PREFACE

Persian Gulf veterans report a variety of symptoms and illnesses that they believe are the result of their service. Although the Departments of Veterans Affairs (VA) and Defense (DoD) have taken important steps to ensure the delivery of quality medical care to these individuals, there is a need to increase understanding of the nature and extent of these illnesses, and their potential connection to service in the Persian Gulf. The overwhelming majority of Persian Gulf veterans who have come to VA or DoD for medical care have been found to have common conditions and have received, or are receiving, treatment for their problems. However, some veterans have symptoms or conditions that physicians have not been able to diagnose. In addition, many veterans have questioned whether the illnesses that are common and diagnosable are etiologically linked to their service in the Persian Gulf conflict. Many questions have been answered with existing knowledge of the Persian Gulf veterans' experience. Others will require scientific research, much of which is currently underway.

The VA, DoD, the Department of Health and Human Services (HHS), and the Environmental Protection Agency (EPA), through the Persian Gulf Veterans Coordinating Board (PGVCB), have led the way in the conduct of research on Persian Gulf veterans' illnesses. The scope of the research issues has necessitated the development of a working plan that will help the Persian Gulf Veterans Coordinating Board coordinate federally sponsored research in a way that all the relevant research issues are targeted but unnecessary duplication is avoided. This document lays out that plan.

Although this plan is primarily intended to guide federal decision makers in establishing research spending priorities, it is also meant to provide information to members of Congress, the scientific community, the public and, most importantly, the veterans of the Persian Gulf conflict, about the manner in which the federal government is carrying out the research mandate.

Because research, by its nature, often leads to unexpected findings, as well as refinement in thinking about specific topics, this plan has been designed to be flexible and changeable over time. In response to new research findings, this plan will be updated periodically to account for new information leading to changes in direction. This plan also attempts to balance the need for specific, targeted research directions, with the awareness that successful research, fostered by sound research questions, arises from the minds of independent scientists in research laboratories. Therefore, this working plan sets the broad research areas in which it is believed investment will most likely bring new and useful knowledge.

It is important to note that this research agenda is only one element of a broader strategy aimed at addressing the problems and concerns of Persian Gulf veterans and their families. The other elements include:

MEDICAL CARE

Providing appropriate medical care has been a top priority of VA and DoD. The two departments have acted aggressively to ensure the delivery of high quality medical care to Persian Gulf veterans.

COMPENSATION

VA and DoD have taken action to ensure prompt compensation of Persian Gulf veterans disabled by their military service.

RESEARCH

Research, which is the subject of the present document, is indispensable to the improvement of medical care for Persian Gulf veterans, and to the formation of a firm basis for compensation.

EDUCATION AND OUTREACH

Persian Gulf veterans, and their health care providers, must have access to the latest information on medical care, compensation, and research. This information will enable veterans to make sound judgments about their own health status, and to know how and where they can seek assistance. It will also enable physicians, and other health care providers, to provide state-of-the art diagnosis and treatment to veterans.

Finally, to help ensure that the U.S. Government is doing everything possible to determine the causes and provide care to those who are ill, the President has established a Presidential Advisory Committee on Gulf War Veterans' Illnesses. This Advisory Committee will review and provide recommendations on the full range of U.S. Government activities on the this important issue.

Through the implementation of this working plan, in conjunction with the other components of the overall strategy, it is hoped that confident, reliable answers to the concerns of Persian Gulf veterans can be obtained in a reasonable time and with maximal efficiency.

Kenneth W. Kizer, M.D., M.P.H.
Under Secretary for Health