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Considerations for Civil-Military Interaction During Public Health Emergencies

Australian Civil-Military Centre | Center for Human Rights and Humanitarian Studies
Research team: Emily Chapman, Natalie McLean, Sam Boland, Adam Levine, and Alexandria Nylen.

Executive Summary
Recent responses to public health emergencies including outbreaks, such as Ebola, Zika, and COVID-19, reflect how domestic and foreign militaries are routinely becoming involved in these responses. This is observed alongside the broader militarisation of domestic disaster response, and more generally, the use of military capabilities in non-traditional roles.

When considering engaging with or using military capabilities in these contexts, it is important to note the characteristics of public health emergencies which make them distinct. By outlining the nuance of civil-military interaction in public health emergencies, together with broader civil-military coordination considerations, this document enables readers to situate the entirety of a response and apply tailored decision making.

Aim and objectives
Accordingly, this document aims to facilitate safe, principled, and pragmatic civil-military interaction in public health emergencies and has the following objectives:
1. To provide readers with existing guidance, core concepts, principles, considerations, and risks that are relevant to civil-military interaction during public health emergencies; and
2. To outline the various activities that militaries might perform during responses to public health emergencies and corresponding insight into interacting with militaries during these activities to enable more concrete and practical dialogue between the civilian and military sectors during the preparedness/readiness, response, and recovery phases.

Reports

Considerations for Civil-Military Interaction During Public Health Emergencies

September 2024 | Australian Civil-Military Centre, Center for Human Rights and Humanitarian Studies
Research team: Emily Chapman, Natalie McLean, Sam Boland, Adam Levine, and Alexandria Nylen

Practical Measures to Prevent and Mitigate Conflict-Induced Hunger

May 2024 | InterAction, Protection of Civilians

What Does Securitization Mean for Forensic Mental Healthcare in Nigeria?

November 2023 | Policy Brief | Nextier | Authors: Aishatu Yusha'u Armiya'u, Chris M.A. Kwaja

Improving Civil-Military Engagement Protection Outcomes in Humanitarian Response

September 2023 | Research Team: Daniel Salaru, Georgia Harrington, Dorothea Omerovic, Elina Pipa, Charlotte Skelsey, David Polatty

Civilian-Military Coordination During the U.S. National Response to COVID-19

May 2023 | Authors: Alexandria J. Nylen, Ahad Bashir, Kethural Manokaran, David Polatty, and Adam Levine

Deadly Deja Vu: Russia Revisits Syria War Tactics in Ukraine

April 2023 | Authors: Tayseer Alkarim

‘Then, We Lost Everything:’ Afghan Evacuee Experiences of Operation Allies Refuge and Operation Allies Welcome
April 2023 | Authors: Alexandria J. Nylen, Omar Bah, Jonathan Bott, Giovanna Deluca, Adam C. Levine, and Subhan Mohebi

She Pays the Highest Price: The Toll of Conflict on Reproductive Health in Northwest Syria

March 2023 | Authors: Houssam Alnahhas, Adrienne Fricke, Leonie Tax, Amany Qaddour, Diana Rayes, Ihlas Altinci, Jennifer Higgins, Abdulselam Daif, Okba Doghim, Ahmad Albik, Mohamed Hamze

Collaborating the Relief and Recovery Efforts in Post Dis aster Situations in Pakistan: Need Assessment and Conceptual Coordination Framework

November 2022 | CHRHS Seed Grant | Authors: Aisha Azhar and Muhammad Nasir Malik

Reviewing Guidance and Perspectives on Humanitarian Notification Systems for Deconfliction
October 2022 | CHRHS and USNWC Report | Authors: Carmen Bebbington, Sierra Fang-Horvath, Georgia Harrington, David Polatty, Jonathan Robinson

Public Action and the Pandemic: The Role of Civil Society in Shaping State Responses
June 2022 | CHRHS Report | Authors: Anindita Adhikari, Maria Carrines P. Alejandria, Benjamin Bradlow, Patrick Heller, Adam C. Levine, Maria F. Lopez-Portillo, Salma Mutwafy, Seth Stulen, Ieva Zumbyte

Humanitarian-Military Relations in Complex Emergencies: Evidence, Insights, and Recommendations

May 2022 | CHRHS Report | Maria Carinnes P. Alejandria, Samuel T. Boland, Hank Brightman, Rob Grace, Adam C. Levine, Alexandria J. Nylen, David Polatty, Zein Tayyeb

