Friday, December 16, 2011

Military Medical Research Programs Survive Congressional Spending Bill Cuts

Hard Won Funding Victory Doesn't Mean Rejoicing 

Written by Anthony Hardie
Madison, Wis.

( After the dust settled on Capitol Hill following tense and contentious appropriations negotiations between the Republican controlled U.S. House of Representative and the Democrat controlled U.S. Senate, a final nine-part omnibus spending bill emerged this week that included funding for twenty-three Congressionally Directed Medical Research Programs (CDMRP).

Most important to veterans of the 1991 Gulf War is the inclusion of $10 million in Fiscal Year 2012 funding for the treatment-focused Peer Reviewed Gulf War Illness (GWI) CDMRP, a hard won 20 percent increase over FY11's $8 million.  Other programs important to Gulf War veterans that were also preserved are the stand-alone ALS and MS peer reviewed research programs.

Veterans and their advocates had sought Senate intervention to further increase that amount to $25 million, nearer to the $40 million levels recommended by the prestigious Institute of Medicine (IOM) and the Congressionally chartered Research Advisory Committee on Gulf War Veterans' Illnesses (RAC-GWVI).

CHART: Peer Reviewed Gulf War Illness (GWI) Treatment-Focused Congressionally Directed Medical Research Program (CDMRP)

GWI CDMRP Funding History Since Program Inception
Federal Fiscal Year - Defense Appropriations
GWI CDMRP Funding (in millions of dollars)

Outcomes of the Senate's Fully Bipartisan Failure

However, earlier this Fall, the Senate's powerful Committee on Appropriations had voted 30-0 to eliminate the GWI and most other CDMRP's and roll most of them under the catch-all Peer Reviewed Medical Research Program (PMRP) at a stagnated $50 million in FY12 funding.  This week's conference committee effort reverted to the more expansive, but still conservative House recommendations.

While the final $10 million GWI CDMRP funding level represents a long awaited restoration of the program's funding to its FY08 level, it will also mean very tough choices for the program's medical researcher and GWI patient consumer panel that oversees the allocation of the program's funds.  Three fledgling consortia -- broad collaborative research efforts involving numerous medical researchers from a myriad of public and private research universities and institutions -- were previously given the go ahead to begin the development of their important and unparalleled work.

The Senate's bipartisan failure, combined with the House's conservative appropriations, will likely spell the early demise of at least two of those three highly promising consortia, unless the U.S. Department of Veterans Affairs (VA) can make good on extremely loose and tentative suggestions that VA "might" be able to help with funding some of the proposed consortia efforts that include VA-employed researchers.

To date, the U.S. Departments of Defense (DoD) and Veterans Affairs (VA) have spend more than $300 million on scientific research reported to Congress as related to Gulf War veterans' health.  However, the bulk of the earliest funding has been repeatedly and heavily criticized in Congressional hearings as being focused more on trying to prove nothing was wrong with Gulf War veterans than on actually helping the estimated 250,000 (most recent IOM estimate) who remain ill with service-caused chronic multi-symtom illness, popularly known as Gulf War Illness (GWI, also called Gulf War Syndrome).

Using these failings as evidence for their cause, Gulf War veterans won a major victory in 2005 with a $75 earmarked appropriation inserted by U.S. Senator Kay Bailey Hutchison (R-Tex.) for a broad five-year consortia effort led by Dr. Robert Haley, a beloved icon in the Gulf War veteran community, whose GWI research efforts began in 1994.

However, less than four years later, VA leaders succumbed to embedded VA bureaucrats' powerful efforts to kill Haley's promising and innovative program. Insiders reported the animosity was fueled in large part because the earmarked program wasn't exclusively using VA employees and because it was out of VA's traditional type of tight managerial control.


In sum, Gulf War veterans can let out a sigh of relief that the most promising federal GWI medical research program to date wasn't allowed to die, despite the highly troubling bipartisan Senate vote earlier this Fall to kill it and many other CDMRP.  And, the Gulf War community can feel a small sense of satisfaction that successful advocacy efforts in the House last summer, led by Rep. Dennis Kucinich (D-Oh.) and a bipartisan array of his colleagues and approved by a bipartisan two-thirds vote of the House, not only reversed the proposed 20 percent cut but added a 25 percent increase back to the FY08 levels.

Aided by assurances from the White House that the President will sign this omnibus FY12 spending bill, current insider estimates are that this final bill will pass Congress this weekend and be enacted into law before the holidays are over.

However, there will be little rejoicing, either, given the level of effort it has taken to get the GWI CDMRP's funding back to its previous levels and, most importantly, the now growing track record of promising GWI medical research consortia efforts destroyed willfully or by neglect.

More than twenty years after the six-week war that forever changed the health and lives of up to one-third of the roughly 697,000 U.S. service members who helped eject Saddam Hussein's armed forces from an occupied Kuwait, Gulf War veterans are still waiting for effective treatments to help remedy their war-related, toxin-caused disabilities, and fact-based reassurance that what happened to them will never again be allowed to happen to current or future U.S. troops.

Research and Development -- Congressionally Directed Medical Research Programs (CDMRP) FY12 Funding (in millions of dollars)
Peer-Reviewed Traumatic Brain Injury and Psychological Health Research $135.5
Peer-Reviewed Breast Cancer Research $120.0
Peer-Reviewed Prostate Cancer Research  $80.0
Peer-Reviewed Medical Research $50.0
Joint Warfighter Medical Research $50.0
Peer-Reviewed Orthopedic Research $30.0
Peer-Reviewed Ovarian Cancer Research  $16.0
Peer-Reviewed Restorative Transplantation Research  $15.0
Peer-Reviewed Cancer Research $12.8
Peer-Reviewed Alzheimer Research $12.0
Peer-Reviewed Hemorrhage Control Research  $10.2
Peer-Reviewed Lung Cancer Research $10.2
Peer-Reviewed Gulf War Illness Research  $10.0
Peer-Reviewed Spinal Cord Research $9.6
Global HIV/AIDS Prevention $8.0
Peer-Reviewed ALS Research $6.4
Peer-Reviewed Autism Research $5.1
Peer-Reviewed Tuberous Sclerosis Complex Research  $5.1
Peer-Reviewed Alcohol and Substance Abuse Disorders Research $4.5
Peer-Reviewed Multiple Sclerosis Research  $3.8
Peer-Reviewed Bone Marrow Failure Disease Research  $3.2
Peer-Reviewed Duchenne Muscular Dystrophy Research  $3.2
Peer-Reviewed Vision Research $3.2


*Note:  These comments are purely my own and are in no way intended to reflect the official position of the DoD CDMRP GWIRP, the RAC-GWVI, or the VA Gulf War Steering Committee on which I serve.  -Anthony Hardie, Madison, Wis.

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