Tighten Pentagon Medical Rules

During the Persian Gulf War, military commanders ordered as many as 250,000 troops to take an experimental drug that had shown promise in reducing the toxicity of soman, a deadly nerve agent that Iraq’s Saddam Hussein was thought to be stockpiling. Last week, Congress concluded a series of hearings into whether the drug pyridostigmine bromide (PB) might have contributed to Gulf War syndrome, a poorly understood constellation of disorders afflicting tens of thousands of military personnel who fought in the 1991 war.

PB, which blocks transmission of messages between nerves and muscles, can have short-term side effects like nausea, abdominal cramps, skin rash and muscle weakness that are similar to the most common long-term symptoms of Gulf War syndrome. At last week’s hearing, a Veterans Affairs health official, Frances M. Murphy, cited several studies since 1994 that she said underscored the need for “further research on possible health effects from PB.” Many veterans afflicted with the syndrome say Pentagon officials and Veterans Administration doctors have been too quick to dismiss their problems as psychosomatic.

Federal rules require that, with civilians, investigational drugs be administered only with the “informed consent” of the person being treated and that there be a thorough system for assessing the drug’s effects. The Pentagon, however, was granted a wartime exemption for PB and now says it does not have records documenting its administering of the drug.

In testimony last week, Undersecretary of the Army Bernard Rostker acknowledged that “we’ve learned a lot from our experience with PB in the Gulf War.” He outlined a plan to comply with an executive order issued by President Clinton in September to have the Pentagon document its use of experimental drugs, communicate health risk information to armed services members and monitor health effects.

Congress also included language in the recently passed defense appropriations bill requiring the Defense Department to expand research into another possible contributor to the syndrome, a vaccine additive called squalene. Full compliance with that provision is particularly important given the perception of many Gulf War veterans, unfounded or otherwise, that vaccinations are contributing to their health problems.

The Pentagon’s plans to beef up oversight of experimental drugs may be imperfect, but they will greatly improve the safety and efficacy of its efforts to protect troops against biological weapons.