You all are keenly aware of how health services, public health, and biomedical science are key not only to improving health but to keeping our country safe. The relationship between the federal government’s public health work and the military goes all the way back to the founding of our country, and the early roots of both HHS and our armed services.
As Prepared for Delivery
Good morning, everyone, and thank you very much for welcoming me here today.
It’s an honor to be with you.
I want to thank especially all the men and women here who are currently serving in uniform, as well as those who’ve worn the uniform of our country in the past. We all share a common mission, working to protect Americans, and I want to thank you for the vital contributions you’ve made to that mission.
Whether you’re providing care at the VA, keeping active-duty soldiers healthy here or abroad, working on research to keep us safe at Fort Dietrich or any of the other military medical research institutions, or working somewhere else, please know that we are grateful for your service.
I also want to thank specifically the members here today of the U.S. Public Service Commissioned Corps, HHS’s uniformed service, who contribute so much to the improvement of public health wherever their missions may take them.
We’re proud of their work and honored that more than 30 percent of them also previously served in one of the armed services.
I also want to thank our foreign partners represented here today, as well as the medical students and those interested in studying medicine, who will help benefit America’s health in the future.
The mission of a health department and the mission of our armed services aren’t often connected in the minds of the American people, but all of you here know why they should be.
You all are keenly aware of how health services, public health, and biomedical science are key not only to improving health but to keeping our country safe.
The relationship between the federal government’s public health work and the military goes all the way back to the founding of our country, and the early roots of both HHS and our armed services.
The Constitution doesn’t explicitly mention a health department, but it does mention authorizing a navy, to protect our merchant ships.
Once a navy has been established, Americans join the navy or the merchant marine, as seamen, and, in time, some of them become sick or disabled in the line of duty.
So, in 1798 Congress passed an “Act for the relief of sick and disabled seamen,” creating a Marine Hospital Service to take care of Navy sailors and merchant mariners.
That Marine Hospital Service was the institution that later became the U.S. Public Health Service, and it is the earliest antecedent of today’s U.S. Department of Health and Human Services, the department I lead.
When Congress acted to establish AMSUS in 1903, they made the connection between the military and HHS’s predecessor clear: AMSUS was established for, quote, “the purpose of advancing the knowledge of military surgery, medicine, and sanitation in the medical departments of the Army, the Navy, and the Marine-Hospital Service.”
The uniformed service that came out of the Marine Hospital Service, the U.S. Public Health Service Commissioned Corps, holds a particularly special place in my heart.
My grandfather arrived at Ellis Island in 1920, stepping off the SS Argentina as an impoverished teenager from Amioun, Lebanon, who spoke no English.
One of the very first people he encountered was a uniformed member of the Public Health Service—who delivered the six-second physical that every arriving passenger went through, to check for diseases like trachoma. It fills me with great pride in our country that, today, I can stand before you, as his grandson, with the honor of leading the department that’s home to the Commissioned Corps.
Some other important HHS institutions that you’re familiar with today trace their roots to military needs, as well. The Centers for Disease Control and Prevention, for instance, grew out of an effort to control malaria in the American South, where the military needed to drill troops in advance of World War II. The first project of the institution that became the CDC was called “Malaria Control in War Areas.”
All of that history underscores a simple truth: We can’t keep our country safe without keeping our people healthy.
Working at the intersection of those concerns is just one reason why medical professionals in uniform play such a vital role.
Today, I want to briefly highlight a few important ways that the armed services and HHS work in tandem to improve health here at home and worldwide.
That includes humanitarian missions by both HHS personnel and members of the armed forces, and work we do together on biomedical research, to protect Americans and people around the world. Finally, I want to mention some important areas of cooperation on healthcare issues here at home.
When natural disasters strike the United States and our territories, HHS leads the public health and medical response.
Providing the right medical care and public health response on the ground, however, can sometimes be impossible without close cooperation with the U.S. military.
HHS has Disaster Medical Assistance Teams of civilian doctors that we can call up to provide care where they’re needed—but often we need military aircraft to get them and their equipment where they need to be.
Especially during Hurricanes Harvey, Irma, and Maria in 2017, HHS personnel and armed forces personnel worked hand-in-hand to meet the needs of our fellow Americans.
Hurricane Maria spurred the largest-ever deployment of military medical capabilities for a disaster response in the United States.
The operation included an Area Support Medical Company, the USNS Comfort, an Army Combat Support Hospital, and an Air Force Expeditionary Medical Support Hospital.
That operation was also one of the largest deployments of HHS emergency resources in history, with more than 1,800 Commissioned Corps officers deployed.
The Comfort and its staff were able to provide surgery for this gentleman on the ship—a cataract/IOL procedure, which I was even able to assist!
After the procedure was done, the man emerged from surgery with his sight restored.
Our medical and public health response to disasters has come to be seen as an area of excellence within the larger federal emergency response enterprise, and all of you should be proud of that.
But it’s not just in disaster situations that the armed services and HHS come together—we work with each other to boost preparedness, too.
Our Office of the Assistant Secretary for Preparedness and Response, for instance, known as ASPR, provides training to communities around the country about medical responses to emergencies.
One of these ASPR training programs, the Counter-Narcotics and Terrorism Operational Medical Support, or CONTOMS [kon-tomz], came out of research work on combat casualties done at the Uniformed Services University of the Health Sciences, where I know many of you work or have trained.
Drawing on the lessons of U-S-U researchers who looked at how to respond to combat injuries, the program teaches emergency responders how to care for injured law enforcement personnel, whether that’s a terrorist attack, a drug raid, or some other event.
