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Hon. Eric Shinseki, Secretary of Veterans Affairs Hon. Jose Riojas, Acting Chief of Staff FROM: James Binns, Chairman Research Advisory Committee on Gulf War Veterans Illnesses SUBJECT: Opportunity DATE: April 29, 2013 Dear Mr. Secretary and Mr. Riojas: With the departure of Mr. Gingrich, I propose to begin submitting bi-monthly reports to you in the format attached. Naturally, I will be pleased to modify the report in any way you prefer, and to answer any questions you may have. As a preface to this report, I would respectfully suggest that the past year has shown that the need for a Congressionally-mandated committee that provides independent advice to the Secretary on what VA staff is doing wrong regarding Gulf War health research remains as necessary as ever. However, it is basically a lousy model. To find treatments for Gulf War illness, your scientific advisors should not spend half their time as watchdogs. The Chief of Staff should not need to be a referee. Instead, your research organizations should be run by people who believe in their mission and do their jobs right in the first place. You have the rare opportunity to put new people in those jobs. There is already a vacancy in the CRADO position at ORD. And the recent Congressional testimony of Dr. Steven Coughlin demonstrates the need to appoint new leadership in several positions at OPH and provides you the ammunition to do so. The path is open to make these offices a model within VA rather than a constant headache, and to get the RAC out of the business of complaining to you and Congress and into full-time scouting for new science that points the way to effective treatments. Unfortunately, the current review of Dr. Coughlin’s charges by the Office of Research Oversight is focused on the important but limited question of the ethical responsibility to provide followup care to veterans who respond in surveys that they have had suicidal thoughts. It is not likely to address the serious issues he raised regarding OPH senior managers’ concealing and manipulating science and lying to the Secretary’s Office. I respectfully encourage you to use other investigative means at your disposal to pursue these issues. A person who could help such an internal investigation is Dr. Lawrence Deyton. Dr. Deyton ran OPH briefly at the time you took office, but left to become head of the new Tobacco Center at FDA. Last month, he left FDA with rave reviews from everyone from the Administrator to the Campaign for Tobacco-Free Kids. He is now on the faculty of Georgetown
University, and probably has no interest in full-time government service, but he cares about veterans, and very likely would be willing to assist in evaluating what is happening at OPH. If senior managers have indeed deliberately misled science and the Secretary’s Office, surely these are grounds for dismissal. Both at OPH and ORD, I would encourage you to involve yourself in the hiring process, Mr. Secretary. At ORD, the internal system will likely identify the current deputy CRADO, Dr. Timothy O’Leary, as a leading candidate. Dr. O’Leary would represent a continuation of past policies, as Dr. Kupersmith has basically done whatever Dr. O’Leary wanted to do, at least on Gulf War issues. There is not a member of the RAC who trusts Dr. O’Leary, for good reasons. I would suggest that you use a group that includes knowledgeable outsiders to screen candidates. Mr. Gingrich attempted to do this himself, personally reading scores of resumes for the Gulf War Research program manager position a couple of years ago. Despite the immense amount of time he devoted to this selection, he had no way to pick up the fact that the candidate recommended by ORD, whom he ultimately approved (Dr. Kalasinsky), had personally worked with Dr. O’Leary at a previous organization. I would urge you to establish a small group of highly qualified people, not selected by internal staff, to screen candidates and recommend several to you, and that you personally interview the finalists and make the choices. I would suggest that you ask them about their experience and views related to illnesses involving toxic exposures. Committee members might include Dr. David Korn (a distinguished Harvard medical professor who serves on VA’s National Research Advisory Council), Dr. Floyd Bloom (a former president of the American Academy for the Advancement of Science, who serves on the RAC), and Dr. Stephen Hauser (chairman of neurology at the University of California San Francisco and a former president of the American Neurological Association, who chaired the committee that wrote the 2010 IOM report -- the one IOM report that wasn’t improperly influenced by VA and DoD staff). Perhaps you would want to add someone you personally trust to be part of the group, even if he or she is not a scientist. If the rules say that outsiders can’t be on a hiring committee, hopefully they can at least be informal advisors. You surely deserve an outside perspective in trying to correct an inside problem. Thank you for your consideration of these suggestions. The right people in charge at ORD and OPH would make an immense difference. It is the only hope for real progress in VA Gulf War health research. Very Respectfully,