By Dan Olmsted
A harsh new report is blasting the relationship between a federal agency and the Institute of Medicine -- saying costly reports the IOM produced were worthless and failed to connect a widespread but baffling epidemic with its true causes.
No, it's not about autism. This criticism relates to the Veterans Administration and studies it commissioned from the Institute of Medicine to look into Gulf War Illness. The Congressionally mandated independent review of Gulf War Studies, in a report to be officially released Tuesday, calls the VA-IOM effort a diversion from the search for the truth.
It says that Saddam Hussein didn't cause Gulf War Syndrome -- we did. The most likely suspects, it concludes, are a nerve gas antidote used protectively (there was never an attack) and widespread exposure to pesticides. And it says multiple vaccinations given to the troops cannot be ruled out.
Too many vaccines … a potent and inadequately tested medicine used to ward off an attack that never came, one that may have mimicked the effects of actual exposure … environmental toxins causing new and catastrophic mental and physical damage … a conflicted government agency using the IOM for its own purposes.
In other words, it sounds a lot like the autism-vaccines report the IOM produced in 2004 for its client, the CDC -- which found no relationship between the two -- and the belief by many in the autism community that the science was skewed to produce a predetermined result. It also goes to the issue of whether scientific research has become so politicized and corporatized, especially in the past eight years, that a top to bottom review is needed -- something President-Elect Obama has said he will order.
Here is the heart of the matter, according to the new report:
"In 1998, with few conclusive answers to continuing questions about Gulf War illness and the federal response to this problem, Congress directed VA to contract with the National Academy of Sciences (NAS) to review available research in order to assist the Secretary of Veterans Affairs in making decisions about Gulf War-related disability compensation. Public Laws … directed that the review identify conditions that affect Gulf War veterans at excess rates and assess the scientific evidence concerning associations between those conditions and a detailed list of Gulf War exposures.
In response, VA commissioned the Institute of Medicine (IOM), within the National Academies, to conduct a series of reviews using a methodology previously established to evaluate diseases affecting Vietnam veterans in relation to Agent Orange. (Hyams/Brown). To date, the resulting Gulf War and Health series has included nine reports, including two updated reports, and provided hundreds of conclusions. The Committee was concerned to find that the IOM reviews were not conducted in accordance with the laws that mandated them. As a result, the Gulf War and Health reports have provided little information that is directly relevant to health conditions that affect Gulf War veterans at excess rates, or their association with Gulf War exposures.
The 1998 legislation specifically directed that VA commission reviews that identify both diagnosed and undiagnosed illnesses that affect Gulf War veterans at excess rates and, based on a comprehensive consideration of available research, determine whether there is evidence that those illnesses are associated with Gulf War exposures or Gulf War service. However, the health conditions considered in the IOM Gulf War and Health reports have primarily included multiple types of cancer and a number of other diagnosed diseases—conditions for which there are no indications that Gulf War veterans have been affected at excess rates. In contrast, the IOM reports have provided almost no information on conditions that do occur at excess rates in Gulf War veterans. That is, the Gulf War and Health reports have not provided findings on possible associations between Gulf War illness or ALS and most Gulf War exposures. Nor do they provide findings on conditions like migraines and seizures, which preliminary information suggests may affect Gulf War veterans at excess rates, in relation to Gulf War exposures.
The legislation also directed that determinations be based on scientific evidence provided by both human and animal studies. Most studies that evaluate biological effects of hazardous exposures are done in animals, for ethical reasons. In recent years, a large number of animal studies have identified biological effects of Gulf War exposures and combinations of exposures that were previously unknown. Although animal research was sometimes described in the IOM reports, findings from animal studies were not considered in drawing conclusions about the evidence that Gulf War exposures were associated with health outcomes. Unlike IOM's earlier Agent Orange reports, the standards used to determine levels of evidence for the Gulf War and Health reports expressly limited IOM panelists to consideration of results from human studies. The omission of animal studies was especially striking in IOM's updated report on sarin (nerve gas for which the antidote was given to U.S. troops), which had been requested by the Secretary of Veterans Affairs in 2003 specifically because of new research in animals that demonstrated adverse effects of low-level sarin exposure.
… The hundreds of findings provided in the IOM reports are largely inconclusive, indicating that there is insufficient evidence to determine if the diseases considered are associated with the exposures considered, based on the types of studies considered.
