§ 1603. AGREEMENT WITH NATIONAL ACADEMY OF SCIENCES.
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Purpose .— The purpose of this section is to provide for the National Academy of Sciences, an independent nonprofit scientific organization with appropriate expertise, to review and evaluate the available scientific evidence regarding associations between illnesses and exposure to toxic agents, environmental or wartime hazards, or preventive medicines or vaccines associated with Gulf War service. Agreement .— The Secretary of Veterans Affairs shall seek to enter into an agreement with the National Academy of Sciences for the Academy to perform the activities covered by this section.
The Secretary shall seek to enter into the agreement not later than two months after the date of enactment of this Act [ Oct. 21, 1998 ]. Identification of Agents and Illnesses .— Under the agreement under subsection (b), the National Academy of Sciences shall— identify the biological, chemical, or other toxic agents, environmental or wartime hazards, or preventive medicines or vaccines to which members of the Armed Forces who may have been exposed by reason of service in the Southwest Asia theater of operations during the Persian Gulf War or, after September 11, 2001 , in another Post-9/11 Global Theater of Operations; and identify the illnesses (including diagnosed illnesses and undiagnosed illnesses) that are manifest in such members.
In identifying illnesses under paragraph (1)(B), the Academy shall review and summarize the relevant scientific evidence regarding illnesses among the members described in paragraph (1)(A) and among other appropriate populations of individuals, including mortality, symptoms, and adverse reproductive health outcomes among such members and individuals. Initial Consideration of Specific Agents .— In identifying under subsection
(c)the agents, hazards, or preventive medicines or vaccines to which members of the Armed Forces may have been exposed for purposes of the first report under subsection (i), the National Academy of Sciences shall consider, within the first six months after the date of enactment of this Act [ Oct. 21, 1998 ], the following: The following organophosphorous pesticides: Chlorpyrifos. Diazinon. Dichlorvos. Malathion. The following carbamate pesticides: Proxpur. Carbaryl. Methomyl. The carbamate pyridostigmine bromide used as nerve agent prophylaxis. The following chlorinated hydrocarbon and other pesticides and repellents: Lindane. Pyrethrins. Permethrins. Rodenticides (bait). Repellent (DEET). The following low-level nerve agents and precursor compounds at exposure levels below those which produce immediately apparent incapacitating symptoms: Sarin. Tabun. The following synthetic chemical compounds: Mustard agents at levels below those which cause immediate blistering. Volatile organic compounds. Hydrazine. Red fuming nitric acid. Solvents. Uranium. The following ionizing radiation: Depleted uranium. Microwave radiation. Radio frequency radiation. The following environmental particulates and pollutants: Hydrogen sulfide. Oil fire byproducts. Diesel heater fumes. Sand micro-particles. Diseases endemic to the region (including the following): Leishmaniasis. Sandfly fever. Pathogenic escherechia coli. Shigellosis. Time compressed administration of multiple live, ‘attenuated’, and toxoid vaccines. The consideration of agents, hazards, and medicines and vaccines under paragraph
(1)shall not preclude the Academy from identifying other agents, hazards, or medicines or vaccines to which members of the Armed Forces may have been exposed for purposes of any report under subsection (i). Not later than six months after the date of enactment of this Act [ Oct. 21, 1998 ], the Academy shall submit to the designated congressional committees a report specifying the agents, hazards, and medicines and vaccines considered under paragraph (1). Determinations of Associations Between Agents and Illnesses .— For each agent, hazard, or medicine or vaccine and illness identified under subsection (c), the National Academy of Sciences shall determine, to the extent that available scientific data permit meaningful determinations— whether a statistical association exists between exposure to the agent, hazard, or medicine or vaccine and the illness, taking into account the strength of the scientific evidence and the appropriateness of the scientific methodology used to detect the association; the increased risk of the illness among human or animal populations exposed to the agent, hazard, or medicine or vaccine; and whether a plausible biological mechanism or other evidence of a causal relationship exists between exposure to the agent, hazard, or medicine or vaccine and the illness. The Academy shall include in its reports under subsection
