A review of the role of the U.S. military in nonemergency health engagement.

In recent decades, the U.S. Department of Defense has become increasingly committed to involvement in nonemergency medical humanitarian and civic assistance. This health policy report reviews the legal and doctrinal justifications behind the U.S. military's participation in nonemergency health engagement, explores whether the aid provided is achieving stated objectives, and provides recommendations on how the military's role could be improved. Legal and doctrinal foundations are threefold: to provide benefit to the recipients, training to the personnel involved, and enhance security for the United States and host nation. A review of the literature reveals serious questions concerning the measurement of the benefit to recipients from the military's short-term health engagement missions. A robust and systematic monitoring and evaluation capability is necessary before the military's success at meeting strategic objectives with HCA can be understood. Regulations should be modified to minimize local capacity displacement. Some of the suggestions in the literature have been adopted and implemented in recent missions. In addition, Department of Defense involvement in disease surveillance appears to be a constructive way for the military to engage with host nations and improve their capacity to detect and respond to outbreaks.