Thursday, October 8, 2009

CAPE COD TIMES: Loss of funding threatens research on Gulf War illness

Written by Scott K. Parks, The Dallas Morning News -- Published in the Cape Cod Times 

(Dallas, Texas - October 8, 2009) - The U.S. Department of Veterans Affairs' cancellation of a $75 million contract with University of Texas Southwestern Medical Center could mean the end to the Dallas university's research into treatments and cures for Gulf War illnesses.

UT Southwestern epidemiologist Dr. Robert Haley told The Dallas Morning News that he and a team of 200 colleagues from eight universities are five years ahead of anyone else engaged in the painstaking research into why 200,000 healthy soldiers went to the Persian Gulf in 1990-91 and returned to civilian lives of chronic illness.

"Without the VA funding, discovery of a treatment is very low," Haley said.

The VA declined to comment on Haley's research. Instead, a spokesperson referred The News to an Aug. 26 news release announcing cancellation of the contract for "persistent noncompliance and numerous performance deficiencies."

Haley has been studying a small group of sick Gulf War veterans for 15 years. His findings show a range of persistent symptoms — chronic fatigue, chronic diarrhea, memory loss, joint pain, loss of muscle strength and persistent headaches — caused by battlefield exposure to pesticides and other chemicals.

The next step, supported by $15 million a year from the VA, was to be a large study of 2,000 Gulf War veterans. The results of that study would show whether chemical exposures harmed a significant number of veterans, Haley said.

"We are looking at unplowed ground," he said. "Nobody has ever looked at pesticide exposure and brain damage and chronic symptoms. People didn't believe this stuff was real, even in the civilian world, and it's never been looked at."

An estimated 700,000 veterans served in the Persian Gulf in 1990-91. Veterans groups had hoped Haley's work might break the gridlock preventing thousands of them from receiving disability benefits and medical care based on exposure to pesticides, nerve gas, oilfield fires or military-issued antidotes to nerve gas.

Haley is convinced that many veterans suffered brain damage from exposure to organophosphates (sprayed pesticides or insect repellants worn like flea collars) and pyridostigmine bromide (nerve gas antidote). He rejects the theory that Gulf War illnesses stem from post-traumatic stress — a psychiatric condition.

"Originally, this (Gulf War illness) was signed, sealed and delivered as stress," Haley said. "Now, we know it's a real disease caused by chemical exposure. It's now the conventional wisdom."

But the VA, which has the power to grant or withhold disability payments, has not embraced that conclusion. Consequently, billions of dollars in monthly veterans' benefits could hang in the balance.

The U.S. House committee on veteran affairs held two hearings on the status of Gulf War illness research in 2009. Testimony showed that federal agencies spent $350 million on 345 projects related to health care needs of Gulf War veterans between 1992 and 2007.

But critics say those projects didn't focus on identifying causes and treatment of Gulf War illnesses.

Dr. Lea Steele, a leading expert on Gulf War illnesses at Kansas State University, testified that much of the research focused on stress and psychiatric conditions and had "little or no relevance to the health of Gulf War veterans."

By contrast, Haley's supporters say his slow, painstaking research on veteran brain diseases is precisely targeted at causes and treatments.

Legally, the VA must seek the opinion of a prestigious group of medical researchers on the Institute of Medicine (IOM) Committee on Gulf War and Health. The committee has reported that it cannot conclusively link toxic exposures to Gulf War illnesses.

On the other side of the ledger, another panel of prestigious scientists, the VA's Research Advisory Committee on Gulf War Veterans' Illnesses, reported in October 2008 that "a unique neurological illness has caused significant morbidity (25 percent) among Gulf War veterans, and this is 'causally' (the highest possible level of association) linked to nerve agent antidote and pesticides used in the 1991 Gulf War."

The VA announcement ending the contract came after repeated disputes between UT Southwestern and government contract managers. A scathing report from the VA inspector general in July accused Haley of violating all sorts of VA contract protocols.

UT Southwestern administrators admitted some mistakes in contract administration and said they tried to correct them, but the VA canceled the contract anyway.

Privately, UT supporters said some longtime VA administrators resent the federal budget earmark that dedicated research funds to UT Southwestern — legislation that prevented the VA from controlling where $75 million was going to be spent on research.

In the Sept. 11 edition of Science magazine, writer Eliot Marshall quoted British psychiatrist Simon Wessely, a noted health researcher, as saying that Haley's work was worthwhile but that it's time to recognize that "we're not going to find the smoking gun that explains the cause of Gulf War illness."

Other critics allege that Haley and his team have spent too much time studying a group of 43 Navy Seabees, subjecting them to sophisticated brain imaging tests and genetic research. Haley chose the Seabees because they traveled all over the Persian Gulf, building bridges and runways in advance of troop movements.

If any group experienced all the wartime conditions in the Persian Gulf, it was the Seabees, he theorized.
Haley and his team believe their published research proves conclusively that the Seabee illnesses stem from toxic chemical exposures during the war. But his critics contend that research on such a small group proves nothing about the overall health of 700,000 men and women who served during the war.

Haley said the VA pulled the plug on his funding just as he was designing a study of 2,000 randomly selected Gulf War veterans — 1,000 sick and 1,000 healthy.

"The VA funding is the final step, the rifle shot, to prove this," Haley said. "Is what we found with the Seabees true of the whole of Gulf War veterans? And that is the final definitive question."

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