Humanitarian-Military Relations in Complex Emergencies: Practical Guidance for Policymakers and Humanitarian Planners

May 2022 | CHRHS Policy Guidance

All Reports >

Journal Articles

“Yeah, this is not going to work for me”–The impact of federal policy restrictions on methadone continuation upon release from jail or prison

January 2025 | Journal of Substance Use and Addiction Treatment | Authors: Justin Berk, Cameron Miller, Michael-Evans James, Megan Martin, Josiah Rich, Eliana Kaplowitzb, Lauren Brinkley-Rubinstein

Challenges and Opportunities in Developing a Comprehensive, Rural, Trauma-Care Program: Experiences from Nepal

October 2024 | Rhode Island Medical Journal | Authors: Ramu Kharel, Mandeep Pathak; Derek Lubetkin, Bibhav Acharya

Jumping off Points for Makerspace Learning Design

September 2024 | International Symposium on Academic Makerspaces | Authors: Madison Dunaway, Johanna Okerlund, Christopher Bull, Janet Hollingsworth, Greg Buckland, Brandon Stafford

Assessment of the HIV Enhanced Access Testing in the Emergency Department (HEATED) program in Nairobi, Kenya: a quasi-experimental prospective study

September 2024 | HIV Research & Clinical Practice | Authors: Adam R. Aluisio, Joshua Smith-Sreen, Agatha Offorjebe, Wamutitu Maina, Sankei Pirirei, John Kinuthia, David Bukusi, Harriet Waweru, Rose Bosire, Daniel K. Ojuka, McKenna C. Eastment, David A. Katz, Michael J. Mello & Carey Farquhar

Observing Context Improves Disparity Estimation when Race is Unobserved

September 2024 | NBER WORKING PAPER SERIES | Authors: Kweku Kwegyir-Aggrey, Naveen Durvasula2, Jennifer Wang, Suresh Venkatasubramanian

Characteristics of Interpersonal Violence and Intimate Partner Violence Among Injured Adults Seeking Emergency Care in Nairobi, Kenya

August 2024 | Rhode Island Medical Journal | Authors: J. Austin Lee, Nicholas Momanyi, Ogechukwu Agatha Offorjebe, Beatrice Ngila, Wamutitu Maina, Sankei Pirirei, Daniel K. Ojuka, Adam R. Aluisio

Modelling climate impacts on paediatric sepsis incidence and severity in Bangladesh

July 2024 | Journal of Global Health | Authors: Gazi Ms Mamun, Katelyn Moretti, Farzana Afroze, Ben J Brintz, Abu Smmh Rahman, Monique Gainey, Monira Sarmin, Shamsun N Shaima, Mohammod J Chisti, Adam C Levine, Stephanie C Garbern

Emergency medical dispatch technologies: Addressing communication challenges and coordinating emergency response in low and middle-income countries

April 2024 | Surgery | Authors: Jason Friesen, Ramu Kharel, Peter G. Delaney

Armed actor interventions in humanitarian and public health crises: examining perspectives of crisis-affected community members

April 2024 | Conflict and Health | Authors: Samuel T. Boland, Alexandria Nylen, Madison Bates, Maria Carinnes Alejandria, Rob Grace, Zein Tayyeb, Adam C. Levine

Mental and physical health morbidity among people in prisons: an umbrella review

April 2024 | The Lancet Public Health | Authors: Louis Favril, Josiah D. Rich, Jake Hard, Seena Fazel

Reimbursing incarcerated individuals for participation in research: A scoping review

January 2024 | International Journal of Drug Policy | Authors: Andrea Mambro, Avideh Afshar, Frederic Leone, Camille Dussault, Mark Stoove, Julian Savulescu, Josiah D. Rich, Daniel H. Rowan, Julia Sheehan, Nadine Kronfli

Methodological Impasses: Facing Interrogation and Silence While Gathering Data on Sexual Violence in India

January 2024 | Political Science and Politics | Authors: Aditi Malik and Poulami Roychowdhury

Descriptive Analysis of Community Based Needs among Asylum Seekers in the Greater Rhode Island Area before and after COVID-19: Evidence from a Student-Run Asylum Clinic

January 2024 | Journal of Human Rights Practice | Authors: Victoria Angenent-Mari, Viknesh S. Kasthuri, Hannah Montoya, Elizabeth Toll

Mental Health Consultations in Immigration Detention: What Can We Learn From Clinical Records?

