Civil-military relations: a review of major guidelines and their relevance during public health emergencies

Abstract

The operational and policy complexity of civil-military relations (CMR) during public health emergencies, especially those involving militaries from outside the state concerned, is addressed in several guiding international documents. Generally, these documents reflect humanitarian perspectives and doctrine at the time of their drafting, and primarily address foreign military involvement in natural and humanitarian disasters. However, in the past decade, there have been significant changes in the geopolitical environment and global health landscapes. Foreign militaries have been increasingly deployed to public health emergencies with responses grounded in public health (rather than humanitarian) approaches, while public health issues are of increasing importance in other deployments. This paper reviews key international policy documents that regulate, guide or otherwise inform CMR in the context of recent events involving international CMR during public health emergency responses, grounded in analysis of a March 2017 Chatham House roundtable event on the subject. Major thematic concerns regarding the application of existing CMR guiding documents to public health emergencies became evident. These include a lack of consideration of public health factors as distinct from a humanitarian approach; the assertion of state sovereignty vis-à-vis the deployment of national militaries; the emergence of new armed, military and security groups and a lack of consensus surrounding the ‘principle of last resort’. These criticisms and gaps—in particular, a consideration for public health contexts and approaches therein—should form the basis of future CMR drafting or revision processes to ensure effective, safe, and sustainable CMR during public health emergency response.

Civil–military cooperation in the early response to the COVID-19 pandemic in six European countries

“…The topic of civil-military relations during public health emergencies has tended to focus on the relationship between international armed forces (including military medical services) and humanitarian actors on overseas intervention operations. 1 While there has been increased emphasis on the importance of national resilience and civil preparedness as a component of national security, this has been perceived to be a civilian responsibility with military support as a last resort. 2 The COVID-19 pandemic has presented many countries with significant challenges and extensive system-wide effects across their society.…”

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

“…There are, however, a number of distinct factors in how militaries and civilians interact in the context of epidemics. 5 In most disease outbreak contexts, the WHO draw on their World Health Emergencies Programme (HEP) rosters, relying on deployments of an international experts. Yet the pandemic nature of COVID-19 highlights a fundamental aw in this structure: as the crisis drew these experts back into their domestic contexts, this resource-a core component of the international architecture developed to respond to disease outbreaks-was unavailable at precisely the time it was needed most.…”

“…In turn, principle-based guidance surrounding CME and best-practice-at both international and domestic levels, and as speci c to individual humanitarian agencies-focuses predominantly on marking boundaries and setting parameters for these speci c areas of engagement. 5 In practice, however, there is a much wider range of modalities in which militaries and civilians interact and exchange support during emergencies. This point is clearly evidenced during the COVID-19 response worldwide as militaries have engaged in these activities across the full range of operational contexts from complex emergencies to stable democracies.…”

“…There is a need, however, for further critical analysis of how applicable such premises and assumptions are to public health emergencies as a speci c form of disaster-which, while sharing many similarities to humanitarian crises, are more consistently de ned by domestic-led responses that entail state civilian leadership, robust military involvement, and sometimes a subordinate role for civil society. 5 All three contexts-China, UK, and the Philippines-are distinct from one another. The Philippines, even before COVID-19, was an ongoing humanitarian response context in which responders have directly referenced CMCoord principles.…”

“…Various sets of principles-notably those of the United Nations O ce for the Coordination of Humanitarian Affairs (UN OCHA)-exist for bounding the role that international military forces play in supporting civilian actors during humanitarian responses activities. 5 These principles aim to maintain overall civilian direction of the response, and ensure that international military contributions are deployed in concordance with established humanitarian principles and as a 'last resort'. 6 But in the case of domestic military support within a country's own public health emergency response, these principles do not necessarily apply.…”