As a component of the U.S. Army Medical Research and Materiel Command (USAMRMC), the Walter Reed Army Institute of Research (WRAIR) maintains four special foreign activities: the U.S. Army Medical Research Unit-Kenya (USAMRU-K) in Nairobi, Kenya; the U.S. Army Medical Component-Armed Forces Research Institute of Medical Sciences (AFRIMS) in Bangkok, Thailand; the U.S. Army Medical Research Unit-Europe (USAMRU-E) in Sembach, Germany; and the newest laboratory, the U.S. Army Medical Research Unit-Georgia (USAMRU-G) in Tbilisi, Georgia.

The laboratories in Kenya, Thailand, and Georgia are dedicated to research on infectious diseases that both endanger U.S. military personnel overseas and are of concern to the host nation. Each also pursues some research unique to its geographic region, but all focus on research related to stresses and exposures U.S. troops encounter and the performance requirements of a deployed military force. The laboratory in Germany is focused on behavioral health and resilience of the warfighter. All WRAIR overseas units are located in host-nation facilities except USAMRU-E, which is located on a U.S. military base in Sembach.

“With any overseas site, we’re there with the support of the host nation and the U.S. embassy. There have been other labs, such as Brazil, that no longer exist. There also are places where we don’t have official labs but do have some kind of field operations,” Col. Jamie Blow, military deputy to the principal assistant for Research and Technology-MRMC, explained.

“Our missions are determined by the U.S. Army and the WRAIR commander. We do collaborate with our host nation partners, such as the Georgia National Center for Disease Control [NCDC], and respond to requests for assistance from them – if we can find funding and it fits within our mission scope.” WRAIR’s oldest – and still primary – effort to combat infectious diseases is overseen by the military infectious disease research program and the military operational medicine research program, along with GEIS (Global Emerging Infections Surveillance and Response System) for the labs in Kenya, Thailand, and Georgia.

The work performed by each laboratory typically extends to smaller field sites in neighboring countries, Director of Overseas Operations Lt. Col. Jennifer Chapman added. “We execute PEPFAR [President’s Emergency Plan for AIDS Relief] and biosurveillance activities in Kenya and other areas of Africa, such as Uganda, Tanzania, and Cameroon,” Chapman said. “In each of our labs, we have regional assets and agreements, which we are establishing in Georgia for the Caucasus region, for example.”

WRAIR’s two primary goals are to advance research and, especially OCONUS (outside the continental United States), to improve the capacity and medical capabilities of the host nation.

WRAIR’s commander, Col. Steven Braverman, said the institute is designed to evolve as mission requirements evolve, such as the higher priority given traumatic brain injury (TBI) research as a result of the wars in Iraq and Afghanistan and relatively new efforts involving behavioral health of the force, intended to help inform commanders about small unit resiliency, for both training and combat operations.

WRAIR’s two primary goals are to advance research and, especially OCONUS (outside the continental United States), to improve the capacity and medical capabilities of the host nation. As a result, he added, studies done in Cambodia or Kenya are designed to ensure they will benefit the people of the host nations and help those nations build their own structures and capacities. That helps build bridges, both medically and diplomatically, with WRAIR’s partner nations.

Behavioral studies in Germany are more directly focused on U.S. and allied service members, but still are representative of WRAIR’s global scope.

 

Armed Forces Research Institute of Medical Sciences-Thailand

AFRIMS-Thailand is the oldest, largest, and most geographically dispersed of the overseas commands. Founded in 1959 as a SEATO (Southeast Asia Treaty Organization) laboratory to help combat a cholera outbreak, it was renamed AFRIMS in 1977 and given a broader mandate in tropical infectious disease research and development. Since then, it has acquired new disease research missions and been refocused many times to meet new challenges.

The largest component of WRAIR, it comprises about one-quarter of the institute’s 2,000 personnel. The overall command of AFRIMS is held by a Royal Thai Army general officer. There are two components to AFRIMS; the U.S. Army Medical Component-AFRIMS (USAMC-AFRIMS) works alongside the Royal Thai Army Component AFRIMS. The USAMC-AFRIMS has a relatively small staff of U.S. military personnel and most of the USAMC-AFRIMS employees are local nationals with many of them being M.Ds. or Ph.Ds.

“It is a unique relationship because the Royal Thai Army really views us as part of their organization,” said Col. William E. Geesey, the USAMC-AFRIMS’ first commander with a non-science (medical logistics) background. “We do collaborate with them on a number of different projects in different areas, but they have other projects, as well – such as drug tests of their military forces. And about 80 percent of our programs also are independent.

“All of our activities fall under the purview of WRAIR. We also work under the Chief of Mission authority of the U.S. Embassy Bangkok. We work with the country team in Thailand and other countries in the region to advance not only the [U.S.] Army’s goals of investigating infectious diseases and disease surveillance, but also to advance overall U.S. government strategy through military-to-military and military-to-civilian relationships that fall within our assigned missions.”