Gaming and Public Health

The Washington Post has an article today about a Centers for Disease Control and Prevention (CDC) exercise simulating a flu pandemic. The contractor that designed and executed the scenario was MPRI (Military Professionals Resources Inc.), is largely staffed by former military, and the leader of the design team used to work on wargames at the Pentagon. This is an example of the recent increase in attention being paid to the public health applications of gaming techniques. Booz Allen Hamilton, another large contractor in the simulation/wargaming business, has moved into public health simulations in a big way as well: (from the Booz Allen response to a survey from Vault.com)

Over the past several years, Booz Allen has transferred its strategic simulation (also called "wargaming") capabilities from the government sector to the public health arena. The firm has conducted a variety of games to help various constituencies understand the implications of different health crises, including HIV/AIDS and a potential influenza pandemic.

The global HIV/AIDs epidemic is at the intersection of public health, political policy, and corporate interests, confronting all of humanity with the greatest challenge of our time. In October 2003, Booz Allen brought together experts from all over the firm to focus on this complex issue, hosting a groundbreaking HIV/AIDS strategic simulation event in India. Working with the Global Business Coalition on HIV/AIDS and the Confederation of Indian Industry, Booz Allen led more than 200 government, business, and nonprofit leaders in a three-day simulation that underscored the need for new public/private partnerships, many of which were born during the simulation itself.

Eighteen months later, Booz Allen and the Global Business Coalition partnered again to host the Joint Summit on Business and AIDS in China. Rates of infection are still relatively low in China, and both the Chinese government and the business community have demonstrated significant leadership since coming together to address the issues at the summit.

In July 2005 and January 2006, Booz Allen brought its health-focused strategic simulation expertise to two senior audiences: at the Aspen Institute Ideas Festival in Colorado, where attendees dealt with the HIV/AIDS epidemic in India and developed approaches to building stronger public/private partnerships; and at the World Economic Forum in Davos, Switzerland, where attendees were confronted with an influenza pandemic and had to address the challenges for delivering essential services during a widespread outbreak.

For more on some of these events, see also: Booz Allen's "HIV/AIDS Epidemic Strategic Simulation" in India and "The Global AIDS Crisis" run at the Aspen Institute Ideas Festival in 2005 (page has a link to a brief after-action summary as well)

One interesting feature of public health gaming is the lack of a real "enemy." The strategic interaction that is the focus of most wargames is not present, although the spread of the disease in the CDC example above would presumably depend in some way on the steps taken by the government to deal with it. In this sense, they share a lot of common ground with the incident response drills run by the Department of Homeland Security, relating to the aftermath of terrorist attacks or natural disasters. In any such exercise (especially in the case of trying to prepare for bioterrorism), public health would be a critical component.