January 2024 | International Journal of Public Health | Authors: Leonel C. Gonçalves, Patrick Heller, Anne-Claire B. Bachmann, Jonathan Barbolini, Clara Fuhrer, Laurent Gétaz, Eric Luke, Hans Wolff, Stéphanie Baggio

Gender identity as a barrier to accesing adequate and inclusive healthcare for Syrian refugees in Lebanon's Northern regions

January 2024 | Fontiers in Human Dynamics | Authors: Jasmin Lilian Diab, Bechara Samneh, Dima Masoud, Kathleen Cravero

Understanding the Materiality of Disaster Injustice in Post-disaster Housing Reconstruction

December 2023 | Philippine Studies: Historical and Ethnographic Viewpoints | Authors: Pamela Gloria Cajilig, Monica F.A.W. Santos, Simon Cervantes, Olivia Alma G. Sicam

Civil-Military Coordination in Disaster Response

2024 | Ciottone's Disaster Medicine | Authors: Michael F. Court, David P. Polatty, Simon T. Horne

Diagnostic Accuracry of the World Health Organization Pediatric Emergency Triage, Assessment and Treatment Tool Plus Among Patients Seeking Care in Nairobi, Kenya

December 2023 | Pediatric Emergency Care | Authors: Chen, Josephine; Aluisio, Adam R. MD, MSc, DTM&H; Tang, Oliver Y. BS; Nwakibu, Uzoma A. MD; Hunold, Katherine M. MD; Wangara, Ali Akida BSc, MPH; Kiruja, Jason BSc, MSc; Maingi, Alice MBChB, MSc; Mutiso, Vincent MBChB, MMed (Surgery); Thompson, Peyton MD, MSCR; Wachira, Benjamin MBChB, FCEM(SA); Dunlop, Stephen J. MD, MPH, CtropMed; Martin, Ian B.K. MD, MBA; Myers, Justin G. DO, MPH

Leveraging emergency care to reach key populations for 'the last mile' in HIV programming: a waiting opportunity

December 2023 | AIDS. | Authors: Smith-Sreen, Joshua; Bosire, Rose; Farquhar, Carey; Katz, David A.; Kimani, Joshua; Masyuko, Sarah; Mello, Michael J.; Aluisio, Adam R.

Interventions to Counter Misinformation: Lessons from the Global North and Applications to the Global South

November 2023 | Current Opinion in Psychology | Authors: Robert Blair, Jessica Gottlieb, Brendan Nyhan, Laura Paler, Pablo Argote, Charlene Stainfield

Prevalence of non-communicable disease among displaced Rohingya in southern Bangladesh: a first look at a persecuted ethnic minority from Myanmar

November 2023 | International Health | Authors: Jason T Tsichlis, Ipsita Hamid Trisha, Ghazal Aghagoli, Meerjady Sabrina Flora, M Ruhul Abid

Integrating long-acting injectable treatment to improve medication adherence among persons living with HIV and opioid use disorder: study protocol

October 2023 | Addiction Science and Clinical Practice | Authors: Kirsten J Langdon, Anthony E Hitch, Alexandra B Collins, Curt G Beckwith, Sara Becker, Karen Tashima, Josiah D Rich

A comparison of the NIRUDAK models and WHO algorithm for dehydration assessment in older children and adults with acute diarrhoea: a prospective, observational study

September 2023 | The Lancet Global Health | Authors: Adam C Levine, Monique Gainey, Kexin Qu, Sabiha Nasrin, Mohsena Bint-E Sharif, Syada S Noor, Meagan A Barry, Stephanie C Garbern, Christopher H Schmid, Rochelle K Rosen, Eric J Nelson, Nur H Alam

The role of civil society organizations (CSOs) in the COVID-19 response across the Global South: A mulitnational, qualitative study

September 2023 | Public Library of Science (PLOS) Global Public Health | Authors: Adam C. Levine, Anna Park, Anindita Adhikari, Maria Carinnes P. Alejandria, Benjamin H. Bradlow, Maria F. Lopez-Portillo, Salma Mutwafy, Ieva Zumbyte, Patrick Heller

Designing Ethically-Integrated Assignments: It's Harder Than it Looks

August 2023 | ICER | Authors: Noelle Brown, Koriann South, Suresh Venkatasubramanian, Eliane S. Wiese

Civil-Military Engagement During Public Health Emergencies: A Comparative Analysis of Domestic Responses to COVID-19

