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DoD biosurveillance supports three strategic missions. Based mostly on existing statute, the highest-priority mission is force health protection, followed by biological weapons defense and global health security.

• However, guidance issued by the White House on June 27, 2013, specified priorities for planning fiscal year 2015 budgets related to the National Strategy for Countering Biological Threats and the associated Global Health Security second-term agenda; this explicit White House priority strengthens the case for the global health security mission.

DoD biosurveillance also supports four desired outcomes: early warning and early detection, situational awareness, better decision making at all levels, and forecast of impacts.

Programs and measures that address priority missions — force health protection in particular — and desired outcomes should be prioritized over those that do not do so.

More near-real-time analysis and better internal and external integration could enhance the performance and value of the biosurveillance enterprise for DoD decision makers, especially for current situational awareness.

Improvements are needed in key enablers, including the need for explicit doctrine/policy, efficient organization and governance, and increased staffing and improved facilities for the Armed Forces Health Surveillance Center (AFHSC).

• AFHSC has requested additional funding to fully implement its responsibilities under the 2012 Memorandum of Understanding between the Assistant Secretaries of Defense for Health Affairs and for Nuclear, Chemical, and Biological Defense Programs. Additional responsibilities for coordinating the entire DoD biosurveillance enterprise would need concomitant resourcing.

There is not a single, unified funding system for the DoD biosurveillance enterprise; the multiple current funding systems would likely benefit from an organizing mechanism with the authority to manage and control funds to meet enterprise goals.