GWIRP-funded study finds elevated rates of 7 chronic health conditions in Gulf War Veterans

(91outcomes.com – March 18, 2019) – Newly published results of a study of a large cohort of U.S. veterans of the 1991 Gulf War show a higher risk of numerous chronic health conditions, as compared to the general population.  The excess risk was linked to reported exposure to Gulf War chemical weapons or an experimental drug troops were forced to take without informed consent.  

Seven of nine surveyed conditions were shown to be at elevated risk among the veterans, including high blood pressure (HBP), high cholesterol, heart attack, diabetes, stroke, arthritis and chronic bronchitis.

For veterans reporting chemical weapons exposure, they showed higher risk of HBP, diabetes, arthritis, and chronic bronchitis. Those who reported taking pyridostigmine bromide (PB) nerve agent protective pills (NAPP’s), showed increased risk of heart attack and diabetes.

“Gulf War veterans are showing accelerated aging patterns resulting in more and earlier chronic medical conditions than the general population of civilians,” says study senior author Kimberly Sullivan, research assistant professor of environmental health. “There is precedent for this type of toxicant-induced disorder in veterans from other wars. For instance, many Vietnam veterans developed chronic conditions of high blood pressure, diabetes, and many types of cancers that were related to exposure to Agent Orange.”

Results also varied by sex. FDC males reported higher rates of the seven conditions compared to the control group, while female veterans showed an increased rate of diabetes but a diminished risk of HBP. During the Gulf War, 93 percent (93%) of U.S. troops were male, with seven percent (7%) female.

The new study built on previous research that found higher rates of numerous conditions among 1991 Gulf War veterans as compared to control populations: chronic multi-symptoms illness including Gulf War Illness (GWI), fibromyalgia, chronic fatigue syndrome (CFS), irritable bowel syndrome (IBS), and functional gastric disorders (FGID’s); neurologic conditions including amyotrophic lateral sclerosis (ALS), brain cancer, repeated seizures, neuralgias and neuritis, and chronic migraine headaches; and other conditions including arthritis, various lung diseases, eye or vision problems, HBP, and heart disease.  

The study compared data from 448 U.S. veterans of the 1991 Gulf War from the Fort Devens cohort(FDC), including 47 female GWV’s, with a comparison group of 2,949 population-based 2013–2014 National Health and Nutrition Examination Survey (NHANES) cohort.  The FDC has become one of the largest research cohorts of 1991 Gulf War veterans and the subject of numerous studies.

The study was funded by the Gulf War Illness Research Program (GWIRP), part of the Congressionally Directed Medical Research Program (CDMRP) within the U.S. Department of Defense (DoD) Health Program.  Led by Dr. Maxine Krengel, with the publication authored byDr. Clara Zundeland overseen by Dr. Kimberly Sullivan, the team of researchers included scientists and clinicians from the Boston University (BU) Schools of Medicine (BUSM) and Public Health (BUSPH), the VA Boston Healthcare System, and the Medical College of Georgia.  

Dr. Steven Coughlin, the research team’s epidemiologist, was formerly chief epidemiologist for the VA. He resigned due to cited ethical concerns related to VA covering up adverse health findings among Gulf War and other veterans with toxic exposures.  As a result, hewas awarded the Research Integrity Award from the International Society for Environmental Epidemiology, and the Deployment Health Researcher of the Year Award from the Sergeant Sullivan Center in Washington, DC.  

The study, entitled, “Rates of Chronic Medical Conditions in 1991 Gulf War Veterans Compared to the General Population,” was published in the International Journal of Environmental Research and Public Health.  

**

SEE ALSO: Boston University: Gulf War Veterans “Aging” Faster

CITATION AND LINK TO THE FULL STUDY:  Zundel, C.; Krengel, M.; Heeren, T.; Yee, M.; Grasso, C.; Janulewicz Lloyd, P.; Coughlin, S.; Sullivan, K., "Rates of Chronic Medical Conditions in 1991 Gulf War Veterans Compared to the General Population." Int. J. Environ. Res. Public Health 2019, 16(6), 949; https://doi.org/10.3390/ijerph16060949.

**

Boston University: Gulf War Veterans “Aging” Faster

SOURCE:  Boston University School of Public Health, Michelle Samuels reporting, March 18, 2019

https://www.bu.edu/sph/2019/03/18/gulf-war-veterans-aging-faster/

ARCHIVED ARTICLE:

Gulf War Veterans “Aging” Faster

POSTED ON: March 18, 2019 TOPICS: cardiovascular disease, chemical exposure, chronic diseases, diabetes, gulf war, gulf war illness, GWI, hypertension, joint pain, stroke, veteran health, veterans

Veterans of the Gulf War march in the 2018 National Memorial Day Parade in Washington, DC.

