Photo By Sgt. 1st Class Timothy Hughes | 18th Theater Medical Command Commanding General U.S. Army Maj. Gen. E. Darwin Cox...... read more read more
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18th Theater Medical Command Commanding General E. Darrin Cox discussed the various ways Army Medicine contributes to campaigning in the Indo-Pacific region during Land Forces Pacific (LANPAC) Symposium & Exhibition 2025 on May 14, 2025.
While flanked by his senior enlisted advisor, Command Sgt. Maj. Jennifer Francis, Cox said the “Pacific Knights” focus is on setting the theater in support of U.S. Army Pacific’s 3Ps: People, Partnership, Prevail.
He said 18th TMC builds relationships and interoperability with allies and partners to “have pre-established agreements for things like blood sharing, medical facility access, and training and rehearsals.”
He further explained the command builds joint interior lines by prepositioning medical supplies in locations such as Joint Theater Distribution Centers.
Modernization to address needs of today and the future has remained a critical part of how Cox’s staff succeeds in pacing the Chinese Communist Party as it challenges internationally recognized norms.
Cox said his command is “continuously transforming by participating in rehearsals with the Joint Force alongside our geostrategic allies and partners."
One challenge 18th TMC faces is shifting from old standards that were applicable in the Iraq and Afghanistan theaters of war but not the Indo-Pacific region -- namely the golden hour of care -- to caring for wounded Troops in contested air, maritime and land domains.
He said to address these issues, coupled with the tyranny of distance, they are continuously “facilitating experiments to explore innovative concepts for prolonged care and medical evacuation.”
The 18th TMC relies on its military allies and partners to support USARPAC’s Theater Army Campaign Plan to project power from the land in order to achieve positional advantage and enable the joint force.
“Our strategy is to campaign through persistent engagement,” Cox said, “to mitigate risk in the three medical Large Scale Combat Operation (LSCO) gaps to clear the battlefield, overcome contested logistics, and maximize return to duty, so that we set the theater to build an enduring advantage.”
Key efforts the theater enabling command highlighted are medical logistics, Operation Pathways and Experimentation, and Health Security Cooperation.
Medical Logistics:
Cox and Francis are spearheading efforts to build robust and resilient medical logistics capabilities through Army Prepositioned Stock and Joint Theater Distribution Centers.
“The availability and proper positioning of Class VIII remains a challenging logistical problem set,” Cox said. “Blood is particularly complex due to its shelf life and specialized cold and frozen chain-storage requirements.
“We are looking at various strategies, including the use of whole blood sharing agreements and new technologies such as commercially available shelf-stable free-dried plasma,” he said.
Operation Pathways and Experimentation:
18th TMC utilizes Operation Pathways as its mechanism for conducting campaign rehearsals.
Cox said the exercises “provide medical units with vital experience in the Indo-Pacific operating environment and build familiarity with its associated challenges."
Those challenges are faced head on, west of the International Date Line, while U.S. Army medical personnel work alongside their allies and partners on their respective homeland.
“Our forward presence expands interoperability with partnered forces and helps build capacity across the region,” Cox said.
Lessons learned from engagements across the Indo-Pacific helps the 18th TMC refine its experimentation ventures, which is its method to achieve continuous transformation and meet modernization objectives.
“We seek to incorporate experimentation into every engagement,” Cox said. "Our team recently tested multiple technologies during Project Convergence as well as a recent exercise in the Philippines.”
He said recent testing ranges from tactical networks to portable diagnostic equipment and unmanned aerial, ground, and maritime systems.
“We work closely with partners such as Army Medical Center of Excellence, Army Futures Command, and the Joint Force to evaluate technologies for their applicability and usefulness in the Indo-Pacific,” Cox said.
Health Security Cooperation Efforts:
The “Pacific Knights” utilize Health Security Cooperation Efforts to build enduring partnerships.
Cox said, “medical capability is a strategic soft power and one of the few spaces we can engage with almost every country in this theater.
“18th TMC’s role in this area is to strategize, plan, synchronize, and then provide oversight of engagements in order to aggregate the effects of health cooperation and ensure we are supporting the theater assure-and-deter strategy,” he said.
How Army Medicine Prevails in the Indo-Pacific:
Cox highlighted how the 18th TMC prevails while addressing LSCO gaps in the Indo-Pacific region.
“By addressing LSCO gaps and synchronizing with the Theater Army Campaign Plan, we will build human and systematic resiliency, medically set the theater, and be ready to prevail in crisis or conflict,” he said.
“We are building joint interior lines and increasing human, procedural, and technical interoperability with the Combined Joint Force,” Cox said.
Visit https://www.army.mil/18medcom or https://www.facebook.com/18thMEDCOM to see the various ways the 18th TMC operationalizes Army Medicine by working alongside its regionally aligned allies and partners.
LANPAC is the premier forum for land power discussions in the Indo-Pacific region. Hosted by the Association of the United States Army (AUSA) and supported by U.S. Army Pacific (USARPAC), LANPAC 2025 brings together representatives from more than 30 Indo-Pacific nations, including a dozen Chiefs of Armies, to address critical security challenges. LANPAC builds trust by fostering dialogue, enabling collaboration, and sharing innovative solutions that enhance joint and multinational readiness.
| Date Taken: | 05.14.2025 |
| Date Posted: | 05.15.2025 14:21 |
| Story ID: | 498029 |
| Location: | HONOLULU, HI, HAWAII, US |
| Web Views: | 81 |
| Downloads: | 0 |
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