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In the future, the United States will need more, not fewer allies to meet the challenges posed by international terrorism, WMD, and other treaties. Strategic building policies such as the State Partnership Program can help bring more allies and coalition partners into the fold while moving the United States toward another increasing vital source of protection: a more free and prosperous world.1 The National Guard (NG) State Partnership Program (SPP) links states with partner countries' defense ministries and other governmental agencies for the purpose of improving relations with the United States. This paper examines the history and the role of the National Guard SPP in support of the 2002 National Security Strategy of the United States and the Global War on Terrorism (GWOT) and why the program expansion should reach deeper into the medical area of cooperation to answer the question, "is there a Medical Concept of Operations (CONOPS) and if not is there a need for an overarching CONOPS in the SPP?" This paper emphasizes SPP events specifically in United States European Command (USEUCOM). In December, 1991, the Soviet Union, with its centralized political and economic system ceased to exist and fifteen newly formed independent countries emerged in its aftermath. The collapse of the Soviet Union transformed political, economic, social and military alliances all over the globe. The National Guard State Partnership Program was established in 1993 in response to the radically changed political-military situation following the collapse of Communism and the disintegration of the Soviet Union.