HONOLULU -- More than 2,000 senior Army leaders, military Allies and Partners, government representatives, and industry partners participated in the Association of the United States Army’s Land Forces Pacific Symposium and Exposition 2023.
A major theme was operationalizing the National Defense Strategy.
“A free and open Indo-Pacific requires multi-lateral cooperation and interoperability with global partners,” said Maj. Gen. Paula Lodi, 18th Medical Command Commanding General. “As the medical theater enabling command, we have a responsibility to set the theater for medical operations.
“We do this by posturing medical forces, building resilient medical logistic capabilities, and developing partnerships through operations, engagements, and experimentation,” said Lodi.
With an increasingly uncertain geostrategic environment in the Pacific, the theater Army is “seizing the initiative” through integrated deterrence, campaigning, and building the warfighting advantage. A major contributor to these efforts are theater enabling commands, who provide unique foundational capabilities to the Joint Force and offer scalable, tailorable, multifunctional, and enduring support capabilities.
“18th Medical Command supports wargaming, warfighting, and campaigning efforts across the Indo-Pacific in order to increase combined joint readiness,” said Command Sgt. Maj. Kristy Cortner, the senior enlisted advisor to 18th MEDCOM’s commanding general.
Operation Pathways is United States Army Pacific’s integrated deterrence strategy to increase regional presence. It allows the Army to project combat forces and equipment west of the International Date Line, in windows of increased risk, so there is a persistent and distributed presence forward. This effort promotes deterrence, increases commitment to partners, and has the added benefit of reducing transportation costs as we work toward interoperability.
“We need capability forward so that if we ever transition to crisis, or need to respond to a natural disaster, we are better postured to support theater wide operations,” said Cortner.
The 18th MEDCOM oversees the Health Service Support and Force Health Protection plan for over 50 annual military-to-military events with nearly 20 partner nations under the Operation Pathways campaign. The unit is doctrinally designed to split into distributed command-and -control nodes to best synchronize medical forces and operations in theater.
“The Indo-Pacific medical concept of support is a combined joint effort” said Lodi. “With our increased presence forward through Operation Pathways, and engagements with rotational forces, we are able to build joint readiness and assess partner interoperability more accurately and consistently.”
With no NATO-like organization and limited permanent basing in the region, security cooperation efforts are essential to the theater Army’s campaigning strategy. Global health engagements are a means to gain access to strategic areas of interest. Knowledge sharing, training, interoperability rehearsals, and civic action programs, all build trust with global partners. Army medicine plays an integral part in security cooperation for the Theater Army as medical exchanges are one of the few universally desired exchanges.
“There are over 210 global health engagements conducted in the Indo-Pacific each year that 18th Medical Command oversees.” said Lodi. “What makes a theater medical command unique is our ability to strategically reach back to medical expertise found within U.S. Army Medical Command, Medical Research and Development Command, or at the Medical Center of Excellence.
“On top of our tactically proficient medical units in the Pacific that constantly engage, train, and rehearse interoperability with partners,” she continued, “we [18th Medical Command] have the ability to leverage the breadth and depth of expertise from across the Army medicine enterprise in order to develop solutions to patient evacuation, medical logistics, public health, and laboratory research and development challenges.”
Overall, our security cooperation efforts emphasize intra and inter agency collaboration among nations in order to identify and implement health solutions. Often, the vehicle to health solutions is through innovation, experimentation, and concept development.
“Modernization projects start at the strategic level with initial designs and testing conducted at the U.S. Army Medical Research and Development Command and in Army Futures Command. Then, in collaboration with Medical Capability Development Integration Directorate at the Medical Center of Excellence, 18th MEDCOM coordinates new medical concept experiments throughout Operation Pathway exercises to test them in the Pacific’s unique environment,” said Col. Carol Anderson, the 18th chief of operations for 18th MEDCOM.
As integrated deterrence is the sum of our capabilities, posture, messaging, and will, 18th MEDCOM serves as an operational bridge between strategic medical concepts and tactical implementation. Medical concepts are currently focused on prolonged field care, tele-health, and medical logistics. Blood re-supply challenges in the Pacific continue to be a major concern. Therefore, experimentation with unmanned aircraft, artificial intelligence, and synthetic blood products are a focus area within Army modernization.
However, in a contested environment, medical logistics and patient movement are anticipated to be our biggest challenges to overcome. 18th MEDCOM is working on solutions through Joint theater medical logistics that are nested with 8th Theater Sustainment Command and the Joint logistics enterprise.
“As the Single Integrated Medical Logistics Manager (SIMLM), 18th Medical Command is able to coordinate re-supply of Class VIII medical items throughout the theater in order to promote supply chain efficiency and minimize the medical logistics footprint,” said Maj. Tanishia Greene, the officer-in-charge of theater medical logistics for 18th MEDCOM.
“Medical logistic resilience includes prepositioning medical equipment and supply. However, executing Joint theater logistics, in a contested environment, requires agility and our network of Allies and Partners.”
“The response to a pandemic, consequences of conflict, and natural disasters are relatively the same in terms of military operational medicine,” said Lodi. “Whether it is climate change that results in a natural disaster or transition to conflict, the consequence is the same. It affects people on land and exacerbates the vulnerability of the government. It leads to food and water insecurities, increased competition for resources, and the displacement of people. Consequently, the result is loss of economic power, instability, and implications to national security.”
Posturing, generating readiness, concentrating training forward, and interoperability are how 18th MEDCOM is operationalizing Army medicine in the Pacific. It includes sharing advances in medical technologies, creating live and at scale medical training opportunities, and building capacity and confidence in our Allies and Partners. Whether it is multi-modal evacuation solutions, blood re-supply at the point of injury, experimentation with doctrinal concepts such as prolonged care, or medical logistic war games, 18th MEDCOM is at the forefront of enabling a decisive and agile land power.
“Synchronizing the Army Health System with Joint and Combined Partners is how we win in the Indo-Pacific.” said Lodi. “In the most consequential theater at the most consequential time, we must strengthen our relationships, build trust, and ensure combined readiness against any adversary.”