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.




21 comments on “The Ebola Crisis and Medical Intelligence”
  1. I am not worried, neither should you be. After all, it’s just a “JV” virus!

  2. Airwalk says:

    Hope we don’t see something like in “The Last Ship”.
    Thanks again John. Your expertise is much appreciated. Wasn’t aware of MEDINT as such.

    1. 20committee says:

      Thanks for your feedback, much appreciated!

  3. hollyasbury says:

    Very interesting post – great info.

  4. mrmeangenes says:

    Reblogged this on mrmeangenes and commented:
    Extremely interesting information !!

  5. Homer Simpson says:

    Good post – I wasn’t aware of MEDINT before either.

  6. Blackshoe says:

    It’s nicely given the media something to freak out about, though. Norah O’Donnell was nicely put in her place by CBS’s in-house doctor; Norah asked about what the worst thing about Ebola in America being, and the doctor responded as sarcastically as possible for him “The situation in Africa”.

  7. Rob says:

    Unreal. How about deploying these troopers to local VA? We cannot even care for our own.. Our we going to give these troops pink slips after they come back too?

  8. Phineas Fahrquar says:

    Reblogged this on Public Secrets and commented:
    Here’s an article on an intelligence agency I’ve never heard of: the National Center for Medical Intelligence. Yes, a US Government intel agency devoted to medical threats to the US military — and, in the latest crisis, to the US itself, I’m sure. And I’ve no doubt there are at least a half-dozen development teams in Hollywood writing pitches for the “NCMI TV series” even now.

  9. MarqueG says:

    OT: John, is there any coherent — even marginally sane — policy to be found in this piece of reporting from Bill Gertz? I take as inspiration your Tweet-stream of last night, Oct. 6.

    How is this wimpy, post-modernist, PC, WEIRD-centric propaganda campaign supposed to counter a chauvinist, Islamic supremacist movement currently exciting so many identity-deprived individuals who are glad to hear they can let their most violent fantasies off leash in the name of God?

    1. 20committee says:

      This bespeaks a fundamental lack of seriousness in this White House (and, to be fair, in its predecessor to a large extent) about the struggle we are in. USG has no business telling anybody what Islam is (or isn’t) – why I cringe whenever any POTUS does that – but we deny the reality of jihadist ideology at our peril.

  10. xtmar says:

    Not related to this post, but I’m not sure if you’d seen this about the (sad) state of the German military. Perhaps this is part of what drives their policy with respect to Russia, since they can’t actually threaten anything realistically.

    View at

    1. 20committee says:

      Yes, my write-up on the sorry state of the Bundeswehr addressed this unfortunate situation.

  11. Wait&C says:

    You are wrong in one major point:

    Ebola does not need to be stopped by quarantine alone.

    Ebola just needs to be slowed down by quarantine until an antidote is available.

    There are already antidotes but yet these are too unreliable. With a bit of luck and cutting some legal corners we might see a viable antidote around christmas which then will need another two months for production. So starting from february on we will see a steady decline in new infections. Not much later but also not much sooner.

    Until then, keep an eye open, your hands clean and live a happy life.

    End of Story.

  12. fpman says:

    Great post!

    I also happen to have a question related to it. I’ve recently read through this report by the CDC:

    There they say that “A potential underreporting correction factor of 2.5 also was calculated.” When modelling what may happen and generating scenarios with such parameters in mind, may it be a typical assignment for NCMI to try and develop a better understanding of how much underreporting there may really be?

    CDC came to its assessment on the basis of the following calculations, apparently: “Substantial underreporting of cases might be occurring both in Liberia and Sierra Leone (7). To correct for underreporting, EbolaResponse was used to predict the number of beds in use on August 28, 2014. This number was then compared with the actual number of beds in use (from expert opinion estimates). The difference between the two estimates is the potential underreporting correction factor of 2.5.”

  13. Bob Agajeenian says:

    Today is October 16 – two weeks after this post. The situation does not seem to be getting any better. I sure hope our intelligence people have a better handle on what’s going on than the media seems to. Long time since a post – hope all’s well.

  14. Alex says:

    This article provides excellent information about government agencies dealing with infectious disease risks that I must admit I did not know before.

    I fear that political correctness, specifically a fear of being labelled as “racist,” would prevent the Obama Administration from responding with the proper measures to prevent or contain an Ebola outbreak, at least as far as immigration policy towards West Africa and the Caribbean goes.

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