medicine Basic research within the Army operational medicine research area provides a basic understanding of the pathophysiology of environmental and occupational threats affecting soldier health and performance. In addition to the risks to health and performance from operations in extreme climatic environments, and the rigors imposed by military operations in and of themselves (e.g., sleep deprivation, jet lag, stress), operation of Army systems may present additional health hazards (e.g., electromagnetic radiation, noise, vibration, blast, and toxic chemical by-products). Most products in this functional area are informational in nature and serve as guidelines for materiel and combat developers (e.g., exposure standards for noise or vibration, work-rest cycles for heat). However, advances in neurosciences and molecular biology may lead to medical products which reduce susceptibility to fatigue or fatigue induced injuries. Biochemistry and neuroscience contribute to the nutritional studies designed to select natural food ingredients which will be converted by the body into physiologically and neurologically active metabolites. This will lead to a reduction in performance decrements due to combat stress and environmental extremes. Work in this area is conducted at the U.S. Army Research Institute of Environmental Medicine (USARIEM), the U.S. Army Aeromedical Research Laboratory (USAARL), and the WRAIR and through grants and contracts with universities and research centers.
Medical Chemical Defense Basic research in medical chemical defense provides an understanding of the pathophysiology of threat chemical agents and seeks to elucidate chemical warfare agent mechanisms of toxicity so that rational countermeasure strategies can be directed against those agents. Reduction of incapacitating effects caused by chemical warfare agents and/or associated therapies remains a high priority research area. This program draws on the advances of neuroscience and molecular biology to develop more effective and less debilitating medical countermeasures. Although current research shows promise for the reduction of nerve agent toxicity, molecular biological approaches may ultimately produce safe and effective prophylaxis and treatments for the effects of blister and respiratory agents. The Army is the DoD Executive Agent for medical chemical and biological agent research and supports research at the U.S. Army Medical Research Institute of Chemical Defense (USAMRICD), USAMRIID, USARIEM, and WRAIR.
Medical Biological Defense Medical biological defense focuses on military threat agents of biological origin. Basic research efforts work to identify infectious agents and toxins and to understand the disease processes or morbidity caused by them. Current research seeks to identify methods of stimulating host immunologic protection mechanisms, in order to provide protection against a broad spectrum of biological warfare agents rather than against specific agents.
Note that effective FY94, both the medical, chemical and biological defense programs were consolidated at OSD with the Army serving as Executive Agent.
c. Other Areas of Research
In addition to providing the basic understanding needed to improve recovery from central nervous system trauma, neuroregulators and neuromodulators may provide the key to controlling cellular and organ functions to improve wound healing, prevent organ failure, and provide better control of circulatory functions. Besides the strictly medical approaches in Army Operational Medicine, nutrition research will ensure that the soldier's diet will sustain health and performance across the spectrum of military operations. The Army is selected to serve as Executive Agent for all DoD nutrition research. Also, under investigation are protein carriers for transport of immunogenic peptides; vectored vaccines with multiple immunogenic properties; approaches to block the actions of threat agents on target receptor sites; and rapid evaluation of genetically altered microbes.
d. Benefits of Research
The Army's basic biomedical research programs provide the foundation for medical technological superiority in support of the National Military Strategy. In peace, medical technological superiority provides a critical element of deterrence, bolsters confidence among our allies, and provides a foundation for soldier readiness. In crisis, it ensures that threats to the health of the force are not a limiting factor in military options available to the National Command Authority. It contributes to the ability to provide humanitarian assistance, disaster relief, and national building. In war, it amplifies individual combat effectiveness, minimizes casualties, and reduces the death and disability rates among those who do become casualties.