Gulf War Illnesses:

Enhanced Monitoring of Clinical Progress and of Research Priorities Needed

T-NSIAD-97-190: Published: Jun 24, 1997. Publicly Released: Jun 24, 1997.

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Nancy R. Kingsbury
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GAO discussed the result of its study on the government's clinical care and medical research programs relating to illnesses that members of the armed forces might have contracted in the Persian Gulf War, focusing on the: (1) efforts of the Departments of Defense (DOD) and Veterans Affairs (VA) to assess the quality of treatment and diagnostic services provided to Gulf War veterans and their provisions for follow-up of initial examinations; (2) government's research strategy to study the veterans' illnesses and the methodological problems posed in its studies; and (3) consistency of key official conclusions with available data on the causes of the veterans' illnesses.

GAO noted that: (1) over 100,000 Gulf War veterans have participated in DOD and VA health examination programs; (2) of those veterans examined by DOD and VA, nearly 90 percent reported a wide array of health complaints and disabling conditions; (3) although efforts have been made to diagnose veterans' problems and care has been provided to many eligible veterans, neither DOD or VA has systematically attempted to determine whether ill Gulf War veterans are any better or worse today than when they were first examined; (4) federal research on Gulf War veterans' illnesses and factors that might have caused their problems has not been pursued proactively; (5) the majority of the research has focused on the epidemiological study of the prevalence and cause of Gulf War illnesses rather than the diagnosis, treatment, and prevention of them; (6) while this epidemiological research will provide descriptive data on veterans' illnesses, methodological problems are likely to prevent researchers from providing precise, accurate, and conclusive answers regarding the causes of veterans' illnesses; (7) ongoing epidemiological federal research suffered from two methodological problems: a lack of case definition, and absence of accurate exposure data; (8) without valid and reliable data on exposures and the multiplicity of agents to which the veterans were exposed, researchers will likely continue to find it difficult to detect relatively subtle effects and to eliminate alternative explanations for Gulf War veterans' illnesses; and (9) support for some official conclusions regarding stress, leishmaniasis (a parasitic infection), and exposure to chemical agents was weak or subject to alternative interpretations.

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