About 200,000 veterans of the 1991 Gulf War continue to suffer from Gulf War Illness (GWI), a set of symptoms including chronic pain, fatigue, and memory impairment caused by sarin chemical warfare agent, pesticides, and pyridostigmine bromide (PB) pills meant to protect soldiers from nerve gas during deployment.

Decades later, these exposures may also be causing higher rates and earlier onset of chronic medical conditions in Gulf War veterans than their non-veteran peers, according to a new study coauthored by School of Public Health and School of Medicine researchers.

The study, published in the International Journal of Environmental Research and Public Health, found Gulf War veterans reported high blood pressure, high cholesterol, heart attack, diabetes, stroke, arthritis, chronic bronchitis, and other chronic conditions at rates normally associated with people about a decade older than them. Veterans who reported being exposed to chemical warfare agents and taking PB pills had especially high rates of heart attack and diabetes.

“Gulf War veterans are showing accelerated aging patterns resulting in more and earlier chronic medical conditions than the general population of civilians,” says study senior author Kimberly Sullivan, research assistant professor of environmental health. “There is precedent for this type of toxicant-induced disorder in veterans from other wars. For instance, many Vietnam veterans developed chronic conditions of high blood pressure, diabetes, and many types of cancers that were related to exposure to Agent Orange.”

The researchers compared the prevalence in 2013 and 2014 of nine chronic medical conditions in two cohorts: 448 members of the Ft. Devens Cohort, the earliest and longest-running study of Gulf War veterans; and 2,949 non-Gulf War veteran participants of the National Health and Nutrition Examination Survey (NHANES) matching the age range and other demographics of the veterans.

They found that male Gulf War veterans were more likely to report high blood pressure, high cholesterol, heart attack, arthritis, and chronic bronchitis than their non-veteran male peers. Female veterans were less likely to report high blood pressure than their non-veteran female peers, but 19.5 percent more likely to report diabetes.

Veterans who reported war-related chemical weapons exposure were three times more likely to report diabetes than veterans who had not been exposed. Veterans who reported taking the prophylactic anti-nerve agent PB pills during deployment were 12 times more likely to report a heart attack than veterans who did not take the pills, and were also more likely to have diabetes. “This is the first study that we are aware of in Gulf War veterans to report these toxicant exposures to be related to increased prevalence of these chronic conditions,” says study lead author Clara Zundel, a doctoral student at the School of Medicine.

The researchers also compared male Gulf War veterans in their 40s, 50s, and 60s with their non-veteran counterparts in the same age ranges (there were not enough female veterans in the sample to do the same for women). They found that male veterans in their 40s were 27 times more likely to report a heart attack, male veterans in their 50s had significantly higher rates of arthritis and chronic bronchitis, and male veterans in their 60s were five times more likely to report a stroke than male non-veterans in the same decades of life. The veterans in each age group reported many of these conditions at rates similar to or even higher than non-veterans a decade older than them.

“Collectively, these results indicate that toxic wounds from GW deployment-related exposures appear to be associated with more than the chronic health symptoms of GWI, but also with chronic conditions of aging,” the authors wrote.

The study was co-authored by Timothy Heeren, professor of biostatistics, and Patricia Janulewicz Lloyd, assistant professor of environmental health. The study was led by Maxine Krengel of the School of Medicine, and the other co-authors were Megan Yee and Claudia Grasso of the VA Boston Healthcare System and Steven Coughlin of the Medical College of Georgia at Augusta University.

—Michelle Samuels

**URGENT ACTION ALERT** -- Gulf War Illness Treatment Research in Congress

Updated April 4, 2019

(91outcomes.com) -- For the last several years, there has been gradually building momentum to develop treatments for Gulf War Illness, a debilitating chronic health condition that science has shown to affect between one-fourth and one-third of the veterans from the 1991 Gulf War and that likely resulted from a combination of toxic exposures.


SPECIFIC ACTION NEEDED:   The current targeted effort seeks co-signers in Congress before the fast approaching deadline for "Dear Colleague" letters to continue funding for the treatment-focused Gulf War Illness Research Program (GWIRP). It is a unique, congressionally-directed program (CDMRP) aimed at improving the health and lives of veterans with Gulf War Illness.

Last year, one-fifth of Congress signed on in support, including 83 Members of the House and 20 U.S. Senators.  (FY19, calendar year 2018).  This year, we saw that increase in the House to 97 Members, while the Senate effort is still in progress.

A list of the current cosigners and the actual text of the Dear Colleague letter are posted below.  Read below for more details before calling your Congressperson and Senators.

1) U.S. House of Representatives.  Contact the Washington, DC office of your Congressman/Congresswoman and ask for him/her to sign onto the "Sablan-Bergman Dear Colleague letter for the Gulf War Illness Research Program" (FY20, DoD-CDMRP). 

House Deadline:  Thursday, March 28, 2019 

2) U.S. Senate. Contact the Washington, DC office of your U.S. Senator and ask for him/her to sign onto the "Baldwin Dear Colleague letter for the Gulf War Illness Research Program" (FY20, DoD-CDMRP).  

Senate Deadline:  Friday, April 5, 2019

******

STEP-BY STEP, HOW YOU CAN HELP IN JUST 5 MINUTES:

1.  Find your federal representatives in Congress.  You have one Representative in the House who represents the Congressional district in which you live and two U.S. Senators who represent your entire state.

• HOUSE: Find your Congressman/Congresswoman in the U.S. House of Representatives here (near the top right corner, enter your zip code).  
• SENATE:  Find your two U.S. Senators here.

2.  Call their Washington, DC office (not any of the in-state offices) and ask for the legislative staff person who handles Department of Defense appropriations (DoD, not VA, not Veterans Affairs).  For example:

• "May I please speak with the legislative staff person who handles DoD appropriations?"

3.  State your name and that you are a constituent.  For example:

• "My name is Norman Schwartzkopf. I'm a constituent who lives in Tampa."

4.  After you reach the legislative assistant who handles Defense (DoD) appropriations, Request the Congressman/Congresswoman/Senator sign onto the specific "Dear Colleague" letter (there is no bill number -- this is a "Dear Colleague" request to get funding into a bill, specifically the Fiscal Year 2020 Defense Appropriations Act).  If you get their voicemail, leave a detailed voicemail with your specific request (below). For example:

• HOUSE:  "I'm calling to request that Congressman Smith sign onto the "Sablan-Bergman Dear Colleague letter for the Gulf War Illness Research Program" (FY2020, DoD).  

• SENATE:   "I'm calling to request that Senator Jones sign onto the "Baldwin Dear Colleague letter for the Gulf War Illness Research Program" (FY2020, DoD). 

5.  Briefly tell them you are a Gulf War veteran (or the loved one of a Gulf War veteran).   For example:  

• "I'm also a Gulf War veteran myself."   

6.  Give the staff person some important details.  They should have a copy of the Dear Colleague request in their system, but if not:

• The deadline to sign-on is: (see the top of this article for deadlines)  
• The staff contacts are:
• House:  Ms. Frances Diaz in the office of Rep. Gregorio Sablan (D), and Mr. Remy Fortin in the office of Rep. Jack Bergman (R) 
• Senate: Mr. Blake Souter in the office of Senator Tammy Baldwin.  

7.  Ask if the staffer would like you to email a short one-pager about the program.  

8.  Thank the staff person for their time.  Ask that the staff person if they would please follow-up with you to let you know the Senator's or Congressman's/Congresswoman's decision.

TIPS:

• Be professional
• Be nice
• Be brief
• Be specific (as described above)
• Do not argue or get angry with the staffer under any circumstance. There are often many factors and processes involved in decisions to sign-on.  Message us if there are any unusual issues.

=======================

FREQUENTLY ASKED QUESTIONS (FAQ's)

1) WHAT IS THE GOAL?

The goal is to get as many members of Congress as possible to co-sign before the deadline.

The goal of the GWIRP is improved health and lives of veterans with Gulf War Illness.

2) WHAT CAN I DO TO HELP? 

Call or message your Congressperson in the U,S. House and your two U.S. Senators for your state.

See above for quick and easy steps to make your request.  

3) WHO IS LEADING THIS FUNDING EFFORT IN CONGRESS?

This is a fully bipartisan effort.

• Rep. Gregorio Sablan (D-U.S. Territory of Northern Mariana Islands), and

• Rep. Jack Bergman, LTG, USMC (Ret.) (R-Michigan) are co-leads.  Both serve on the U.S. House Committee on Veterans' Affairs. 

• House Veterans Affairs Committee Chairman Rep. Mark Takano (D-California) and Ranking Member Rep. Phil Roe, M.D. (R-Tennessee) were the first House co-signers. 

• U.S. Senator Tammy Baldwin (D-Wisconsin) is leading the bipartisan effort for the Senate. 

4) AT WHAT LEVEL SHOULD THE FUNDING BE SUPPORTED, AND WHY?

The request is for sufficient continuation funding for this successful, unique, and important program.  

5) WHY IS THIS PROGRAM NEEDED?

Reports by the National Academy of Sciences’ Institute of Medicine (IOM)2 (pp. 10, 260-64) and the Congressionally-mandated VA Research Advisory Committee (RAC) on Gulf War Veterans’ Illnesses3 emphasize that:

 “effective treatments, cures, and, it is hoped, preventions” for GWI can “likely be found,” “…through a concerted national effort and rigorous scientific input.” 

In addition, important discoveries made by the GWIRP may also help protect current and future U.S. military service members at risk of similar toxic exposures. (RAC 2014, pp. 1, 4, 5, 13, 78, 83; IOM 2010, pp. 10, 260-64.)

6) WHO SUPPORTS THIS PROGRAM?
Many national veterans service organizations (VSO's) have supported the GWIRP.

The Congressionally-mandated Research Advisory Committee (RAC) on Gulf War Veterans' Illnesses and the Independent Budget called for support for this program in their reports.  

VSO supporters (updated as new supporters are added) for FY20 include:

1	Veterans of Foreign Wars (VFW)
2	Veterans for Common Sense
3	Disabled American Veterans (DAV)
4	Vietnam Veterans of America (VVA)
5	Iraq and Afghanistan Veterans of America (IAVA)
6	AMVETS
7	Paralyzed Veterans of America (PVA)
8	Blinded Veterans Association
9	The Enlisted Association (TREA)
10	Military Officers Association of America (MOAA)
11	Fleet Reserve Association
12	Association of the United States Navy (AUSN)
13	Air Force Sergeants Association (AFSA)
14	National Gulf War Resource Center
15	Burn Pits 360
16	Sgt. Sullivan Circle
17	National Vietnam and Gulf War Coalition

From previous years:

FY2019 VSO supporters included:  Veterans of Foreign Wars, Veterans for Common Sense, National Gulf War Resource Center, National Vietnam and Gulf War Coalition, Burn Pits 360, Disabled American Veterans, Paralyzed Veterans of America, AMVETS, Vietnam Veterans of America, Jewish War Veterans of the USA, Fleet Reserve Association, Military Order of the Purple Heart, Enlisted Association of the National Guard of the United States, and the Air Force Association.  

FY18 VSO supporters included:  The American Legion; AMVETS; Burn Pits 360; Disabled American Veterans (DAV); Lung Cancer Alliance; National Gulf War Resource Center (NGWRC); National Vietnam & Gulf War Veterans Coalition; Paralyzed Veterans of America (PVA); Sergeant Sullivan Circle; Veterans for Common Sense (VCS); Veterans of Foreign Wars (VFW); and Vietnam Veterans of America (VVA).  

FY17 VSO supporters included:  the American Legion; AMVETS; Association of the U.S. Navy (AUSN); Burnpits360; Disabled American Veterans (DAV); Lung Cancer Alliance; National Gulf War Resource Center (NGWRC); National Vietnam & Gulf War Veterans Coalition; Paralyzed Veterans of America (PVA); Sergeant Sullivan Circle; Toxic Wounds Task Force; Veterans for Common Sense (VCS); Veterans of Foreign Wars (VFW); Vietnam Veterans of America (VVA).  

The FY15 Independent Budget Veterans Service Organizations (IBVSO’s, composed of AMVETS, DAV, PVA, VFW, and 53 other organizations that serve veterans) stated that the GWI CDMRP, “has made great strides in the short time it has been operating.” ^{(pp. 126-27)}

7) WHEN SHOULD I CALL MY SENATORS'/CONGRESSPERSON'S OFFICE?

Right away.  The deadline is fast approaching.  Typically, their offices need a few days to secure approval to sign-on.  

8) WHEN IS THE DEADLINE? 

Refer to the top of this article for the deadline to sign-on.

9) WHERE CAN I GET MORE INFORMATION?

The Gulf War Illness Research Program (GWIRP) is a Congressionally Directed Medical Research Program (CDMRP), a Congressionally directed activity funded under the U.S. Department of Defense and separate from the VA.

• GWIRP official website:  http://cdmrp.army.mil/GWIRP 

• GWIRP program booklet:  http://cdmrp.army.mil/gwirp/pbks/gwirppbk2018.pdf

• GWIRP "The Gulf War Illness Landscape" (the state of the science on GWI):  https://cdmrp.army.mil/gwirp/pdfs/GWIRP_Landscape.pdf 

• About the GWIRP (published by Veterans for Common Sense):  https://www.scribd.com/document/402231039/2019-About-the-Gulf-War-Illness-Research-Program-GWIRP-FY20 

10) WHAT DOES RECENT RESEARCH SAY ABOUT GULF WAR ILLNESS?

In addition to the resources listed above, recent research shows that a combination of toxic exposures are likely the cause of Gulf War Illness.  Psychiatric causes have been ruled out.  

This paper reviews the recent medical literature on the health of 1991 Gulf War veterans, focusing particularly on the central nervous system and on effects of Gulf War toxicant exposures:

• http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4724528/pdf/nihms746360.pdf

11) WHO IS CURRENTLY SIGNED ON?

This list is updated daily.

SENATE (out of 100 Senators total):  

	Last Name	First Name	State
1	Baldwin	Tammy	WI
3	Blumenthal	Richard	CT
13	Booker	Cory	NJ
11	Duckworth	Tammy	IL
17	Harris	Kamala	CA
10	Hirono	Mazie	HI
15	Klobuchar	Amy	MN
5	Markey	Edward J.	MA
6	Menendez	Robert	NJ
16	Peters	Gary C.	MI
12	Rosen	Jacky	NV
9	Sanders	Bernie	VT
14	Smith	Tina	MN
18	Stabenow	Debbie	MI
2	Tester	Jon	MT
4	Warren	Elizabeth	MA
8	Whitehouse	Sheldon	RI
7	Wyden	Ron	OR

HOUSE (out of 435 Members total) -- The 97 Members of the House who cosigned this year are: (FINAL LIST)

	Last Name	First Name	District
1	Beatty	Joyce	OH-03
2	Bergman	Jack	MI-01
3	Bilirakis	Gus M.	FL-12
4	Bost	Mike	IL-12
5	Brindisi	Anthony	NY-22
6	Brown	Anthony G.	MD-04
7	Brownley	Julia	CA-26
8	Buchanan	Vern	FL-16
9	Bustos	Cheri	IL-17
10	Cárdenas	Tony	CA-29
11	Carson	André	IN-07
12	Chu	Judy	CA-27
13	Cicilline	David N.	RI-01
14	Cisneros, Jr.	Gilbert R.	CA-39
15	Clarke	Yvette D.	NY-09
16	Correa	J. Luis	CA-46
17	Crow	Jason	CO-06
18	Davis	Susan A	CA-53
19	Davis	Danny K.	IL-07
20	DeFazio	Peter A.	OR-04
21	DeGette	Diana	CO-01
22	DeLauro	Rosa L.	CT-03
23	Delgado	Antonio	NY-19
24	DeSaulnier	Mark	CA-11
25	Dingell	Debbie	MI-12
26	Doggett	Lloyd	TX-35
27	Dunn	Neal P.	FL-02
28	Escobar	Veronica	TX-16
29	Eshoo	Anna G.	CA-18
30	Espaillat	Adriano	NY-13
31	Gabbard	Tulsi	HI-02
32	Gallego	Ruben	AZ-07
33	Garcia	Jesús G. 'Chuy"	IL-04
34	González Colón	Jenniffer	PR-00
35	Gosar, D.D.S.	Paul A.	AZ-04
36	Grijalva	Raúl M.	AZ-03
37	Hastings	Alcee L	FL-20
38	Hayes	Jahana	CT-05
39	Horsford	Steven	NV-04
40	Hunter	Duncan	CA-50
41	Jackson Lee	Sheila	TX-18
42	Johnson	Bill	OH-06
43	Johnson, Jr.	Henry C. "Hank"	GA-04
44	Katko	John	NY-24
45	Keating	William R.	MA-09
46	Kim	Andy	NJ-03
47	Kind	Ron	WI-03
48	Krishnamoorthi	Raja	IL-08
49	Kuster	Ann McLane	NH-02
50	Lamborn	Doug	CO-05
51	Larsen	Rick	WA-02
52	Larson	John B.	CT-01
53	Lee	Barbara	CA-13
54	Lipinski	Daniel W.	IL-03
55	Loebsack	David	IA-02
56	Lowenthal	Alan S.	CA-47
57	Luria	Elaine G.	VA-02
58	Lynch	Stephen F.	MA-08
59	Marshall, M.D.	Roger	KS-01
60	McGovern	James P.	MA-02
61	McMorris Rodgers	Cathy	WA-05
62	Moore	Gwen	WI-04
63	Omar	Ilhan	MN-05
64	Panetta	Jimmy	CA-20
65	Pappas	Chris	NH-01
66	Payne, Jr.	Donald M.	NJ-10
67	Perlmutter	Ed	CO-07
68	Peters	Scott	CA-52
69	Peterson	Collin C.	MN-07
70	Pingree	Chellie	ME-01
71	Plaskett	Stacey E.	VI-00
72	Radewagen	Aumua Amata C.	AS-00
73	Raskin	Jamie	MD-08
74	Rice	Kathleen M.	NY-04
75	Richmond	Cedric L.	LA-02
76	Roe, M.D.	Phil	TN-01
77	Rouda	Harley	CA-48
78	Ruiz, M.D.	Raul	CA-36
79	Rush	Bobby L.	IL-01
80	Sablan	Gregorio Kilili Camacho	MP-00
81	Sánchez	Linda T.	CA-38
82	Scanlon	Mary Gay	PA-05
83	Schakowsky	Jan	IL-09
84	Shalala	Donna E.	FL-27
85	Sherrill	Mikie	NJ-11
86	Sires	Albio	NJ-08
87	Slotkin	Elissa	MI-08
88	Soto	Darren	FL-09
89	Speier	Jackie	CA-14
90	Takano	Mark	CA-41
91	Tipton	Scott R.	CO-03
92	Tlaib	Rashida	MI-13
93	Veasey	Marc	TX-33
94	Vela	Filemon	TX-34
95	Welch	Peter	VT-AL
96	Yarmuth	John	KY-03
97	Yoho, DVM	Ted S.	FL-03

12) WHAT DOES THE "DEAR COLLEAGUE" LETTER ACTUALLY SAY?  

The text of the Sablan-Bergman (House) and Baldwin (Senate) Dear Colleague letters is below.  They are naturally very similar.

****
SENATE FY20 DEAR COLLEAGUE:

MARCH xx, 2019

The Honorable Richard Shelby                                  The Honorable Richard Durbin

Chairman                                                                               Vice Chairman

Subcommittee on Defense                                                  Subcommittee on Defense 

Committee on Appropriations                                            Committee on Appropriations 

119 Dirksen Senate Office Building                           113 Hart Senate Office Building

Washington, DC  20510                                                      Washington, DC  20510    

Dear Chairman Shelby and Vice Chairman Durbin: 

Thank you for your continued support for the Gulf War Illness Research Program (GWIRP) within the Department of Defense (DoD) Congressionally Directed Medical Research Programs (CDMRP), including the $22 million provided in Fiscal Year (FY) 2019.  As your Subcommittee begins work on the FY 2020 DoD Appropriations Bill, we are writing to share details of the program and to respectfully request that you include adequate funding to continue the GWIRP’s successful work on behalf of Gulf War veterans.

By congressional design, the GWIRP is a unique medical research program narrowly focused on a vision of improved health and lives of Veterans who have Gulf War Illness (GWI).[1] Successive reports by the congressionally-mandated Research Advisory Committee on Gulf War Veterans' Illnesses (RAC) and the National Academy of Sciences (NASEM) have shown that: 1) Gulf War Illness (GWI) is a physical condition – likely caused by toxic exposures – that affects up to one-third of the nearly 700,000 veterans who served in the 1991 Persian Gulf War; 2) Debilitating GWI symptoms typically include "some combination of widespread pain, headache, persistent problems with memory and thinking, fatigue, breathing problems, stomach and intestinal symptoms, and skin abnormalities."[2]^(p.2),[3] 

While two-thirds of GWIRP studies are still in progress, the positive news is that there is a growing body of GWIRP-funded study results, many published in peer-reviewed scientific journals, that demonstrates steady advances of GWIRP’s goals of identifying underlying mechanisms, diagnostic markers, and treatments.¹ For example, the GWIRP-funded consortia at Boston University and Nova Southeastern University identified several potential treatments through their interdisciplinary preclinical and computational biology research projects; those treatments will now be tested in the Gulf War Illness Clinical Trials and Interventions Consortium (GWICTIC), which will include five clinical trials at seven study sites (three VA) to target GWI’s inflammation, energy production, and immune function issues.[4] And, the GWIRP-funded Boston Biorepository, Recruitment, and Integrative Network (BBRAIN) will aggregate biological samples and data to further advance GWI diagnostic marker efforts.⁴These successes are the direct result of clear treatment-focused congressional direction, stable appropriations for the GWIRP, and effective GWIRP management. 