August 2023 | Stability: International Journal of Security & Development | Authors: Samuel Boland, Rob Grace, and Josiah Kaplan

Derivation and External Validation of a Clinical Prediction Model for Viral Diarrhea Etiology in Bangladesh

July 2023 | Open Forum Infectious Diseases | Authors: Stephanie Chow Garbern, Md Taufiqul Islam, Kamrul Islam, Sharia M Ahmed, Ben J Brintz, Ashraful Islam Khan, Mami Taniuchi, James A Platts-Mills, Firdausi Qadri, Daniel T Leung

Implementation and Evaluation of the WHO Basic Emergency Care Course in Rwanda

July 2023 | Prehospital and Disaster Medicine: Cambridge University Press | Authors: Ramu Kharel, Nidhi Kadakia, Iju Shakya, John Lee, Maria Diaz, Pascal Mugemangago, Vincent Ndebwanimana, Naz Karim

The Rich Have Peers, the Poor Have Patrons: Engaging the State in a South Indian City

July 2023 | American Journal of Sociology | Authors: Patrick Heller, Siddharth Swaminathan, Ashutosh Varshney

Ebola vaccine uptake and attitudes among healthcare workers in North Kivu, Democratic Republic of the Congo, 2021

July 2023 | Front Public Health | Authors: Doshi RH, Garbern SC, Kulkarni S, Perera SM, Fleming MK, Muhayangabo RF, Ombeni AB, Tchoualeu DD, Kallay R, Song E, Powell J, Gainey M, Glenn B, Mutumwa RM, Hans Bateyi Mustafa S, Earle-Richardson G, Gao H, Abad N, Soke GN, Fitter DL, Hyde TB, Prybylski D, Levine AC, Jalloh MF, Mbong EN

Measuring and mitigating voting access disparities: a study of race and polling locations in Florida and North Carolina

June 2023 | American Journal of Sociology | Authors: Mohsen Abbasi, Calvin Barrett, Kristian Lum, Sorelle Friedler, Suresh Venkatasubramanian

Parties, Civil Society and Democratic Deepening: Comparing India, Brazil and South Africa

June 2023 | Studies in Indian Politics | Author: Patrick Heller

COVID-19 Vaccine Perceptions among Ebola-Affected Communities in North Kivu, Democratic Republic of the Congo, 2021

May 2023 | Vaccines (Basel) | Authors: Garbern SC, Perera SM, Mbong EN, Kulkarni S, Fleming MK, Ombeni AB, Muhayangabo RF, Tchoualeu DD, Kallay R, Song E, Powell J, Gainey M, Glenn B, Gao H, Mutumwa RM, Mustafa SHB, Abad N, Soke GN, Prybylski D, Doshi RH, Fukunaga R, Levine AC

Staying Power: Strategies for Weathering Criminal Violence in Marginal Neighborhoods of Medellín and Monterrey

April 2023 | Latin American Research Review | Authors: Rebecca Bell-Martin and Jerome F. Marston Jr.

Post COVID-19 Test Score Recovery: Initial Evidence from State Testing Data

April 2023 | National Bureau of Economic Research | Authors: Clare Halloran, Claire E Hug, Rebecca Jack, Emily Oster

Health Care in US Correctional Facilities - A Limited and Threatened Constitutional Right

March 2023 | New England Journal of Medicine | Authors: Marcella Alsan, Crystal S Yang, James R Jolin, Lucy Tu, Josiah D Rich

Utopias Latino-Americanas: Polıtica, Sociedade, Cultura

March 2023 | Hispanic American Historical Review | Authors: James N Green

Attitudes of US Emergency Medicine Program Directors Towards the Integration of Climate Change and Sustainability in Emergency Medicine Residency Curricula

February 2023 | The Journal of Climate Change and Health | Authors: Katelyn Moretti, Caitlin Rublee, Lauren Robison, Adam Aluisio, Benjamin Gallo Marin, Timothy McMurry, Amita Sudhir

Moving Humanitarian‑Military Relations Forward: A New Typology

February 2023 | Journal of International Humanitarian Action | Authors: Rob Grace, Maria Carrines Alejandria, Madison Bates, Samuel T. Boland, Alexandria J. Nylen, Zein Tayyeb, and Adam Levine

All Journal Articles >

Modelling climate impacts on paediatric sepsis incidence and severity in Bangladesh

“Yeah, this is not going to work for me”–The impact of federal policy restrictions on methadone continuation upon release from jail or prison