VA’s Limited Scope of Research Not Focused on Treatments Prevents Gulf War Vets From Getting the Benefit of the Doubt

Written by staff of the U.S. House of Representatives Committee on Veterans' Affairs
Contact Kristal DeKleer

Washington, D.C. – On Thursday, July 30, 2009, the House Veterans’ Affairs Oversight and Investigations Subcommittee, led by Chairman Harry Mitchell (D-AZ), conducted a hearing to analyze and evaluate the scientific information on Gulf War Illness Research. The hearing focused specifically on the differences between finding of the Research Advisory Committee (RAC) and the Institute of Medicine (IOM) and how VA uses this research to formulate policy. Gulf War Illness research is critical because the questions surrounding the science continually affect the claims, benefits, compensation, and treatment of the veterans who served in the first Gulf War.

The United States deployed nearly 700,000 service members to the Persian Gulf in support of Operations Desert Shield and Desert Storm, beginning in 1990. Gulf War veterans were exposed to a multitude of toxins, agents and chemicals that were not documented. This created a challenge with the science and research since the amount and combination of chemicals is an unknown and cannot be replicated or studied in humans or animals. As a result, there are many veterans with undiagnosed illnesses and multi-symptom illnesses as a result of serving in the first Gulf War who are still suffering from toxin exposure and are fighting the VA to have Gulf War Illness recognized as a service-connected condition.

“We have learned and will continue to learn that Gulf War Illness Research is a challenge and a missing link appears to be a lack of documentation of exposure and compounds that exposed our veterans,” Chairman Mitchell said. “The future and direction of this research is vital because the questions surrounding the science continually impact the claims, benefits, compensation and treatment of veterans. This series of hearings has shed light on the fact that we aren’t doing enough for our Gulf War Veterans who deserve closure and recognition for what they have sacrificed in service for their country.”

In 1998, Congress mandated the appointment of a public advisory panel of independent scientists and veterans to advise the VA on federal research studies and programs to address the health consequences of the Gulf War. As directed, VA contracts with IOM to obtain independent and objective professional opinions concerning available scientific evidence. IOM has produced several studies with research parameters set by Congress regarding Gulf War Exposures.

The VA’s Research Advisory Committee (RAC) was appointed by the Secretary of Veterans Affairs in 2002 and directed to evaluate the effectiveness of government research in addressing central questions on the nature, causes, and treatments of Gulf War-related illnesses.

While both IOM and RAC agree that Gulf War Illness exists, the two organizations do not agree on the methodologies of the scientific research and come to markedly different conclusions. One major difference is how diagnosed and undiagnosed illnesses were evaluated. Currently, no diagnostic tests exist that allow diagnosis for Gulf War Illness, and undiagnosed illnesses are self reported. The other difference is how animal and human studies and findings were evaluated in formulating findings.

Dr. Lea Steele, former RAC scientific director, testified, “I want to be clear that members of the RAC have great respect for the IOM, generally, and were not anxious to criticize IOM’s Gulf War reports…. The differences between the RAC and IOM reports are not subtle, and are not explained by minor variations in the review methods used or how individual study results were interpreted or weighed. Rather, they are the result of major differences in the scope of questions addressed by the two reports, and the scope of the evidence used to answer those questions.”

“The research surrounding Gulf War Illness is complicated for many reasons – lack of veteran immunization records, little or no knowledge of specific chemical exposure, inadequate or nonexistent pre and post deployment health assessments,” said Bob Filner (D-CA), Chairman of the House Committee on Veterans’ Affairs. “What is not complicated is that Gulf War Illness exists. We cannot ask veterans to wait for 100% scientific evidence, but instead must act to provide care and medical treatment. The future of research is critical to America’s service members serving on the battlefield today, as well as our veterans who deserve closure and recognition for their sacrifices.”

Witness List

Panel 1:

· Lynn Goldman, M.D., MPH, Professor, John Hopkins University Bloomberg School of Public Health, Member, Committee on Gulf War and Health, Institute of Medicine, The National Academies

Accompanied by:

o Roberta Wedge, M.S., Senior Program Officer, Institute of Medicine, The National Academies

· James H. Binns, Chairman, Research Advisory Committee on Gulf War Veterans' Illnesses

· Lea Steele, Ph.D., Former Scientific Director, Research Advisory Committee on Gulf War Veterans’ Illnesses, Adjunct Associate Professor, Kansas State University School of Human Ecology

Panel 2:

· Robert W. Haley, M.D., FACE, FACP, Professor of Internal Medicine, University of Texas Southwestern Medical Center

· Roberta F. White, Ph.D., Professor and Chair of the Department of Environmental Health, Associate Dean for Research, Boston University School of Public Health

· Anthony Hardie, Madison, WI, Gulf War Veteran

Panel 3:

· Douglas E. Dembling, Associate Chief Officer for Program Coordination, Office of Public Health and Environmental Hazards, Veterans Health Administration, U.S. Department of Veterans Affairs

Accompanied by:

o Victoria A. Cassano, M.D., MPH, Acting Chief Consultant, Environmental Health Strategic Health Care Group, Veterans Health Administration, U.S. Department of Veterans Affairs

o Joel Kupersmith, M.D., Chief Research and Development Officer, Office of Research and Development, Veterans Health Administration, U.S. Department of Veterans Affairs

o David Barrans, Deputy Assistant General Counsel, Office of General Counsel, U.S. Department of Veterans Affairs

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Prepared testimony for the hearing and a link to the webcast from the hearing is available on the internet at this link: http://veterans.house.gov/hearings/hearing.aspx?newsid=455

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