(i)a full discussion of the scientific evidence and reasoning that led to its conclusions under this subsection. Review of Potential Treatment Models for Certain Illnesses .— Under the agreement under subsection (b), the National Academy of Sciences shall separately review, for each chronic undiagnosed illness identified under subsection (c)(1)(B) and for any other chronic illness that the Academy determines to warrant such review, the available scientific data in order to identify empirically valid models of treatment for such illnesses which employ successful treatment modalities for populations with similar symptoms. Recommendations for Additional Scientific Studies .— Under the agreement under subsection (b), the National Academy of Sciences shall make any recommendations that it considers appropriate for additional scientific studies (including studies relating to treatment models) to resolve areas of continuing scientific uncertainty relating to the health consequences of exposure to toxic agents, environmental or wartime hazards, or preventive medicines or vaccines associated with service described in subsection (c)(1)(A). In making recommendations for additional studies, the Academy shall consider the available scientific data, the value and relevance of the information that could result from such studies, and the cost and feasibility of carrying out such studies. Subsequent Reviews .— Under the agreement under subsection (b), the National Academy of Sciences shall conduct on a periodic and ongoing basis additional reviews of the evidence and data relating to its activities under this section. As part of each review under this subsection, the Academy shall— conduct as comprehensive a review as is practicable of the evidence referred to in subsection
(c)and the data referred to in subsections (e), (f), and
(g)that became available since the last review of such evidence and data under this section; and make determinations under the subsections referred to in subparagraph
(A)on the basis of the results of such review and all other reviews previously conducted for purposes of this section. Reports .— Under the agreement under subsection (b), the National Academy of Sciences shall submit to the committees and officials referred to in paragraph
(6)periodic written reports regarding the Academy’s activities under the agreement. The first report under paragraph
(1)shall be submitted not later than 18 months after the date of enactment of this Act [ Oct. 21, 1998 ]. That report shall include— the determinations and discussion referred to in subsection (e); the results of the review of models of treatment under subsection (f); and any recommendations of the Academy under subsection (g). Reports shall be submitted under this subsection at least once every two years, as measured from the date of the report under paragraph (2). In any report under this subsection (other than the report under paragraph (2)), the Academy may specify an absence of meaningful developments in the scientific or medical community with respect to the activities of the Academy under this section during the 2-year period ending on the date of such report. In each report under this subsection submitted after the date of the enactment of this paragraph [ Oct. 13, 2010 ], any determinations, results, and recommendations as described in paragraph
(2)shall be submitted separately as follows: For the Southwest Asia theater of operations for the period of the Persian Gulf War ending on September 11, 2001 . For the Post-9/11 Global Theaters of Operations for the period of the Persian Gulf War beginning on September 11, 2001 . Reports under this subsection shall be submitted to the following: The designated congressional committees. The Secretary of Veterans Affairs. The Secretary of Defense. Sunset .— This section shall cease to be effective on October 1, 2015 . Alternative Contract Scientific Organization .— If the Secretary is unable within the time period set forth in subsection
(b)to enter into an agreement with the National Academy of Sciences for the purposes of this section on terms acceptable to the Secretary, the Secretary shall seek to enter into an agreement for purposes of this section with another appropriate scientific organization that is not part of the Government, operates as a not-for-profit entity, and has expertise and objectivity comparable to that of the National Academy of Sciences. If the Secretary enters into an agreement with another organization under this subsection, any reference in this section and section 1118 of title 38 , United States Code (as added by section 1602(a)), to the National Academy of Sciences shall be treated as a reference to such other organization. Definitions .— In this section: The term ‘Persian Gulf War’ has the meaning given that term in section 101(33) of title 38 , United States Code. The term ‘Post-9/11 Global Theater of Operations’ means Afghanistan, Iraq, and any other theater of operations for which the Global War on Terrorism Expeditionary Medal is awarded for service.