Gulf War Illnesses:

Management Actions Needed to Answer Basic Research Questions

NSIAD-00-32: Published: Jan 6, 2000. Publicly Released: Feb 2, 2000.

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Pursuant to a congressional request, GAO provided information on management actions needed to answer basic research questions about Gulf War Illnesses, focusing on the: (1) amount of money the Departments of Veterans' Affairs (VA), Defense (D0D), and Health and Human Services (HHS) spent on research and investigation of Gulf War veterans' illnesses and health concerns in the fiscal years 1997 and 1998, including current and projected spending by the Office of the Special Assistant to the Deputy Secretary of Defense for Gulf War Illnesses; (2) productivity of this research spending, including the extent to which the Coordinating Board has determined that federal research objectives have been satisfied, and the extent to which the research has resulted in peer-reviewed publications and the identification of the causes or successful treatments for Gulf War veterans' illnesses; (3) extent of coordination between the Research Working Group of the Coordinating Board and the Office of the Special Assistant for Gulf War Illnesses; and (4) Office of the Special Assistant for Gulf War Illnesses' contract management.

GAO noted that: (1) during fiscal years (FY) 1997-1998, DOD, VA, and HHS spent more than $121 million on research and investigation of Gulf War veterans' illnesses, with DOD spending more than $112 million of that total; (2) these funds supported a growing catalog of research and investigatory efforts intended to address both veterans' health concerns and their questions about hazards encountered in the conflict; (3) the Office of the Special Assistant to the Deputy Secretary of Defense for Gulf War Illnesses spent about $65.3 million in FY 1997 and FY 1998, with another $65.4 million in spending planned for FY 1999 and FY 2000; (4) basic questions about the causes, course of development, and treatments of Gulf War veterans' illnesses remain unanswered; (5) as of November 30, 1999, the Research Working Group of the Persian Gulf Veterans' Coordinating Board had not published an assessment of the extent to which the research program had answered the major questions it identified as research objectives in 1995, and no date had been set to publish such an assessment; (6) while federally sponsored studies have resulted in some descriptive information concerning veterans' symptoms, many basic questions remain; (7) although the question of causation is unresolved, VA has begun recruiting patients for trials of antibiotic and exercise-behavioral treatments for a set of veterans' unexplained symptoms; (8) although the Office of the Special Assistant for Gulf War Illnesses expends more than half of the federal funds supporting research and investigation into Gulf War veterans' illnesses, its activities are not effectively coordinated with those of the Research Working Group; (9) the weak coordination between the Group and the Office increases the potential to miss opportunities to leverage ongoing and completed work by other agencies; (10) the Office rapidly developed relationships with various contractors to support its mission; (11) however, two of the largest task orders were awarded improperly, and the Office discouraged competition for another task order by specifying a preferred vendor; and (12) because the Office is likely to continue to spend a significant part of its budget on support contracts, it needs to ensure that its contracts fully comply with applicable requirements.

Recommendations for Executive Action

  1. Status: Closed - Not Implemented

    Comments: A report is in review. For further information, see comments associated with VA.

    Recommendation: With respect to the health research efforts coordinated by the Research Working Group of the Persian Gulf Veterans' Coordinating Board, the Secretaries of Veterans' Affairs, Defense, and Health and Human Services should direct the executive director of the Research Working Group to establish and achieve a target date within fiscal 2000 for publishing its assessment of progress toward addressing the research objectives it identified in 1995.

    Agency Affected: Department of Defense

  2. Status: Closed - Not Implemented

    Comments: A report to Congress is currently under review. Refer to the comments associated with VA and DOD for further information.

    Recommendation: With respect to the health research efforts coordinated by the Research Working Group of the Persian Gulf Veterans' Coordinating Board, the Secretaries of Veterans' Affairs, Defense, and Health and Human Services should direct the executive director of the Research Working Group to establish and achieve a target date within fiscal 2000 for publishing its assessment of progress toward addressing the research objectives it identified in 1995.

    Agency Affected: Department of Veterans Affairs

  3. Status: Closed - Not Implemented

    Comments: The Secretary of Defense has not directed the Executive Director of the Research Working Group to collect such data. For further information, refer to the status of VA's response to the recommendation.