The specific information included in the Gulf War and Health reports is also problematic, in that it appears to reflect a process of reporting selected results from subgroups of studies, rather than integrating and analyzing results from all available research. This is a pervasive problem. …
In short, IOM's Gulf War and Health series of reports have been skewed and limited by a restrictive approach to the scientific tasks mandated by Congress, an approach directed by VA in commissioning the reports. These limitations are most notably reflected in the selective types of information reviewed and the lack of in-depth analysis of the research literature and scientific questions associated with the health of Gulf War veterans. There is a fundamental disconnect between the Congressional directive to VA and VA's charge to IOM for reviewing evidence on Gulf War exposures and their association with illnesses affecting Gulf War veterans. The reports have particularly fallen short in advancing understanding of associations between Gulf War exposures and Gulf War illness, the most prominent health issue affecting Gulf War veterans."
This set-up, of course, will be familiar to Age of Autism readers knowledgeable about the CDC-mandated-and-manipulated IOM study of autism and vaccines, which pulled every kind of punch -- from hurrying up the report to avoid looking at new studies, to ignoring or denigrating studies like the hair-mercury analysis and the violent reaction to thimerosal in mice bred to have autoimmune problems, to overweighting slipshod epidemiological studies that even the IOM acknowledged could fail to identify a susceptible subset of children.
Bottom line: The VA-IOM debacle is an analogous case study to the IOM-CDC cover-up, with similar consequences -- lack of understanding of what really caused Gulf War Syndrome; lack of understanding of what really caused the autism epidemic. At a deeper level, the study suggests a culture in which "science" is just another political tool to silence criticism and prevent the truth from emerging. In Patrick Fitzgerald's memorable phrase in the Scooter Libby trial, the IOM appears to have become a mechanism for "kicking sand in the umpire's face."
This connection was not lost on Steve Robinson, one of America's leading veterans advocates, who was instrumental in exposing the Bush Administration's shabby treatment of returning Iraq and Afghanistan veterans.
"It's the three-card monte game they use to have a pre-determined outcome," Robinson told me. And it's no mere game -- at stake are treatment and compensation for, in this case, hundreds of thousands of Gulf War vets whose lives have been damaged by their decision to serve their country.
"How do we break the code of how corrupt it is to manipulate science this way, not just for vets but for autism and other issues?" asked Robinson, who has been informally working with the Obama transition team on veterans' issues. He said Obama "is not going to get the ground truth from these people" in any of the areas where the science has been corrupted.
"What does he inherit? A politicized federal government [science program] that is defunct and corrupt." The problem is most acute four or five levels down from the top, where the actual manipulation occurs, he said. Those are the people who need to come clean.
The Gulf War review panel basically called for a mulligan on the shoddy VA/IOM collaboration -- recommending that the VA ask the IOM to redo all its studies and that the VA office involved in the previous studies, the Office of Public Health and Environmental Hazards, be removed from all participation in the new effort.
Here's an idea, one that's been circulating in the autism community for some time: Redo the IOM studies on autism and vaccines and remove the CDC, the U.S. Public Health Service and their pharma-flacking cronies from all oversight and responsibility.
Maybe the debacle at the VA will encourage the Obama Administration to take another look at the autism-vaccine "science" produced by the CDC and stamped "approved" by the IOM. A number of autism advocates worked hard for years to get the Bush administration to reconsider the Immunization Safety Review findings on autism. They made modest progress: the IOM sponsored a "Workshop on Autism and the Environment" last year.
Age of Autism Editor-at-Large Mark Blaxill was a member of the Planning Committee for that workshop. "The workshop was a small step in a better direction," says Blaxill, "but even getting that far was a huge struggle. And in no way whatsoever did it undo the damage done by the 2004 report. We need to see some intellectual courage from our scientific leadership. So far, all we've seen is systemic cowardice and a complete perversion of the scientific process. In the meantime, families are suffering and no one is doing anything about it."
A final note -- while the IOM may claim it was just doing its job as mandated by the VA, that's not good enough, not for an institution that is part of the National Academies, which calls itself "Advisers to the Nation on Science, Engineering and Health." IOM could just as easily have read the Congressional mandate and told the VA that its request was not in accordance with the law -- in common parlance, illegal. In fact, why didn't they stand up for good science? Was the contract too enticing? Yet the IOM says it advises "the nation."
The nation is not the VA -- the nation is veterans. The nation is not the CDC -- it's families and individuals coping with an autism epidemic. And the nation is certainly not the federal government -- the nation is the people who elected that government to protect and defend them; it's you and me.
And we, the people, keep getting royally screwed.
Dan Olmsted is Editor of Age of Autism.