James H. Binns
Chairman Mitchell, Ranking Member Roe, Members of the Committee, I am honored to address you again as chairman of the Research Advisory Committee on Gulf War Veterans Illnesses. The Committee was created by Congress in 1998 to provide advice to the Secretary of Veterans Affairs on the conduct of federal Gulf War health research. Its membership includes the most experienced researchers in this field, some of the most respected neuroscientists in the country (including the head of the CDC neurotoxicology research laboratory and a former president of the American Academy for the Advancement of Science), and several Gulf War veterans. I thank you for holding this third hearing in your series on Gulf War illness. There has been a dramatic change in the recognition of this problem in the year since the last hearing, and much of it can be attributed to your spotlighting attention on it.
Great credit must also be given to two other people who will address you today. As VA Chief of Staff, Mr. John Gingrich has personally led a Task Force to re-examine VA Gulf War policy from top to bottom, bringing to this effort the urgency and concern for his troops he demonstrated as a battalion commander during the war. You will not hear him say, as the VA representative testified at your first hearing, that “Gulf War veterans are suffering from a wide variety of common and recognized illnesses.”
Dr. Stephen Hauser has chaired a courageous new Institute of Medicine committee which refused to limit its review to the narrow assignment given by VA staff and which has forcefully recognized this problem. Unlike what you heard at your second hearing, the Research Advisory Committee and the IOM are now in agreement on major scientific conclusions: that chronic multisymptom illness is a diagnostic entity; that it is associated with service during the Gulf War, affecting as many as 250,000 veterans; that it cannot be ascribed to stress or other psychiatric disorders; that it is likely the result of genetic and environmental factors; and that a major national research program is urgently needed to identify treatments. The IOM committee did not feel the data were strong enough to identify specific environmental causes, while our Committee did, but that is a relatively minor difference.
The question before us this morning is what the government will do, now that the problem has been recognized. The Task Force is a major initiative to reform VA system-wide, and VA leadership’s decision to open its draft report to public comment was wise. There is much in the report that is good, but there is also much that reflects old attitudes the report is supposed to change. The test will come in the final draft of the report and how its recommendations are implemented.
I will focus my comments on research. Now that there is a scientific consensus that Gulf War illness is real, important, and solvable, we have arrived where we should have been in 1995. The task remains to mount an effective national research program – “a well-planned, top-down program, employing the best in American science, run by people who go to bed at night and wake up in the morning thinking about this problem,” as Dr. Houser described to me what his IOM committee felt was necessary.
This country is not doing that. At VA, there are some individual researchers doing excellent work, and VA is in the process of launching a new program to replace the one cancelled at the University of Texas, Southwestern, and hiring a toxicologist to staff it. They have issued requests for proposals that include most topics recommended by the Research Advisory Committee’s 2008 report. They have appointed a steering committee of outside scientists to guide this program, including several from the Research Advisory Committee. There is a plan being developed for a major genetics component. It all sounds very positive.
However, the new RFA’s have failed to attract much interest from the VA research community, which is not surprising after nineteen years of denial regarding this problem. There is no comprehensive research plan. The places that VA has found to invest most of the funds committed this year are not for priority research topics. Research involving the psychological aspects of chronic illness is again being favored. The new steering committee was not consulted on several new research studies announced last week. The press release announcing the studies carried the stale old message that Gulf War veterans’ problems are mainly psychological.
I am confident that this message was not approved by the Secretary’s office, but regardless of their intentions, VA’s new research program resembles far too much VA’s old research program. To mount an effective program, the Office of Research and Development must engage its new steering committee to create a comprehensive plan, focused on priority research topics, under the leadership of a scientist who understands the problem, who harbors no doubts as to its nature, and who goes to bed at night and wakes up in the morning thinking about how to solve it. Marginal improvement is not enough. The program must be built for success. Or the successors of everyone in this room will be having this same conversation twenty years from now and wondering why we didn’t act.
Assuming that VA makes these major necessary changes, it cannot do the job alone. Yet the Department of Defense, which historically has funded two-thirds of Gulf War illness research, has eliminated this research entirely from its budget for many years. This action is tragically shortsighted, given the major implications of this research to current and future military personnel at risk of multisymptom illness and toxic exposures.
Congress has responded by establishing a Gulf War illness research program within the DoD Congressionally Directed Medical Research Program (CDMRP). This well-managed program is open to all researchers. However, it is grossly underfunded, having received just $8 million in FY2010. Congressional supporters have proposed $25 million for this program in FY2011, and I support that request, as necessary to the scope and importance of the problem.
Compare these figures to the billions of dollars recently calculated to cover the care and disability of Vietnam veterans exposed to Agent Orange. How much better for ill Gulf War veterans, current and future U.S. military personnel, and the public treasury, to cure this illness rather than to allow veterans’ health to deteriorate. I urge you to make this bipartisan issue a priority and to press upon your colleagues the vital importance of adequate funding for Gulf War illness research at CDMRP.
I also encourage you to support Gulf War illness reform at VA. As last week’s press release and the undesirable parts of the draft Task Force report make clear, there is still push-back within the bureaucracy to the initiatives Secretary Shinseki and Chief of Staff Gingrich have begun. The bureaucrats believe that they will remain while appointed leaders come and go. I urge you to consider legislation to ensure the permanence of reforms. I urge you to hold annual follow-up hearings to keep the spotlight on.
Finally, I urge you to reaffirm the purpose of the Research Advisory Committee to provide independent advice to the Secretary on the conduct of Gulf War research, as intended by Congress. Recently VA staff have attempted to change the charter of the Committee to make us dependent on VA staff – in the name of standardization. In other words, the people whose work we review would staff our meetings, our reports, and our recommendations. I am sure this is not what Congress had in mind when it directed our Committee to review federal Gulf War research.
It is important to close on a positive note. Twenty years into this battle, the objective is finally in sight. It is time for leaders and resources adequate to accomplish the mission. It is within reach. It is a matter of choice.