The Defense Threat Reduction Agency at Fort Belvoir, VA is awarding contracts to find new anti-viral compounds that are effective against hemorrhagic fever viruses, a class that includes Ebola et. al.

DID would caution readers that drug development is a long and expensive process ($100 million is often mentioned as the table stakes to get a drug through approvals), and that promising therapies don’t all make it through the research and testing stages. Even so, we think the research is interesting, and worth our time to share and explain. The latest award is a contract to research a treatment called “Bavituximab.” DID explains that, and more, below…

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Walsh Construction in Chicago, IL received a $71.6 million firm-fixed price contract to build a 4-story addition to the James A. Lovell Federal Health Care Center in North Chicago, IL. The work also provides for some demolition and renovation work for tie-in connections to the VA Medical Center in North Chicago, IL.

The new center is the result of merging the North Chicago VA Medical Center and the Great Lakes Naval Hospital. The USA’s first joint Veterans Affairs (VA)/Navy care facility is scheduled to open in 2010, and will care for nearly 100,000 veterans, sailors, retirees and family members. The project was originally a $130 million joint initiative, and is named after astronaut and Chicago native Jim Lovell. Most people know him as the commander of the “Houston, we have a problem” Apollo 13 mission, but he was also the command pilot of Apollo 8, the first Apollo mission to enter lunar orbit. Lovell is a recipient of the Congressional Space Medal of Honor and the Presidential Medal of Freedom.

Work will be performed in North Chicago, Ill., and is expected to be complete by July 2010. This contract was competitively procured via the Navy Electronic Commerce Online website, with 3 proposals received by the Naval Facilities Engineering Command, Midwest in Great Lakes, IL (N40083-08-C-0059).

Satterfield & Pontikes Construction, Inc. in Houston, TX received a $33.4 million firm-fixed price contract to build a primary health care clinic at Fort Sam Houston near San Antonio, TX. Work is expected to be complete by Jan 30/10. Fort Sam Houston is named for the former Republic of Texas’ first President, and its tenants include US Army Medical Command (MEDCOM).

Contract funds will not expire at the end of the current fiscal year. Web bids were solicited on Feb. 14, 2008, and four bids were received. U.S. Army Engineer District, Fort Worth, TX manages this contract (W9126G-08-C-0024).

The USA’s Mine-Resistant, Ambush Protected (MRAP) program has been a long road for BAE Systems. In the wake of the US Army’s belated realization that mine protection was critical for vehicles in theater, BAE’s designs, long-standing experience in the field, and production capacity had made them an early favorite. By June 20/07, however, contracts had been issued for 3,266 Category I patrol & Category II squad-sized MRAP vehicles, fully 42% of a the program’s planned 7,774 orders. Force Protection had racked up orders for 1,780 Cougar vehicles, and Navistar/Plasan Sasa had come out of the tests at Aberdeen with orders for 1,216 of its MaxxPro joint design. BAE sat in 4th place with orders for just 90 vehicles – 2.8% of the total. It had to be a humbling experience for the firm that went into 2004 as the world leader in the field.

BAE has worked hard to catch up, and recent contracts have put them solidly back into the competition, even as the number of MRAPs in the program has expanded. The latest orders widen their lead over 3rd place firm Force Protection, and make them one of just 2 firms with a foothold under the new MRAP-II qualifications. MRAP-II includes protection against EFP (explosively-formed projectile) land mines that fire the equivalent of a cannon shell at the vehicle, in addition to the standard underbody blasts. Meanwhile, BAE continues to receive maintenance contracts, and a significant contract for engineering changes to its designs…

• BAE MRAP: The Vehicles
• BAE MRAP: The Current Tally
• BAE MRAP: Contracts & Key Events [updated]
• Appendix A: MRAP Competition Half-Time Update, June 28/07
  
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Few of us would argue that soldiers returning from the battlefield deserve treatment for stress as well as wounds, as a moral obligation. Not to mention preventative programs and techniques similar to those discussed in Grossman’s On Combat book and “Bulletproof Mind” presentations, Richard Strozzi-Heckler’s work in SOCOM’s Trojan Warrior Project (1980s) and the Marine Martial Arts Program, et. al.

DID has covered a number of programs and issues related to soldier medical care. When analyzing current or proposed situations, however, it helps to know some math. This is true for all military programs, and it is true here. Since DID often provides statistics, and the issue appears to be current, we offer these:

If Bloomberg news is correct, 1.6 million American troops have been to Iraq or Afghanistan during this war, and about 4,560 have died to this point. If those 1.6 million people have exactly the same rate of suicide as the general population for the rest of their lives, the national rate of suicide in 2005 for ages 15 and up was 13.14 per 100,000. Assume that the average age of the soldiers is 30, and a conservative estimate gives them 40 years of exposure to the risk of suicide. 1.6 million x (13.14/100,000) x 40 years = 8,409 suicides at rates exactly equivalent to the American population as a whole. Versus about 4,560 killed so far in almost 7 years of combat. Media coverage that is surprised by this casualty comparison, and portrays soldiers as generally unbalanced on that basis, opens itself to serious professional questions. Perhaps enlistments in Raytheon’s Math Moves U program could be arranged.

You would also wish to know military statistics for suicide, of course (17.3/100,000 overall, 19.9/100,000 for those serving in Iraq and Afghanistan), as well as general population statistics for men age 20-44 (21.82/100,000) and women age 20-44 (5.54/100,000) per 2004/05 figures. Adjusted for US military figures of 17% women, an equivalent general American population would have a near-term annual suicide rate of 19.06 per 100,000.

