Military Management Studies, Netherlands Defense Academy, Breda, Netherlands
Athena Institute, VU University Amsterdam, Amsterdam, Netherlands.
BMJ Glob Health. 2022 Jun;7(6). doi: 10.1136/bmjgh-2022-009228.
Civil-military cooperation (CMC) in infectious disease outbreak responses has become more common, and has its own cooperation dynamics. These collaborations fit WHO's call for multisectoral cooperation in managing health emergencies according to the emergency management cycle (EMC). However, the literature on CMC on this topic is fragmented. The core aim of this review is to understand the breadth and dynamics of this cooperation by using the EMC as a framework and by identifying challenges and opportunities in the management of outbreaks.
A scoping review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guideline was conducted. A systematic search for peer-reviewed journals was performed in PubMed, Embase, Web of Science and Scopus. Eligible papers addressed substantive contributions to the understanding of CMC. Papers were categorised by EMC phase and relevant information on study characteristics and areas of cooperation were extracted from the data. Recurring themes on challenges and opportunities in cooperation were identified by means of qualitative interpretation analysis.
The search resulted in 8360 papers; 54 were included for analysis. Most papers provided a review of activities or expert opinions. CMC was described in all EMC phases, with the fewest references in the recovery phase (n=1). In total, eight areas of CMC were explored. Regarding the better understanding of cooperative dynamics, the qualitative analysis of the papers yielded five recurring themes covering challenges and opportunities in CMC: managing relations, framework conditions, integrating collective activities, governance and civil-military differences.
Guided by these five themes, successful CMC requires sustainable relations, binding agreements, transparency, a clear operational perspective and acknowledgement of organisational cultural differences. Early and continuous engagement proves crucial to avoid distrust and tension among stakeholders, frequently caused by differences in strategical goals. Original research on this topic is limited.
军民合作（CMC）在传染病爆发应对中变得越来越普遍，并有其自身的合作动态。这些合作符合世卫组织根据紧急情况管理周期（EMC）呼吁多部门合作管理卫生紧急情况的要求。然而，关于这一主题的 CMC 文献却支离破碎。本综述的核心目的是通过使用 EMC 作为框架，了解这种合作的广度和动态，并确定在疫情管理方面的挑战和机遇。
根据系统评价和荟萃分析扩展的首选报告项目扩展进行了范围审查。在 PubMed、Embase、Web of Science 和 Scopus 中进行了系统的同行评审期刊搜索。符合条件的论文对理解 CMC 做出了实质性贡献。根据 EMC 阶段对论文进行分类，并从数据中提取关于研究特征和合作领域的相关信息。通过定性解释分析确定合作中挑战和机遇的反复出现的主题。
搜索结果产生了 8360 篇论文；其中 54 篇被纳入分析。大多数论文提供了对活动或专家意见的评论。CMC 在 EMC 的所有阶段都有描述，在恢复阶段（n=1）的参考文献最少。总共探索了 CMC 的八个领域。关于更好地了解合作动态，对论文的定性分析产生了五个反复出现的主题，涵盖了 CMC 中的挑战和机遇：管理关系、框架条件、整合集体活动、治理和军民差异。
在这五个主题的指导下，成功的 CMC 需要可持续的关系、有约束力的协议、透明度、明确的运营视角和承认组织文化差异。尽早和持续参与对于避免利益相关者之间的不信任和紧张关系至关重要，这种不信任和紧张关系通常是由于战略目标的差异造成的。关于这个主题的原始研究是有限的。
