1. 4th GHSA Ministerial Meeting, Kampala, Uganda October 2017 Panel Discussion: Role of Security and Defence in GHSA
Colonel Jeremy Tuck
CBE, MBBS, MSc, MRCGP, FFPH, FIHM
Chief of Staff
Director Medical Policy, Operations and Capability
HQ Surgeon General, United Kingdom MOD

2. OVERVIEW Security and Defence in GHSA UK Comprehensive Approach
Vignette – Ebola in Sierra Leone
Questions/Possible areas for discussion.

3. Security and Defence in GHSA
Is there a role for Security and Defence in GHSA?
What can Defence and Security Bring to GHSA?
Building prior relationships by using a range of specialists who can contribute to capacity building and systems strengthening through Defence Engagement.
An ability to respond to emerging crises with range of capabilities held at readiness eg Co-ordination, Communication, Information, Aviation, Logistics, Engineers, Medical.
Physical security? Certainly has the capability to maintain/restore security but would the recipient want/accept it and would the donor offer it in the first instance?

4. Security and Defence in GHSA
What might the barriers be to Defence and Security in GHSA?
The more “reactive” capability you want, the longer it takes to bring on line – and there is finite limit on what can be offered and for how long.
Not routinely geared to high volume/low tech “reactive” events but good at high volume/low tech Defence Engagement.
Other National considerations - Other military commitments, permissive/non-permissive environment, diplomatic, etc.
Other actors – State, Commercial, Not for profit/charity/third sector.
Traditional working boundaries and vested interests. “Information is power”.
Money! Everyone needs it. Everyone wants more. There is never enough.

5. UK Comprehensive Approach
A model embedded in Defence and wider Government for stakeholder integration in planning and delivery of UK strategic objectives.
Calls for cross Government inputs eg UK Cabinet Office, Foreign Office, Home Office, Department of Health, Ministry of Defence.
Seeks to ensure cross government consensus and avoid duplication of effort or missing important issues.
Works well in the UK because all the major departments of State are co-terminus. Local issues are subordinate to the National. While there are frictions, National Government trumps Local.

6. Vignette – Ebola in Sierra Leone 2014/15
Principal Stakeholders – People and Government of Sierra Leone
UK Stakeholders.
Cabinet Office
Department for International Development.
Foreign and Commonwealth Office.
Department of Health.
Home Office.
Ministry of Defence.
Revenue and Taxes.
Other Stakeholders.
International.
Charity sector.
Commercial Sector.
Media.

7. Vignette – Ebola in Sierra Leone 2014/15
UK Response.
Joint Interagency Task Force (JIATF) led by Department for International Development (DfID) supported by Foreign and Commonwealth Office.
Deployed JIATF HQ underpinned by a UK Joint Logistics HQ from the UK MoD.
Original intent:
Support the Government of Sierra Leone National Ebola Response Centre – the importance of prior relationships.
Build a high level treatment centre run by the UK Defence Medical Services located with a UK funded treatment centre run by Save the Children.
Deploy a non-Ebola facing patient care pathway to manage other threats to health and wellbeing (Road traffic crash, malaria, gastro intestinal illness) for
Added task to design and enable the build of 5 additional treatment centres to be run by Sierra Leonean healthcare providers and international healthcare providers from the commercial and not for profit sectors. Logistics to be led by DfID.
UK Military capability: Command (co-ordination), Communications, Engineers, Information management, Medical (Ebola facing and non-Ebola facing, Aviation, Strategic Evacuation of contacts and cases.

8. Questions? What is the security requirement?
What are the views on the growing presence of the commercial sector in GHSA?
Capacity building and systems strengthening or response/ reaction? Or both?