The XX Committee

The Ebola Crisis and Medical Intelligence

There’s now no denying that West Africa’s Ebola outbreak has become a global crisis. After months of downplaying the threat, Western governments are facing the painful fact that the situation is deteriorating fast. It’s now plain to see that the world is at the precipice of something genuinely awful, with official predictions of more than a million new infections by the new year. Given that the death rate among those infected with Ebola is roughly fifty percent — and a good deal higher in underdeveloped regions like West Africa — serious concern is warranted.

Now that a Liberian visitor has brought Ebola to American shores, the assurances of officials that the situation is “under control” are being viewed skeptically by many. Our self-reporting system for preventing diseases entering the United States has failed, and investigators are reaching out to a hundred or more travelers who might have been exposed to Ebola as Thomas Duncan made his way from Liberia to Texas.

The White House is facing awkward questions about the crisis, with even the reliably liberal Chris Matthews repeatedly lambasting President Obama for low-balling the Ebola threat to the public, in an “effort to try to downplay concerns at the expense of being a truth-teller.” Now that Ebola as become a domestic, not just foreign issue, Americans are paying attention more, and many don’t like what they see.

Then there’s the reality that the White House’s much-ballyhooed efforts to fight Ebola in Africa aren’t faring so well. While this has much to do with the chaos that is shaking West Africa due to the outbreak, to say nothing of that region’s weak medical infrastructure, nobody in the West Wing will welcome headlines in The New York Times asserting that America’s anti-Ebola campaign is “barely off the ground”. Like George W. Bush in Iraq, Barack Obama has sent the U.S. military into a deteriorating situation, in a misplaced belief that the powerful Pentagon can work magic.

Fortunately for the Department of Defense (DoD), it possesses the only full-fledged medical intelligence outfit on earth. That’s the decidedly unique National Center for Medical Intelligence (NCMI), a component of the Defense Intelligence Agency (DIA) that’s located at Fort Detrick, Maryland. It’s been around, in one guise or another, since the Second World War, doing intelligence analysis of medical threats to the American military. DIA was given the medical intelligence mission in 1963, and since 1979 it’s resided at Fort Detrick (which, if you believe one of the better-known KGB disinformation operations, is where DoD invented AIDS). It was known as the Armed Forces Medical Intelligence Center (AFMIC) for years, being rebranded as NCMI in 2008, getting a $7.8 million facility upgrade two years later, since the agency had outgrown its spaces; in a typical Intelligence Community story, NCMI lacked sufficient office space and, critically, parking for its 150 staffers.

NCMI is made up of personnel from all the armed services plus DoD civilians. Many are doctors of various sorts, both M.D.s and Ph.D.s, specializing in the full range of relevant disciplines, above all epidemiology. Its mission is producing medical intelligence (known, of course, as MEDINT for short), which is defined by the Pentagon as:

That category of intelligence resulting from collection, evaluation, analysis, and interpretation of foreign medical, bio-scientific, and environmental information that is of interest to strategic planning and to military medical planning and operations for the conservation of the fighting strength of friendly forces and the formation of assessments of foreign medical capabilities in both military and civilian sectors. 

In English, this means that NCMI tracks medical threats to the U.S. military and, more broadly, the United States. The Pentagon every day sends men and women into regions teeming with weird and often deadly diseases that are seldom encountered in the developed world, and it’s NCMI’s job to provide senior military and civilian decision-makers the specialized intelligence they need to understand and mitigate these threats.

This isn’t a bunch of 007s in lab coats. NCMI is made up of analysts, not collectors, and most of them are medical professionals who learn the intelligence trade, not the other way around. As NCMI’s director explained in 2012, “We take these very smart people and turn them into intelligence officers.” This center, while tiny by the standards of America’s vast seventeen-agency Intelligence Community, punches well above its weight, partnering closely with many IC agencies — there are liaison officers from the whole range of IC alphabet-soup agencies at NCMI, while they send experts out to work at those agencies in return — as well as a wide range of U.S. Government entities, including the Department of Agriculture and especially the Centers for Disease Control, who have fully cleared people embedded at Fort Detrick to facilitate collaboration and information-sharing.

As an all-source intelligence analysis organization, NCMI is dependent on raw intelligence provided by other agencies — signals intelligence and satellite imagery, especially — as well as open-source reporting from many places. Surprising as it may sound to many Americans, the National Security Agency, the Central Intelligence Agency, and the National Geospatial-intelligence Agency, among others, have longstanding intelligence requirements for things such as disease and epidemics, and it’s the job of NCMI to make sense of what’s coming in, since there aren’t many epidemiologists working at Langley or Fort Meade.

While NCMI puts out some very detailed and specialized reporting, it also provides DoD and the IC with assessments that, I can attest, are written in refreshingly normal English, since the average consumer of medical intelligence isn’t a medical professional, but a layperson who needs to understand the complex issues. NCMI has worried about Ebola for a long time, and here its Infectious Disease Division, which assesses potential epidemics in literally every country on earth, walks point.

We can be assured that NCMI is providing Washington, DC, with detailed medical intelligence about the nature of the Ebola threat, both in West Africa and to the American homeland. This is vitally important, given the remote yet extant possibility that Ebola might mutate and be transmitted in any airborne fashion, which represents every epidemiologist’s nightmare scenario. No doubt NCMI has some classified assessments on that too.

So far, America has been spared serious worry about Ebola, and let’s hope that remains so. But hope is not a strategy, as every wise strategist knows, and we must soon begin contemplating unpleasant things like quarantines and travel bans to stave off catastrophe. Here NCMI and its medical intelligence will be critical to decision-makers in Washington, DC. Given recent revelations indicating a cavalier attitude towards intelligence in the Obama White House, let’s hope that NCMI reports are making their way to the highest levels of our government, and are being read closely.



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