Congress of the United States Washington, DE 20515 April 3, 2017 The Honorable Kay Granger The Honorable Peter J. Visclosky Chairwoman Ranking Member Subcommittee on Defense Subcommittee on Defense House Committee on Appropriations House Committee on Appropriations H-405 The Capitol 1016 Longworth House Office Building Washington, DC 20515 Washington, DC 20515 Dear Chairwoman Granger and Ranking Member Visclosky: Thank you for your interest in and continued support of the Gulf War Illness Research Program (GWIRP) within the Department of Defense (DoD) Congressionally Directed Medical Research Programs (CDMRP). As your Subcommittee begins work on FY2018 DoD appropriations, we respectfully request adequate funding for the GWIRP. Since its inception, the GWIRP has demonstrated significant progress in developing treatments for Gulf War illness. The most recent (2014) report of the Congressionally- mandated Research Advisory Committee on Gulf War Veterans’ Illnesses (RAC), which built on landmark RAC 2008 and Institute of Medicine (IOM) 2010 reports, concluded: + “Scientific research [since 2008]... supports and further substantiates .... that Gulf War illness is a serious physical disease, affecting at least 175,000 veterans of the 1990-1991 Gulf War, that resulted from hazardous exposures in the Gulf War theater.” * “Symptoms typically include some combination of widespread pain, headache, persistent problems with memory and thinking, fatigue, breathing problems, stomach and intestinal symptoms, and skin abnormalities.” "Research has found an elevated incidence of ALS [Lou Gehrig's Disease],” and “Gulf War veterans who were most exposed to the release of nerve gas by the destruction of the Khamisiyah Iraqi arms depot have significantly elevated rates of death due to brain cancer.” There are concerns for the health of this vulnerable population as time progresses. * “Important progress has been made ... However, much work remains to be done.” These landmark reports emphasize that “effective treatments, cures, and, it is hoped, preventions” for GWI can “likely be found,” “..through a concerted national effort and rigorous scientific input.” In addition, important discoveries made by the GWIRP may also help protect current and future U.S. military service members at risk of similar toxic exposures.FY 18 Defense Appropriations - Gulf War Illness Research Program The GWIRP has shown itself to be a model on how to conduct treatment-oriented research to address a challenging illness. By Congressional design, the GWIRP is narrowly focused on “improving the health and lives of veterans who have Gulf War Illness,” by funding, “innovative Gulf War Illness research to identify effective treatments, improve definition and diagnosis, and better understand pathobiology and symptoms.” The GWIRP is making significant progress where earlier research failed to seek evidence-based treatments. Additionally: + GWIRP’s highly competitive, multi-stage peer-reviewed process is open to all researchers, whereas VA research is restricted to VA staff, few of whom have expertise in this rapidly-evolving, cutting-edge area. The GWIRP continues to fund interdisciplinary and inter-institutional research collaborations to better solve complex issues than by single researchers working alone. ‘+ GWIRP-funded research aimed at unlocking GWI's underlying mechanisms is showing great promise, and has found that even low-dose chemical warfare agent and/or other Gulf War exposures lead to persistent brain changes associated with GWI; correlation between animal models of exposure and markers of Gulf War Illness in veterans; evidence of mitochondrial dysfunction in GW/I and testing potentially relevant treatments; further evidence supporting that GWI includes chronic inflammation, made worse by exercise challenge, and testing potential treatments; a potential explanation of GWI immunological dysfunction; lipid dysfunction following GWI exposures and testing potentially relevant treatment; and other findings important to aiding veterans with cw. * Asa testament to the success of previously funded GWIRP treatment development. research, the GWIRP has for the first time recently funded projects to test the efficacy and safety of treatments predicted by that earlier research. + GWIRP’s efforts to date are steadily advancing, with most (75%) GWIRP funding to date ~ in 25 states and DC -- committed to projects that remain