    Recommendation: With respect to the health research efforts coordinated by the Research Working Group of the Persian Gulf Veterans' Coordinating Board, the Secretaries of Veterans' Affairs, Defense, and Health and Human Services should direct the executive director of the Research Working Group to compile data on the number of Gulf War veterans with unexplained illnesses, the progression of their illnesses, the treatments they are receiving, and the success of these treatments (recognizing that application of some working case definitions or categorization scheme may be useful for purposes of such an accounting).

    Agency Affected: Department of Veterans Affairs

  4. Status: Closed - Not Implemented

    Comments: The Executive Director of the RWG has not received direction to collect such data. For further information on progress toward implementing this recommendation, see the comments associated with VA and DOD.

    Recommendation: With respect to the health research efforts coordinated by the Research Working Group of the Persian Gulf Veterans' Coordinating Board, the Secretaries of Veterans' Affairs, Defense, and Health and Human Services should direct the executive director of the Research Working Group to compile data on the number of Gulf War veterans with unexplained illnesses, the progression of their illnesses, the treatments they are receiving, and the success of these treatments (recognizing that application of some working case definitions or categorization scheme may be useful for purposes of such an accounting).

    Agency Affected: Department of Defense

  5. Status: Closed - Not Implemented

    Comments: VA did not concur with this recommendation, which called for specific Secretarial direction to the Executive Director of the Research Working Group. The Department indicated that the Research Working Group had already provided sufficient information on the scope of activities that it continued to coordinate among VA, DOD, and HHS. GAO found, however, that substantially similar activities fell outside this scope and observed nothing in the law that would limit the Group's coordinating efforts to this scope of activities.

    Recommendation: With respect to the health research efforts coordinated by the Research Working Group of the Persian Gulf Veterans' Coordinating Board, the Secretaries of Veterans' Affairs, Defense, and Health and Human Services should direct the executive director of the Research Working Group to effectively coordinate the efforts of the Office of the Special Assistant for Gulf War Illnesses with related activities of DOD, VA, and HHS to prevent duplication and improve the efficiency of resource use.

    Agency Affected: Department of Health and Human Services

  6. Status: Closed - Not Implemented

    Comments: The Executive Director of the Research Working Group has not received such direction. For further information, see the comments associated with VA.

    Recommendation: With respect to the health research efforts coordinated by the Research Working Group of the Persian Gulf Veterans' Coordinating Board, the Secretaries of Veterans' Affairs, Defense, and Health and Human Services should direct the executive director of the Research Working Group to effectively coordinate the efforts of the Office of the Special Assistant for Gulf War Illnesses with related activities of DOD, VA, and HHS to prevent duplication and improve the efficiency of resource use.

    Agency Affected: Department of Defense

  7. Status: Closed - Not Implemented

    Comments: The Secretary of Defense has not directed the Research Working Group to coordinate OSAGWI's efforts with the VA and HHS. For further information, see the status report on VA's response to this recommendation.

    Recommendation: With respect to the health research efforts coordinated by the Research Working Group of the Persian Gulf Veterans' Coordinating Board, the Secretaries of Veterans' Affairs, Defense, and Health and Human Services should direct the executive director of the Research Working Group to effectively coordinate the efforts of the Office of the Special Assistant for Gulf War Illnesses with related activities of DOD, VA, and HHS to prevent duplication and improve the efficiency of resource use.

    Agency Affected: Department of Veterans Affairs

  8. Status: Closed - Not Implemented

    Comments: The subject task order expired, and the services that OSAGWI had purchased under it are now purchased from the same contractor (then known as BDM, now TRW) under a Blanket Purchase Agreement formed pursuant to FAR 13.303.

    Recommendation: The Secretary of Defense should direct the Office of the Special Assistant for Gulf War Illnesses to replace the task order issued under the Management, Organizational, Business Improvement Services contract with a proper contracting arrangement as soon as practicable.

    Agency Affected: Department of Defense

  9. Status: Closed - Not Implemented

    Comments: DOD did not concur with this recommendation. While DOD did not take issue with GAO's conclusion that it had issued a task order outside the scope of a multiple-award task order contract, it asserted that OSAGWI's contracting actions complied with the laws and regulations in effect at the time of the award, and stated that OSAGWI had relied on the judgment of contracting professionals outside that office. As GAO noted in the report, this would not absolve the office of responsibility concerning how its contract support is acquired, which would include, at a minimum, responsibility for determining and articulating its requirements.

    Recommendation: The Secretary of Defense should direct the Office of the Special Assistant for Gulf War Illnesses that all future support contracts should comply fully with applicable laws and regulations.

    Agency Affected: Department of Health and Human Services

 

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