Posted September 3, 2020

By Kate Poindexter, CDMRP Public Affairs Office

Some took a break from managing their laboratories. Others carved out some time from managing their symptoms. Hundreds of scientists and Veterans met online last month to discuss the ongoing medical issues facing Gulf War Veterans at the first Virtual Gulf War Illness State of the Science Conference. The event was co-hosted by the Department of Veterans Affairs (VA), Office of Research and Development (ORD) and the Department of Defense (DoD) Congressionally Directed Medical Research Programs (CDMRP), and coincided with the 30-year anniversary of the start of the 1990-1991 Gulf War, Operation Desert Shield. The two-day conference included a keynote address by former VA Chief of Staff, COL John Gingrich USA-Ret., a panel of Gulf War Veterans living with Gulf War Illness, and both live and pre-recorded presentations of ongoing research from the VA and CDMRP research portfolios. The virtual conference created a forum for Gulf War Veterans to engage directly with scientists and learn about the studies that are being conducted to further understand and treat the disease. More than 600 people dialed into the conference and more than 200 connected on a virtual platform.

�We were proud to join the VA as we recognized the Veterans who deployed in support of Operation Desert Shield 30 years ago, and those who have been affected by Gulf War Illness (GWI). Such a complex condition demands the best minds coming together to strategize the way forward. This important conference provides the needed collaboration and helps set synergistic research priorities to identify the treatments needed for our Gulf War Veterans,� said COL Sarah B. Goldman, Director, CDMRP while welcoming participants to the conference. COL Goldman continued, �CDMRP�s Gulf War Illness Research Program (GWIRP) has been Congressionally-directed since 2006 and remains committed to treatment-focused research that will improve the health and lives of our Veterans with GWI. Fully integrating Gulf War Veterans and their families into helping make GWIRP recommendations, investment strategy, and research focus is important, and CDMRP is committed to continuing to lean on their valuable input.�

Dr. Rachel Ramoni, Chief Research and Development Officer for VA gave opening remarks and COL Gingrich, USA-Ret. Gulf War Veteran and former Chief of Staff for VA gave a keynote address.

�The lively dialog that has taken place between the research community and the Gulf War Veteran community is a wonderful model for doing research in VA,� said Dr. Ramoni after the meeting. �I am grateful for the Veterans who are making their voices heard in this conference. They are helping us ensure that our Gulf War research is targeting the most critical needs, and they are setting an inspiring example for other Veteran communities, as well.�

In his keynote, COL Gingrich spoke about the need to continue to build trust, and the importance of collaboration among researchers and good communication with Veterans.

�I am encouraged with this meeting,� he said. �This symposium is an example of VA-DoD synergy and collaboration, which is the way scientific discoveries happen. True lasting success will be achieved if solutions are timely, well-communicated, understood and accepted by Veterans, and implemented effectively.�

Karen Block, Ph.D., Gulf War Research Program manager, VA ORD welcomed the Gulf War community and stated, �The purpose of the conference was to present and advance the state of the science regarding GWI, raise awareness of the federal research funding landscape related to GWI, and to encourage collaboration and enable idea exchange among research groups and across disciplines.� According to Dr. Block, VA ORD�s program goals are to build trust with the Gulf War community and improve health and quality of life among Gulf War Veterans. Research goals include elucidating mechanisms and developing effective treatments, identifying biomarkers and improving diagnoses, and continuing surveillance/health monitoring for the aging Gulf War population.

Kristy Lidie, Ph.D., manages CDMRP�s GWIRP. The program�s research goals include identifying effective treatments and accelerating their clinical application. The GWIRP also funds research that improves definition and diagnosis and promotes better understanding of the pathobiology and symptoms of disease. In FY06, FY08-19* the GWIRP managed 202 awards totaling $129M. For FY20, the GWIRP has a budget of $22M and anticipates 12 awards.

Dr. Lidie opened the conference by acknowledging the challenges of adapting to an online-only venue. �I know it can be hard to be engaged virtually but the now narrowing medical and scientific evidence in the field superseded any thought of postponing or canceling the conference due to the pandemic. In line with the goals for this conference, for the next two days we will talk, listen with an open mind, and share ideas. This is truly when science is at its best, and I am hopeful the information learned will enable new research partnerships to significantly advance Gulf War Illness research and treatment,� she said.

As a conference organizer she urged presenters and attendees to continue to work together to identify solutions that can have real impact on Veterans� lives. �Research makes a difference. Collaborative research goes even further.�

Input from Veterans

CDMRP has a unique way of combining the contributions of scientists and consumers to maximize efforts that show results. GWIRP funding applications are reviewed and evaluated by researchers and consumers. Consumer reviewers may be Veterans, survivors, family members, or care givers who understand the effects of the disease. Gulf War Veteran Anthony Hardie, National Chair and Director of Veterans for Common Sense, participated as a consumer reviewer for the GWIRP for many years. He currently serves as a Programmatic Panel member and was the panel chair for five years. He says his days spent poring over innovative research on the panels helped him explore some new channels with his doctors to find relief for his own GWI symptoms. He was on the conference steering committee and organized and led the Veteran panel. He said it helped foster new conversations. �The conference was incredibly important. It was the first of its kind � an interagency online conference that brought together researchers who were working separately and provided for collaboration and discussion. After our Veterans panel, presenters were in chat rooms, on phone lines and emailing, asking questions and receiving feedback,� he said.

Updates on Research and Treatment

Investigators funded by the VA and CDMRP presented findings in a series of plenary sessions. Research topics included consortia, biorepositories, treatments, epidemiology, definition and diagnosis/biomarkers, and pathobiology.

�There were several themes woven throughout as well, such as Veteran satisfaction and needs from the healthcare system and the recognition that multiple biological systems likely interact, perhaps in unique ways, to impact the heterogeneous disease collectively referred to as GWI,� said Dr. Dane B. Cook, professor of kinesiology at the University of Wisconsin-Madison and a conference planning committee member.

Research into Action

VA�s research agenda is determined through a strategic planning process that incorporates guidance and input from a broad and diverse array of stakeholders: scientific and medical experts, Veterans and Veteran Service Organizations, and advisory groups such as the Congressionally mandated Research Advisory Committee on Gulf War Veteran's Illnesses. Study proposals from VA investigators undergo rigorous review by medical and scientific experts before they are funded.

Dr. Block told the investigators that their research was making a difference. �It is important to publish your data and cite your funding. Negative results are just as important as ground-breaking results,� she said. She urged them to increase strategic partnerships and to �engage and listen to our Gulf War heroes. Share your findings and conclusions with them,� she said.

Mr. Hardie is already looking to expand the agenda for a future conference. He would like to see even more discussion on treatment options for Veterans. Event organizers are taking notes.

�We hope to conduct the conference again next year,� said Dr. Cook. We plan to survey scientists and participants in order to determine what worked, what needs to be changed, and what we can add to improve upon this successful start.�

Dr. Lidie added, �It has been such a privilege to be a part of this historic conference. We now have the responsibility to harness the power of science and evidence and make sure it is translated into action. It is important to pay careful attention to all voices and I�d especially like to thank all of the Veterans who participated in the panel and in the chat.�

Find more information on the Virtual Gulf War Illness State of the Science Conference here: Gulf War Illness State of the Science Virtual Conference. Find more information on CDMRP�s GWIRP at https://CDMRP.HEALTH.MIL/gwirp/ and the VA ORD at http://www.research.va.gov/.

*The program was not funded in FY07.

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