Estimates of the numbers of 1991 Gulf War veterans who have CMI range from 175,000 to 250,000 (about 25–35% of the 1991 Gulf War veteran population), and there is evidence that CMI in 1991 Gulf War veterans may not resolve over time. Preliminary data suggest that CMI is occurring in veterans of the Iraq and Afghanistan wars as well. In 2010, a previous committee of the Institute of Medicine (IOM) recommended “a renewed research effort with substantial commitment to well-organized efforts to better identify and treat multisymptom illness in Gulf War veterans” (IOM, 2010).
THE CHARGE TO THE COMMITTEE
The present study was mandated by Congress in the Veterans Benefits Act of 2010 (Public Law 111-275, October 13, 2010). That law directs the secretary of veterans affairs “to enter into an agreement with the Institute of Medicine of the National Academies to carry out a comprehensive review of the best treatments for CMI in Persian Gulf War veterans and an evaluation of how such treatment approaches could best be disseminated throughout the Department of Veterans Affairs [VA] to improve the care and benefits provided to veterans.” In August 2011, VA asked that IOM conduct a study to address that charge, and IOM appointed the Committee on Gulf War and Health: Treatment for Chronic Multisymptom Illness. The complete charge to the committee follows.
The IOM will convene a committee to comprehensively review, evaluate, and summarize the available scientific and medical literature regarding the best treatments for chronic multisymptom illness among Gulf War veterans.
In its evaluation, the committee will look broadly for relevant information. Information sources to pursue could include, but are not limited to:
• Published peer-reviewed literature concerning the treatment of multisymptom illness among the 1991 Gulf War veteran population;
• Published peer-reviewed literature concerning treatment of multisymptom illness among Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn active-duty service members and veterans;
• Published peer-reviewed literature concerning treatment of multisymptom illness among similar populations such as allied military personnel; and
• Published peer-reviewed literature concerning treatment of populations with a similar constellation of symptoms.
In addition to summarizing the available scientific and medical literature regarding the best treatments for chronic multisymptom illness among Gulf War veterans, the IOM will: