Science 5 May 2006

Science 5 May 2006:
Vol. 312. no. 5774, p. 668

News of the Week

VETERANS ADMINISTRATION:

Texas Earmark Allots Millions

to Disputed Theory of Gulf War Illness

By Jennifer Couzin

Scientists usually bristle when U.S. legislators mandate a project that benefits their constituents. But Gulf War illness researchers are especially troubled by such a funding provision inserted by Senator Kay Bailey Hutchison (R-TX) in this year's budget for the Department of Veterans Affairs (VA). The $15 million earmark to the University of Texas (UT) Southwestern Medical Center in Dallas not only avoids the traditional peer-review process, but it also marks the rare--and possibly first ever--VA funding of a program outside its research network, and to a researcher whose theory of the debilitating illness hasn't won much scientific support.

"The particular avenue of research being pursued is not one that has found much favor with the scientific community," says Simon Wessely, director of the King's Centre for Military Health Research at King's College London. Adds John Feussner, a former head of VA research now at the Medical University of South Carolina in Charleston, "This takes money directly out of the VA research portfolio. … I can't think of any advantage" from the new Gulf War research program.

The money will fund a new center at UT Southwestern, unveiled on 21 April. It exists thanks to Hutchison, who chairs the spending panel that sets the VA's budget and has long urged more government-funded research into Gulf War illness. Her priority "is getting the money to the person who can best help battle this illness," says spokesperson Chris Paulitz. In her mind, that individual is epidemiologist Robert Haley, who for years has reported a strong link between exposure to neurotoxins, such as nerve gas and pesticides, and the puzzling cluster of symptoms that struck thousands of veterans after the 1990-'91 Gulf War.

Haley was initially funded by former presidential candidate and businessman Ross Perot and later by the Department of Defense. He believes that Gulf War illness is "an encephalopathy" marked by abnormalities in brain structures and in the nervous system. Many troops, he believes, were exposed to low levels of nerve gas during the first Gulf War.

Now, Haley expects to pin down how these toxins affect the brain, and how to ease their effects, once and for all. Certainly, there's no shortage of funds: Hutchison expects the center--which Haley says will be called the Gulf War Illness and Chemical Exposure Research Center--will receive $75 million from VA over 5 years. Haley says it will initially focus on brain imaging, a survey of veterans from the first Gulf War, animal studies, and a Gulf War illness research and treatment clinic at the Dallas VA Medical Center.

But "this is not a grant to Robert Haley," he says. The dean of UT Southwestern's medical school, Alfred Gilman, will convene a merit review committee, and "all of our projects will go through" it, says Haley, adding that the committee's precise function hasn't been set. Traditional peer review as practiced by agencies such as VA and the National Institutes of Health, says Haley, has helped scientists take small steps forward. But it has failed to solve the enigma of Gulf War illness. "If we continue at this rate," he says, "it's going to be 50 years before we help these people."

Haley's Gulf War theories, however, put him in the minority. Animal studies disagree on whether low-dose neurotoxin exposure is deleterious in the long term, and the neurotoxin theory has come up short in expert reviews. In 2004, the Institute of Medicine (IOM) in Washington, D.C., concluded that "there is inadequate/insufficient evidence" to forge a link between exposure to low levels of sarin gas and the memory loss, muscle and joint pain, and other symptoms that characterize Gulf War illness. Wessely argues that British troops, which have the same rates of Gulf War illness as seen in Americans, were nowhere near the Khamisayah weapons depot in Iraq, the most cited example of suspected nerve gas exposure during the war. The IOM report notes that an attempt to replicate Haley's findings of genetic susceptibility to nerve gas proved unsuccessful.

A VA committee that included Haley came to a different conclusion. It reported in 2004 that neurotoxin exposure was a "probable" explanation for Gulf War illness and recommended that VA spend at least $60 million over 4 years on Gulf War illness research. The neurotoxin arena "is the most promising area for research at the present time," says James Binns, a Vietnam veteran and Arizona businessman, who chaired the committee that wrote the report. VA agreed (Science, 19 November 2004, p. 1275) but never put up the money--until Hutchison's amendment compelled it to do so. Initial funding will be limited to UT Southwestern and other schools, generally in Dallas, with which Haley collaborates, he says.

Joel Kupersmith, VA's chief research and development officer, calls the plan "an opportunity to move ahead on Gulf War research" and expressed "confidence" in UT Southwestern. But then again, VA had little choice but to move forward. "We follow what the laws and regulations are," says Kupersmith.