Genetic Chemistry, Inc. in Palo Alto, CA received a $6 million cost-plus-fixed-fee contract for “research to develop countermeasures to an intercellular bio threat agent.”

Work will be performed in Palo Alto, CA and is expected to be complete by July 28/11. Multiple bids were solicited in October 2006, and 1 bid was received by the Research, Development & Engineering Command Acquisition Center in Research Triangle Park, NC (W911NF-08-C-0023).

The US Department of Defense’s prescription drug spending alone is estimated to reach $15 billion by 2015. GAO examined DOD’s prescription drug spending trends from fiscal years 2000 – 2006 and DOD’s key efforts to limit its prescription drug spending at retail pharmacies, military treatment facilities (MTF), and the TRICARE Mail Order Pharmacy (TMOP). That spending more than tripled to $6.2 billion in 2006 from $1.6 billion in fiscal year 2000, and retail pharmacy spending drove most of this increase with a $3.4 billion. Part of the issue is that more people arer using more costly retail pharmacies instead of MTFs or mail order, and so the US DoD has used a variety of techniques to try and slow that cost growth.

Report #GAO-08-327, “DOD Pharmacy Program: Continued Efforts Needed to Reduce Growth in Spending at Retail Pharmacies,” goes into more detail regarding these issues, and the solutions being tried, from pharmacy rebates, to outreach efforts like the Member Choice Center, to initiatives aimed at changing copayment policies to provide the right incentives. See also “TRICARE Trials & Tribulations,” which places prescription drug costs within a much larger issue of US military medical costs more generally.

US aeromedical evacuation has changed. Forward-based units or helicopters are still the primary link from the battlefield during the “golden hour” that follows major trauma. Once a patient has been stabilized, however, more advanced care at more advanced facilities may be needed. For several decades, the USA had a fleet of dedicated aircraft, the last being its DC-9 derived C-9A “Florence Nightningale” fleet. In its place is a new approach devised by USAF Lt. Gen. Paul K. Carlton Jr., the Air Force surgeon general until 2002. The idea is that every USAF Air Mobility Command aircraft can become an aeromedical aircraft, as newly arrived aircraft on the tarmac are loaded with about 800 pounds of gear and supplies per patient and diverted to hospitals like Landstuhl in Germany. Instead of waiting for days to stabilize a patient, outbound flights are sometimes coordinated while a patient is still in surgery. The result? Lower average cargo volume and weight statistics for US transport aircraft missions, and a 90% survival rate for troops injured in current operations. In Operation Desert Storm in 1991, the rate was about 75%.

On to the next step in quality improvement, which could have significant implications for civilian disasters as well. USAF aircraft without organic litter systems rely on the patient support pallet (PSP), whose weight and bulk make it heavily reliant on cargo handling equipment for loading and unloading. This assumes the PSP is even present with the evacuation crew, of course; if not, additional stops will be required to pick up the equipment. In an age of rising fuel prices, those side-trips get very expensive, and time is always of the essence.

Enter the Air Mobility Battlelab. They were established in 2001, and will deactivate in September 2008 as part of a USAF cost-savings initiative. Before they go, however, they’re developing an idea that might solve these problems…

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Brain injuries have become a focus of study and controversy received during the current war. This is partly the result of improved detection and understanding of maladies whose symptoms are sometimes subtle, and can be mistaken for purely psychological maladies. It is also partly the result of enemies whose primary tactical approach is land mine warfare. When these go off, they have a tendency to throw vehicles around pretty hard. Being slammed against the top or side of one’s vehicle leads to concussions, and sometimes to brain injuries. US veterans have been pushing for more work and funding in this area in order to help soldiers who have encountered this hazard, and to improve the future design of equipment and vehicles.

Henry M. “Scoop” Jackson was a US Senator [D-WA], who was known as one of the most consistent supporters of a powerful US military and a strong anti-communist foreign policy within his party. He was also known as a smart lawmaker who authored the National Environmental Policy Act, was a key player in the grant of statehood to Alaska and Hawaii, strongly supported the US submarine fleet, and sought his party’s nomination for President in 1972 & 1976. With the shift of USS Ohio and three other ballistic missile submarines to SSGN special forces and conventional strike roles, the lead sub of the US Trident fleet is now the SSBN 730 Henry M Jackson based in Bangor, WA. His legacy is also continued by the The Henry M. Jackson Foundation for the Advancement of Military Medicines...

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Carothers Construction Inc. in Water Valley, MS received a $10.1 million firm-fixed-price contract for construction of a diagnostic imaging center radiology oncology clinic at Keesler Air Force Base. This project will provide an elevated one-story steel frame and concrete addition on pile foundation, with a concrete slab, concrete and glass exterior, a modified bitumen roof, and all mechanical and electrical systems. The facility will be an adequately sized, efficient, modern, hurricane-protected Diagnostic Imaging Center for the Radiation Oncology Clinic to serve the eligible personnel in the Biloxi/Gulfport MS area, with a connector to the existing hospital.

Work will be performed in Biloxi, MS, and is expected to be complete by September 2009. This contract was competitively procured via the Naval Facilities Engineering Command e-solicitation website, with 5 proposals received by the Naval Facilities Engineering Command, Southeast in Jacksonville, FL (N69450-08-C-0758).