The Department of Veterans Affairs and the Institute of Medicine have done a grave disservice to tens of thousands of veterans of the first Gulf War by minimizing their health problems and suggesting that promising research that could help their conditions be halted, a School of Public Health researcher told a Congressional committee Tuesday.
“To recommend stopping research into the mechanisms underlying the disease, just as research into these mechanisms has begun to make real progress, is shockingly shortsighted,” White said in testimony to the committee, which convened a hearing on health outcomes associated with the war on the 25th anniversary of the conflict.
The hearing comes two weeks after the Institute of Medicine (IOM) issued a report saying that, based on available research data, it did not appear that a single mechanism could explain the multitude of symptoms reported by Gulf War veterans, and that it was “unlikely (that) a definitive causal agent or agents can ever be identified.”
The IOM concluded that the health conditions associated with Gulf War deployment are primarily mental health disorders and functional medical disorders that are based on “subjective symptom reporting.”
The IOM report effectively dismisses reams of studies by researchers from BU and other institutions which have shown that the occurrence of Gulf War illness is associated with troops’ exposures to chemicals, especially pesticides and anti-nerve-gas pyridostigmine bromide pills given to soldiers.
Noting that US troops won the first Gulf War in less than a week, White said it was disheartening that “the troops who produced this victory are and will remain ill, without legitimate acknowledgement of their health problems and the associated disabilities.”
Despite decades of scientific evidence to the contrary, she said, the VA and the IOM “have recently produced documents that minimize the poor health of these veterans by terming their illnesses as ‘functional’ disorders, a medical term for psychiatric illness. This injustice is then compounded by a treatment guideline that suggests ineffective, unproven, purely palliative, and potentially harmful treatments for Gulf War illness that focus on psychiatric symptomatology.”
White, a professor of neurology at the School of Medicine, served for eight years as scientific director of the Congressionally mandated Research Advisory Committee on Gulf War Veterans’ Illnesses (RAC), which recommended aggressive research into the causes of the debilitating disorder affecting about 30 percent of deployed troops.
She said research “has repeatedly shown that post-traumatic stress disorder and other psychiatric disorders do not predict whether a veteran will have Gulf War illness.” Instead, studies have found that the chemicals to which troops were exposed affect the central nervous and immune systems, producing chronic symptoms that affect multiple body systems.
White noted that a previous IOM report had concluded that the unexplained medical symptoms reported by deployed veterans could not be “reliably ascribed to any known psychiatric disorder.”
She said recent research has identified potential treatments of Gulf War illness that target specific nervous system and immunological mechanisms.
“The scientific findings from this research hold great scientific promise. In addition, they are the only source of hope for veterans with Gulf War illness who are suffering from the disorder and wish to lead healthier, more productive lives,” she said.
White noted that the committee that wrote the recent IOM report had no members with clinical experience treating Gulf War veterans. She compared the situation faced by Gulf War vets to that of World War I veterans, who were exposed to mustard gas in the trenches of Europe, but who received little support for their health problems after returning home.
“We are experiencing the same phenomenon with the 1991 Gulf War,” she said.
Others testifying at the hearing included VA officials; James H. Binns, former chairman of the Research Advisory Committee on Gulf War Veterans’ Illnesses; and Anthony Hardie, director of Veterans for Common Sense.