Recognizing the program's progress, the last RAC report's recommendations remain instructive:

"Congress should maintain its funding to support the effective treatment-oriented [GWIRP]."^2(p.14) These gradually building scientific results continue to represent encouraging steps toward achieving the 2010 NASEM treatment goals "to speed the development of effective treatments, cures, and, it is hoped, preventions"^3(p.1) for current and future U.S. forces at risk of similar exposures and outcomes. Indeed, the GWIRP has served as a model of how to conduct treatment-oriented research to address a challenging illness and is succeeding where earlier programs failed. Its two-tier peer-reviewed and highly competitive process ensures the independence and value of the results produced. While VA’s research program is intramural (it only funds VA researchers), GWIRP is not similarly constrained and seeks to find and fund the best research by any combination of government, academic, or private-sector research teams. 

We respectfully request that you provide the necessary resources to continue this vital and effective program in the FY20 DoD Appropriations Bill. Furthermore, it is critical to the program's success and accountability that it remains a stand-alone program within the CDMRP and not be combined as a topic area within broader, less-targeted research programs.

Thank you for your consideration of our request, which is supported by the Veterans of Foreign Wars (VFW), Veterans for Common Sense, Disabled American Veterans (DAV), Vietnam Veterans of America (VVA), Iraq and Afghanistan Veterans of America (IAVA), AMVETS, Paralyzed Veterans of America (PVA), Blinded Veterans Association, The  Enlisted Association (TREA), Military Officers Association of America (MOAA), Fleet Reserve Association, Association of the United States Navy (AUSN), Air Force Sergeants Association (AFSA), National Gulf War Resource Center, Burn Pits 360, Sgt. Sullivan Circle, and the National Vietnam and Gulf War Coalition.

Sincerely, 

****

 HOUSE FY20 EDC and DEAR COLLEAGUE:

Support FY20 funding for DoD-CDMRP  
Gulf War Illness Treatment Research 

Deadline to sign on is Thursday, March 29 2019

Dear Colleague: 

We invite you to join us in sending a letter (text below) to the House Defense Appropriations Subcommittee urging continued support in FY 2020 for the treatment-focused Gulf War Illness Research Program within the Department of Defense Congressionally Directed Medical Research Programs (CDMRP).  

The Gulf War Illness Research Program is a unique federal program with an unprecedented vision to achieve,“improved health and lives of Veterans who have Gulf War Illness.” The GWIRP continues to succeed in efforts to “fund innovative Gulf War Illness (GWI) research to identify effective treatment and accelerate their clinical application, improve definition and diagnosis, and better understand pathobiology and symptoms.”As specified in more detail in the letter, the GWIRP continues to demonstrate its effectiveness in its mission to improve the health and lives of veterans debilitated and suffering from Gulf War Illness.  We need to ensure that these efforts continue for these veterans and for current and future U.S. forces at risk of similar exposures and outcomes. 

By congressional design, the Congressionally-directed Gulf War Illness Research Program (GWIRP) is a unique medical research program narrowly focused on identifying treatments and diagnostic markers for Gulf War Illness (GWI).¹

The most recent report of the Congressionally-mandated Research Advisory Committee on Gulf War Veterans’ Illnesses (RAC) recommended maintaining funding for this effective treatment-oriented program. 

The FY 2019 GWIRP request was supported by 83 offices, including current House Veterans Affairs Committee Chairman Takano and Ranking Member Roe, as well as then-Ranking Member Tim Walz and signed onto the letter. 

The Veterans of Foreign Wars and Veterans for Common Sensesupport this funding request.

The deadline to sign on is March 28, 2019. Please contact  Frances Diazat in Rep. Sablan’s office or Remy Fortin in Rep. Bergman’s office for more information or to sign this letter.  

Sincerely, 

GREGORIO SABLAN                                                             JACK BERGMAN                    

Member of Congress                                                                                                              Member of Congress  

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April 1, 2019

The Honorable Pete Visclosky                           The Honorable Ken Calvert

Chairman                                                                                                                Ranking Member 

Subcommittee on Defense                                                                      Subcommittee on Defense 

Committee on Appropriations                                                             Committee on Appropriations 

H-405, The Capitol,                                          1016 Longworth House Office Building

Washington, DC  20515                                                                                Washington, DC  20515    

Dear Chairman Visclosky and Ranking Member Calvert:

As your Subcommittee begins work on the Fiscal Year 2020 Defense Appropriations Bill, we respectfully request adequate funding for the Gulf War Illness Research Program within the Department of Defense Congressionally Directed Medical Research Programs (CDMRP). We
also thank you for providing the program $22 million in Fiscal Year 2019.

