The Committee of the Chiefs of Military Medical Services in NATO (COMEDS) is the senior committee for medical care within the Organization. It acts as the central point for the development and coordination of military medical matters and for providing medical advice to the NATO Military Committee.

The military medical community plays a key enabling role within NATO and, more specifically, within NATO’s defence planning process. The military medical community not only provides medical care, but also preventive health care, veterinary support and psychological support for deployed troops. It provides essential combat service support, making it one of the key planning domains for operations, along with armaments, logistics, air traffic management and other areas of specialization.
COMEDS makes recommendations concerning the development and assessment of NATO military medical policy and procedures for medical support. It seeks to improve existing arrangements between member countries in the fields of co-ordination, standardization and interoperability. It also helps to improve the exchange of information between countries so, for instance, advances made by one member state are available to all. Additionally, COMEDS undertakes studies of general and particular interest such as preventive medicine, dental service, food hygiene and military psychiatry. For this purpose, it has several subordinate working groups and expert panels to which subject matter experts contribute.
The meetings of the chiefs of Military Medical Services are conducted bi-annually and include participants from member and partner countries.

Roles and responsibilities
COMEDS
As explained above, COMEDS advises the Military Committee on military medical matters affecting NATO. It also acts as the coordinating body for the Military Committee regarding all military medical policies, procedures and techniques within NATO. In recent years, COMEDS has come to represent the medical community at NATO HQ, in the NATO Standardization Organization, as well as in specific areas such as defence planning and the chemical, biological, radiological and nuclear (CBRN) field.
COMEDS’ objectives include improving and expanding arrangements between member countries for coordination, standardization and interoperability in the medical field and improving the exchange of information relating to organizational, operational and procedural aspects of military medical services in NATO and Partner countries.

The military medical support system
COMEDS is a key component of the Alliance’s military medical support system, principally in the preparation phase of an operation. It facilitates the development of medical capabilities in individual countries and helps to improve the quality and interoperability of capabilities between them.
Generally speaking, the military medical support system contributes to preserving the “fighting strength” and meeting the increasing public expectation of an individual’s right to health and high quality treatment outcomes. Medical services make a major contribution to force protection and sustainability. Effectively, health is a key force multiplier of fighting power.
Countries that allocate forces to NATO retain responsibility for the provision of medical support to their own forces. However, upon Transfer of Authority, the NATO commander shares the responsibility for their health and will determine the medical support requirements. Multinational arrangements usually require more responsibility of the NATO commander.

Working mechanisms

1. Frequency of meetings –  COMEDS meets biannually in plenary session and reports annually to the Military Committee.
2. Composition –  The chairman is elected by the committee in plenary session for a three year term. The country of origin of the chairman is also responsible for providing a Liaison Officer to NATO HQ. He/she is the point of contact for military medical matters for NATO HQ and individual countries. For practical reasons, this Liaison Officer cooperates closely with the medical branch of the International Military Staff, which also supports his/her work. COMEDS also cooperates closely with the medical branch of Allied Command Operations (ACO) and Allied Command Transformation (ACT) in developments regarding defence planning, capability development, standardization needs, training and education and certification.
   In December 2009, the chairmanship of COMEDS was transferred from Germany to the Netherlands.
3. COMEDS is composed of:
   • the Chiefs of the military medical services of all member countries;
   • the International Military Staff medical staff officer; and
   • the medical advisors of the two strategic commands – ACO and ACT.
   Its meetings in plenary session, as well as its activities benefit from the participation of the following observers:
   • the Chiefs of the military medical services from all Partnership for Peace, Mediterranean Dialogue and Istanbul Cooperation Initiative countries;
   • the Chairman of the Joint Medical Committee;
   • a representative of the NATO Standardization Agency, the Military Committee, the Senior NATO Logisticians Committee, the NATO Military Medical Centre of Excellence, the Human Factors and Medicine Panel of the NATO Research and Technology Agency, the Health and Societal Dimensions Panel of the NATO Science for Peace and Security Committee, and the CIOMR, the organization of military medical reserve officers.
   COMEDS can also invite partners from “Contact countries”, non-NATO troop-contributing countries and organizations.
4. Subordinate working groups
   To assist in carrying out its tasks and in addition to the bodies referred to above, COMEDS has a number of subordinate working groups which meet at least annually and address the following topics: military medical structures, operations and procedures (including planning and capability development); military preventive medicine (force health protection); military healthcare; standardization; CBRN issues; emergency medicine; military psychiatry; dental services; medical materiel and military pharmacy; food and water hygiene and veterinary medicine; medical training; mental healthcare; medical naval issues; and medical information management systems.
5. Evolution
   Historically, medical matters within NATO were regarded strictly as a national responsibility. Consequently, for the greatest part of the Alliance’s existence, there was not a high-level military medical authority within NATO.
   New NATO missions and concepts of operations have placed increased emphasis on joint military operations, enhancing the importance of coordination of medical support in peacekeeping, disaster relief and humanitarian operations.
   COMEDS was established in 1994 for that purpose.
   Today, COMEDS is very active in developing new concepts of medical support for operations, with emphasis on multinational health care, modularity of medical treatment facilities, and partnerships. Increasingly, the developed doctrines are open to non-NATO countries and are sometimes released on the internet.
   In 2011, COMEDS established the Dominique-Jean Larrey Award in recognition of a significant and lasting contribution to NATO multinationality and/ or interoperability within military medical support or healthcare developments in NATO operations and missions ¹. The award is named after the French surgeon general of the Napoleanic imperial forces, who invented amongst other things the field ambulance, which helped to significantly improve medical care in the field.

Footnote:
1. Any individual belonging to the military medical service may be nominated to receive the COMEDS Dominique-Jean Larrey Award. In exceptional circumstances, the award may be given to more than one individual where it is clearly demonstrated that the nominees have individually and collectively met the selection criteria. This includes a military medical organisation and/ or structure. The Award is granted no more than once a year.

From NATO Website