Basic Operational Medical Research Science

Warfighters operate under extreme physiological conditions, sometimes with limited resources and manpower, and must acclimate quickly to changing operational needs. The Physiological Overmatch program is investigating innovative approaches to allow the warfighter to adapt rapidly to operational challenges during deployment by developing novel detection and treatment systems. The program will initiate work in aiding the deployed soldier's ability to defend against biological pathogens, resist fatigue, combat sleep deprivation, and maintain a high capacity for operational performance. This program will seek to develop technology devices for in vivo release of therapies as needed by the warfighter and to understand the biological mechanisms of fatigue, which will enable improvements to warfighter health and operational performance. This approach represents a significant enhancement to warfighter performance by providing protection from impacts to operational readiness and provides information related to fatigue states and the ability to operate with prolonged sleep deprivation. Beginning in FY 2026, this program will be funded in PE 0601122E, Project EMR-04.

The Combatting Anti-Microbial Resistant Pathogens program is investigating fundamental methods for using preexisting host machinery as a technology to create medical countermeasures that degrade or deactivate pathogen targets. The DoD has long recognized the warfighter's outsized risk of exposure to biological threat agents and to infectious disease, including the increasing prevalence of antimicrobial-resistant (AMR) organisms that are ranked as a Tier 1 threat to the U.S. military. Similarly, the danger posed by bacterial biothreats persists with few countermeasures available. Key advances expected from this research include identifying methods to discover and develop new classes of chimeric therapeutics for AMR bacteria, bacterial biothreats, and other DoD-relevant diseases and threats. These approaches represent a significant departure from conventional therapeutics, which typically rely on a limited number of small molecules with a narrow set of targets and mechanism of action. Advances in this area may be applied to the mitigation of known, new, and emerging diseases that impact military readiness and pose a global health threat. Beginning in FY 2026, this program will be funded in PE 0601122E, Project EMR-04.

*Formerly Preventing Blood Stream Infections in Warfighters After Trauma Bloodstream infections (BSI) are a significant source of morbidity in service members that sustain combat-related injuries. Trauma temporarily degrades the efficacy of the host immune system thereby increasing the risk of life-threating opportunistic infections from fungi and bacteria that enter into the blood. If unchecked, bloodborne fungi and bacteria lead to debilitating conditions such as invasive fungal infections (IFI), sepsis, and shock. The Synthetic Hemo-technologies to Locate and Disinfect (SHIELD) program is developing a systems-level approach to prevent BSI in warfighters that suffer trauma from burn or blast. Prophylactic medical countermeasures circulating in the blood will be developed to bind infectious particles in the blood early and label pathogens for clearance and deliver drugs to destroy pathogens and/or restore healthy physiology. Ultimately, this program will develop novel technologies that will protect service members from morbidity and mortality associated with BSI. Beginning in FY 2026, this program will be funded in PE 0601122E, Project EMR-04.

*Formerly Modernized Field Anesthesia The Anesthetics for Battlefield Care (ABC) program aims to produce safe, battlefield-ready anesthetics to reduce the trauma associated with injury and improve combat casualty outcomes. Current therapeutics that enable life-saving interventions and wound stabilization must be used in hospitals or highly monitored settings due to their lack of safety. Prolonged peer or near-peer conflict could severely impact medical evacuation times, resulting in extended time before patients reach a hospital. The ABC program seeks to uncover mechanisms of anesthesia at multiple biological levels ranging from the molecular to the organismal. Novel treatments developed under the program will exhibit the desirable properties of anesthetics, including calming effects and loss of sensation and consciousness but will have vastly improved safety profiles, making them usable in the field by warfighters with minimal medical training. Beginning in FY 2026, this program will be funded in PE 0601122E, Project EMR-04.

*Formerly Accelerated Training and Readiness Assessment The Objective Prediction of Team Effectiveness via Models of Performance Outcomes (OP TEMPO) program seeks to advance technologies to drive efficiency and efficacy of military operator preparation and expertise building. This program seeks to understand fundamental biological processes to support real-time physiological assessment, performance diagnostics, and objective prediction of warfighter and team proficiency, with the ultimate goal of improved DoD mission readiness and execution. Advances in this program will result in a significant enhancement to warfighter team performance by providing methods to determine teaming potential and actionable paths to optimal teaming. Beginning in FY 2026, this program will be funded in PE 0601122E, Project EMR-04.

The Simulating Microbial Systems (SMS) program is developing the general capability to simulate microbial cell function and behavior to prevent strategic surprise. SMS is investigating combinations of computational advances with data acquisition techniques to advance the state of the art of cellular modeling. Bringing together communities in cell modeling, computational techniques, and wet lab measurements, this program will build from partial physics-based models of a minimal synthetic cell to more complete and faithful simulations of a DoD-relevant organism. SMS will experimentally evaluate simulations via milestones and pressure tests that relate to both general cell simulation and tailored stakeholder use cases. SMS is postured to be a valuable tool for acceleration of medical countermeasure developments and biomanufacturing. Additionally, the program will provide a baseline for further simulation development and importantly will provide the DoD and its stakeholders the ability to run microbial simulations to prevent surprise. Beginning in FY 2026, this program will be funded in PE 0601122E, Project EMR-04.

DoD warfighters are often required to perform complex tasks in a high-stress situation. Warfighters under stress can make poor decisions with immediate and/or lasting consequences that may also contribute to long-term trauma. The CoasterChase program seeks to evaluate host response to stimulation of the digestive tract. The program will explore stress response to improve decision making and reduction of long-term trauma response with a combined sensing and stimulation ingestible device. The program aims to understand behavioral and physiological biomarkers of stress and inform device design parameters. Ultimately, the technology will enable improved memory retention, reduced effects of post-traumatic stress disorder (PTSD), maintenance of immune defense, and regulation of metabolism in austere domains. Beginning in FY 2026, this program will be funded in PE 0601122E, Project EMR-04.

Warfighter defense against pathogens is reliant on multiple vaccinations administered repeatedly to maintain effective protection. The Assessing Immune Memory (AIM) program sought to increase the longevity of infectious disease protection in warfighters by establishing tools that can be employed in new prophylactic development pipelines. Specifically, this program progressed our understanding of critical host factors and immune responses that lead to durable protection following vaccination. This work served to de-risk the future development of research and evaluation (R&E) tools capable of predicting candidate vaccine durability. Advances made during this program will inform future DoD efforts to ensure broader and consistent immunity in field-forward domains.

The Improved Interventions program sought to develop novel pharmacological interventions that optimize the performance of the healthy warfighter and improve treatment of the injured warfighter. The status quo for pharmacological intervention is one drug, one target, which often has many undesirable side effects. This program created a platform for the development of pharmacological interventions with reduced side effects and increased safety. Therapeutics and countermeasures designed with this platform act by engaging multiple targets within biological systems of the body. Research within this program focused on the integration of novel bioinformatics approaches and chemical synthesis methods in order to achieve desired physiological effects with no negative side effects. This program established new pharmacological discovery and design principles that lead to safe and effective interventions for the treatment of battlefield causalities.