We’ve also been proud to have the FDA engage with DoD, through the U.S. Army Medical Research and Materiel Command, regarding the military’s priority needs for medical products.
This cooperation has cleared the way for the use of freeze-dried plasma and cold stored platelets in theater by our warfighters, when conventional products are not available or when their use isn’t practical, which has real potential to save lives.
The military and HHS also have a shared interest in understanding health threats that may have national security implications: often categorized as chemical, biological, radiological, and nuclear threats, or CBRN.
The emergency response arm of HHS that I just mentioned, ASPR, is home to an institution HHS created to develop countermeasures for these threats.
That institution is known as the Biomedical Advanced Research and Development Authority, or BARDA—a bit like the health version of DOD’s DARPA.
BARDA has a close working relationship with our health and biomedical counterparts in the armed services, and it has played a crucial role in moving from basic research to countermeasures that are FDA-approved and purchased for our Strategic National Stockpile.
In October, we marked the 52nd FDA approval, licensure or clearance for a BARDA-developed product—an amazing accomplishment for a 12-year-old program and a tribute to cooperation across our biodefense enterprise.
Some of the important foundational work on infectious disease threats comes out of U.S. military institutions, including institutions overseas.
Earlier this year, I visited the Naval Medical Research Unit in Peru, one of six such naval institutions worldwide—it is very creatively dubbed NAMRU-6.
At NAMRU-6, Navy personnel conduct research on and surveillance of a wide array of infectious diseases that are of particular concern for military and public health officials in the region, including influenza, malaria, dengue fever, yellow fever, and Zika.
This work is aimed at keeping the American warfighter safe from biological threats, but it also helps keep Americans here at home and the people of Latin America safer and healthier, too.
NAMRU-6 collaborates with Peru’s Ministers of Defense and Health as well as universities and NGOs throughout Latin America, USAID, CDC, NIH, and the Pan American Health Organization.
Before my NAMRU visit, I had heard a great deal about the impressive work done in military research institutions overseas, and I walked away even more impressed than I expected.
We see room for even more cooperation between the armed services and HHS in further development of the Commissioned Corps as an emergency asset, ready as soon as possible to fill the gaps in our health system.
We have several Commissioned Corps deployment teams that are ready to deploy within 6 hours, and the service overall stands at more than 95 percent readiness.
We’re now looking ahead to the establishment of a Ready Reserve Corps, which will emulate the success of the reserve components of our armed forces by providing a ready and nimble surge capacity.
This is part of broader work to ensure that the Commissioned Corps is designed and supported to meet its mission, which I’ve made a priority for HHS.
We were pleased to sign a memorandum of understanding with the National Guard Bureau last year to support the creation of the Ready Reserve, and we look forward to support from Congress on this mission in the near future.
I’m grateful to the Commissioned Corps for the work they do today to protect and enhance Americans’ health and well-being.
That is why I was disappointed to learn that a new veterans’ memorial in Washington, the National Native American Veterans Memorial, will not include mention of the hundreds of Native Americans who have served in the Commissioned Corps.
It is wonderful that we will have a memorial recognizing the contributions Native Americans have made to the defense of our country, serving at higher rates than any other ethnic group. But I hope, going forward, we can find a way to provide recognition for those who wore the Commissioned Corps uniform as well.
The kind of close cooperation I’ve described today extends to so many public health and healthcare issues. Providing the best possible healthcare for our service members and veterans is a top priority for President Trump.
At the most recent Cabinet meeting, the President had leaders from across the administration discuss what they’re doing to support veterans and service members, and I was honored to discuss what HHS does in cooperation with the Pentagon and VA on suicide prevention.
As just one example, NIH and the Army together carried out the Army STARRS project, the largest ever study of suicide and mental health among military personnel.
One component of the project linked about 40 data sources from the Army and DoD, examining more than 1 billion administrative records from more than 1.6 million soldiers.
Using these data, NIH and the Army worked with the VA to develop predictive models that can identify patients receiving VA care with predicted suicide risk 20-30 times higher than average. Today, through a program called REACH VET, VA runs these algorithms on their patient population each month to identify the 0.1 percent of the population at greatest risk for suicide, to whom a prevention coordinator is then assigned to get the veteran the services he or she needs.
The VA is the first health system in the country to use such methods.
Our cooperation goes well beyond mental health and suicide. This year, HHS expanded our work with older and disabled veterans as part of a VA program that helps them stay in their homes and created a partnership between HHS and the VA to protect veterans from questionable healthcare providers.
I also want to offer a particular note of praise to the VA and the Pentagon for their ongoing work on many healthcare issues we’ve been tackling on at HHS, like striving to put patients in charge of their own care and their own health information, and combating the opioid crisis through pioneering effective alternative methods of pain management.
The President has a particular vision for healthcare: a system that’s personalized, patient-centric, puts you in control, and treats you like a person, not a number.
I know that is what many of you are working toward, both in every day patient care and through systematic reform at the Pentagon and the VA, and I’m grateful for those efforts.
Given the array of areas for cooperation we have, we know the relationships between HHS and the larger military medical community are only going to deepen and strengthen.
This cooperation reflects the fact that we share a common purpose: protecting life and lives.
Much of the work we do at HHS would not be possible without the expertise and capabilities provided by the military, and certainly, we could not enjoy the remarkable fruits of American prosperity, and the health that brings, without the protection of American servicemen and women.
So I want to close by thanking all of you here today, for your devotion to keeping our country safe, to protecting and healing those who serve us, and to improving the health and well-being of all Americans.
We at HHS are so proud to call you partners, and I look forward to many more years of collaboration together.
Thank you again for having me here today.