in progress. ‘The interest in the scientific community created by the landmark RAC and IOM reports, consistent Congressional support, effective GWIRP management, and scientific discover related fields are making possible significant advances towards GWIRP’s goals. The RAC, more than 50 Independent Budget Veterans’ Service Organizations (IBVSO's), scientist GWIRP panelists, and consumer reviewers serving with the GWIRP have expressed strong support for the GWIRP to improve the health and lives of veterans suffering from GWI The FY15 IBVSO's said the GWI CDMRP, “has made great strides in the short time it has been operating,” and the IBVSO’s for the 115th Congress (DAV, PVA, VFW, and 27 others) ask Congress to “...provide sufficient funding to resume robust research to identify effective treatments...”FY 18 Defense Appropriations - Gulf War Illness Research Program This request is supported by The American Legion, Veterans of Foreign Wars, Disabled American Veterans, Paralyzed Veterans of America, AMVETS, Vietnam Veterans of America, Veterans for Common Sense, National Vietnam and Gulf War Veterans Coalition, Sergeant Sullivan Circle, and the National Gulf War Resource Center. We respectfully request that you provide the necessary resources to continue this vital and effective program. Sincerely, WO, JgCk BERGMAT GREGORIO KILIL! CAMACHO SABLAN mber of Congress Member of Congress V ™ < PH PHIL ROE, M.D. Member of Congress Member of Congress pL bee zx Y (atiig? b - ‘ALCEE L. HASTINGS oe BOBBY L. RUSH Member of Congress Member of Congress JOHN K. DELANE’ Member of Congress ; en JULIA BROWNLEY Member of Congress Member of Congress \LBIO SII Mint: Member of Cony Ss Member of Congress Uehle Gomiun Cosel Coleman Kealaamn, CHELLIE PINGREE AUMUA AMATA COLEMAN RADEWAGEN Member of Congress Member of CongressFY 18 Defense Appropriations - Gulf War Illness Research Program ea PETER A. DEFAZIO. RON KIND. Member of Congress Member of Congress WALTER B. JONES CAROL SHEA-PORTER Member of Congress ber of Congress Ud ELIZABETH H. ESTY /EN MOORT Member of Congress Member of Congress Member of Congress Member of Congress Behe ORowrke. BETO O'ROURKE DAVID LOEBSACI Member of Congress Member of Congress KATHLEEN M. RICE SHEILA JACKSON FEE Member of Congress Member of Congress BILL. ) RUI Member of ae Member of Congress ED PERLMUTTER Member of Congress Ingress ‘ ate : DZ, : 4 ‘aul M. abrvos DANIEL W. LIPINSKI ’AUL M. GRUALV: Member of Congress Member of CongressFY 18 Defense Appropriations - Gulf War Iliness Research Program ISCHAKOWSKY f, CE. ber of Congress Member of Congress be a Deore Duy JOHN KATKO DEBBIE DINGELL Member of Congress Member of Congress DAVID N. CICILLINE RICK LARSEN Member of Congress Member of Congress lies BR. JI SA & [ARDENAS LINDA T. SANCHE: Mentber of Congress Member of Congress WILLIAM R. KEATING DONALD M. PAYNE, JR Member of Congress Member of Congress — ae LOIS FRANKEL Member of Congress Le ot OLIS /ERN BUCHANAN, ber of Congress Member of Congress JARED, Mer JUDY CHU MARK POCA Member of Congress Member of Congress ROSA L, DELAURO HENRY C. "HANK” JOHNSON, JR. ‘Member of Congress Member of CongressFY 18 Defense Appropriations - Gulf War Illness Research Program Cmn® &. m7 Lo} BB. MCKINLEY, ber of Congress Ofua- (eblille DIANA DEGETTE. Member of Congress MAE Pahl Member of Congress Ldn ob ff ADAM B. SCHIFF Member of Congress ES P. MCGOVERN mber of Congress KIE (Spo mber of Congress é JOSH GOTTHEIMER Member of Congress ELUAH E. CUMMINGS Te Member of Congress Member gf Congress STEVE KNIGHT Member of Congress Wy SINEMA. Member of Congress hdl MON VELA Member of Congress COLLIN C. PETERSON Member of Congress a a 4h, FOOT S hk “OTT H. PETERS — Member of Congress - oo joGGETT mber of Congress BLO BILL PASCRELL, JR. Member of Congress ER WELCH Member of Congress 4 IARC VEASEY Member of Congr:FY 18 Defense Appropriations - Gulf War Illness Research Program CHE TED S. YDHO, D, Member of Conbréss ber oi {IAN J. MAST Member of Congress BARBARA LEE ee Member of Congress \CKY ROSEN, Member of Congress ANTHONY BROWN Member of Congress RALF HAM, M.D. Member of Congress CHERI’BUSTO: Member of Congress JOE COURTNEY Member of Congress on floor GUS BILIRAKIS Member of Congress ELEANOR HOLMES NORTON Member of Congress MADELEINE Z,BORDALLO- it ‘ongress our fall ALAN LOWENTHAL Member of Congress Wytase. ‘ANN MCLANE KUSTER| Member of Congress Gadpncg 8 Uleors FREDERICA S.WILSON Member of Congress