The Secretary of VA  is required to submit an annual report on the results, status, and priorities  of federal research activities related to the health consequences of military  service in the Gulf War to the Senate and House Veterans’ Affairs  Committees. Federal Research on Gulf War Illnesses Has Decreased, and VA Has Not Collectively Analyzed Research Findings to Determine Research Needs

As of September 2003, about 80 percent of the 240 federally funded  research projects on Gulf War illnesses have been completed. Additionally,  funding for Gulf War-specific research has decreased, federal research  priorities have been expanded to incorporate the long-term health effects  of all hazardous deployments, and interagency coordination of Gulf War  illnesses research has diminished. Most Federal Gulf War Illnesses Research Projects Are Complete, and Funding Is Decreasing as Research Priorities Evolve

Since 1991, 240 federally funded research projects have been initiated by  VA, DOD, and HHS to address the health concerns of individuals who  served in the Gulf War. VA’s Coordination of Federal Gulf War Illnesses Research Has Lapsed, and VA Has Not Determined Whether Key Research Questions Have Been Answered

VA’s coordination of federal Gulf War illnesses research has gradually  lapsed. Starting in 1993, VA carried out its responsibility for coordinating  all Gulf War health-related activities, including research, through  interagency committees, which evolved over time to reflect changing  needs and priorities. Additionally, VA has not reassessed the extent to which the collective  findings of completed Gulf War Illnesses research projects have addressed  the 21 key research questions developed by the RWG. The  only assessment of progress in answering these research questions was  published in 2001, when findings from only about half of all funded Gulf  War illnesses research were available. Moreover, the summary did not  identify whether there were gaps in existing Gulf War illnesses research or  promising areas for future research. In 2000, we reported that  without such an assessment, many underlying questions about causes,  course of development, and treatments for Gulf War illnesses may remain  unanswered. However, VA and RAC are  exploring ways to improve information sharing, including VA’s hiring of a  senior scientist who would both guide the agency’s Gulf War illnesses  research and serve as the agency’s liaison to provide routine updates to  RAC. RAC Officials Cite VA’s Poor Information Sharing and Limited Collaboration as Impediments in Meeting Its Mission

According to RAC officials, VA senior administrators’ poor information  sharing and limited collaboration with the committee about Gulf War  illnesses research initiatives and program planning may have hindered  RAC’s ability to achieve its mission of providing research advice to the  Secretary of VA. RAC is required by its charter to provide advice and make  recommendations to the Secretary of VA on proposed research studies,  research plans, and research strategies relating to the health consequences  of service during the Gulf War. Without a comprehensive reassessment of  Gulf War illnesses research, underlying questions about the unexplained  illnesses suffered by Gulf War veterans may remain unanswered. However,  at the time of our review most of these changes had not been formalized. Appendix II: Charter For the VA Research Advisory Committee On Gulf War Veterans’ Illnesses (RAC)

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Why GAO Did This Study

More than a decade after the 1991 Persian Gulf War, there is continued interest in the federal response to the health concerns of Gulf War veterans. Gulf War veterans' reports of illnesses and possible exposures to various health hazards have prompted numerous federal research projects on Gulf War illnesses. This research has been funded primarily by the Department of Veterans Affairs (VA), the Department of Defense (DOD), and the Department of Health and Human Services (HHS). In 1993, the President named the Secretary of VA as the responsible party for coordinating research activities undertaken or funded by the executive branch of the federal government on the health consequences of service in the Gulf War. In 2002, a congressionally mandated federal advisory committee--the VA Research Advisory Committee on Gulf War Veterans' Illnesses (RAC)--was established to provide advice on federal Gulf War illnesses research needs and priorities to the Secretary of VA. This statement is based on GAO's report entitled Department of Veterans Affairs: Federal Gulf War Illnesses Research Strategy Needs Reassessment (GAO-04-767). The testimony presents findings about the status of research on Gulf War illnesses and VA's communication and collaboration with RAC.

What GAO Found

The federal focus on Gulf War-specific research has waned, but VA has not yet analyzed the latest research findings to identify whether there were gaps in research or to identify promising areas for future research. As of September 2003, about 80 percent of the 240 federally funded medical research projects for Gulf War illnesses had been completed. In recent years, VA and DOD have decreased their expenditures on Gulf War illnesses research and have expanded the scope of their medical research programs to incorporate the long-term health effects of all hazardous deployments. Interagency committees formed by VA to coordinate federal Gulf War illnesses research have evolved to reflect these changing priorities, but over time these entities have been dissolved or have become inactive. In addition, VA has not reassessed the extent to which the collective findings of completed Gulf War illnesses research projects have addressed key research questions or whether the questions remain relevant. The only assessment of progress in answering these research questions was published in 2001, when findings from only about half of all funded Gulf War illnesses research were available. Moreover, it did not identify whether there were gaps in existing Gulf War illnesses research or promising areas for future research. This lack of a comprehensive analysis of research findings leaves VA at greater risk of failing to answer unresolved questions about causes, course of development, and treatments for Gulf War illnesses. RAC's efforts to provide advice and make recommendations to the Secretary of VA on Gulf War illnesses research may have been hampered by VA senior administrators' poor information sharing and limited collaboration on research initiatives and program planning. For example, VA failed to inform RAC about its 2002 major research program announcement that included Gulf War illnesses research. VA and RAC are exploring ways to improve information sharing and collaboration, including VA's hiring of a senior scientist who would both guide VA's Gulf War illnesses research and serve as the agency's liaison for routine updates to the advisory committee. However, most of these changes had not been finalized at the time of GAO's review.