By congressional design, the GWIRP is a unique medical research program narrowly focused on the vision of improving the health and lives of Veterans with Gulf War Illness.

Reports by the congressionally-mandated Research Advisory Committee on Gulf War Veterans' Illnesses (RAC) and the National Academy of Sciences (NASEM) have shown that: 1) GWI is a
physical condition - likely caused by toxic exposures - that affects up to one-third of the nearly
700,000 veterans who served in the 1991 Persian Gulf War; 2) Debilitating GWI symptoms typically include "some combination of widespread pain, headache, persistent problems with
memory and thinking, fatigue, breathing problems, stomach and intestinal symptoms, and skin abnormalities." [1 • 2]

Two-thirds of GWIRP studies are still in progress. However, the positive news is that
there is a growing body of GWIRP-funded study results, many published in peer-reviewed
scientific journals, that demonstrate steady advances of GWIRP's goals of identifying underlying mechanisms, diagnostic markers, and treatments. For example, the GWIRP-funded consortia at
Boston University and Nova Southeastern University identified several potential treatments
through their interdisciplinary preclinical and computational biology research projects. Those
treatments will now be tested in the Gulf War Illness Clinical Trials and Interventions
Consortium, which will include five clinical trials at seven study sites to target OWi's
inflammation, energy production, and immune function issues.[3] Additionally, the GWIRP-funded Boston Biorepository, Recruitment, and Integrative Network will aggregate biological samples
and data to further advance GWI diagnostic marker efforts. These successes are the direct result of clear, treatment-focused congressional direction, stable appropriations for the GWIRP, and effective GWIRP management.

Recognizing the program's progress, the most recent RAC report's recommendations remain instructive: "Congress should maintain its funding to support the effective treatment­oriented [GWIRP]."[4] The discoveries through the program continue to represent encouraging steps toward achieving the 2010 NASEM treatment goals "to speed the development of effective treatments, cures, and, it is hoped, preventions" for current and future U.S. forces at risk of similar exposures and outcomes. Indeed, the GWIRP has served as a model of how to conduct treatment­oriented research to address a challenging illness and is succeeding where earlier programs failed. Its two-tier peer-reviewed and highly competitive process ensures the independence and value of the results produced. Unlike the VA's GWI research program which only funds VA researchers, GWIRP seeks out and funds the best research by any combination of government, academic, or private-sector research teams.

We respectfully request that you provide the necessary resources to continue this vital and effective program in the FY20 Defense Appropriations Bill. Furthermore, it is critical to the program's success and accountability that it remains a stand-alone program within the CDMRP and not be combined as a topic area within broader, less-targeted research programs.

Thank you for your consideration of our request, which is supported by the Veterans of Foreign Wars (VFW), Veterans for Common Sense, Vietnam Veterans of America (VVA), Iraq and Afghanistan Veterans of America (IAVA), AMVETS, Paralyzed Veterans of America (PVA), Blinded Veterans Association (BV A), The Retired Enlisted Association (TREA), Military Officers Association of America (MOAA), National Gulf War Resource Center, Bum Pits 360, Sgt. Sullivan Circle, National Vietnam & Gulf War Veterans Coalition.

Sincerely, 

GREGORIO KILILI CAMACHO SABLAN                   JACK BERGMAN 

Member of Congress                                                                                              Member of Congress 

MARK TAKANO                                                         PHIL ROE, M.D.

Member of Congress                                                                                                 Member of Congress 

...with 97 total Members of Congress cosigning.

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[1]Research Advisory Committee on Gulf War Veterans' Illnesses, U.S. Department of Veterans Affairs, “Gulf War Illness and the Health of Gulf War Veterans: Research Update and Recommendations, 2009-2013,” 2014. 

[2]National Academy of Sciences, Institute of Medicine, “Gulf War and Health, Volume 8: Update of Health Effects of Serving in the Gulf War,” 2010.

[3]GWIRP: https://cdmrp.army.mil/gwirp/research_highlights/18klimas_highlight

[4]Research Advisory Committee on Gulf War Veterans' Illnesses, U.S. Department of Veterans Affairs, “Gulf War Illness and the Health of Gulf War Veterans: Research Update and Recommendations, 2009-2013,” 2014

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--Anthony Hardie, 91outcomes.com Author and Gulf War veteran advocate.