Some of the country’s top universities are sounding alarms over the Pentagon’s elimination of a battlefield medicine research program and are planning to take their fight to the Hill to keep funding alive.
Critics say that the Pentagon’s decision to nix funding for the Medical Free Electron Laser (MFEL) program could halt tangible advances in research that could find cures for injuries and diseases afflicting troops fighting in the Middle East.
The push comes as Congress throws its weight and funding priorities behind military healthcare and combat-injury treatment as a result of complicated and often severe battle wounds in Iraq and Afghanistan. At the same time, the Pentagon is struggling to balance high operational and personnel costs with the need to develop new weapons systems.
But supporters of the MFEL program are grappling with the Pentagon’s decision to ax this particular effort, which they say has had a proven success record for more than 20 years. John Young, the acting acquisition czar and formerly the director of defense research and engineering, decided to zero out funding for the program starting in 2008. Across the various 2008 defense-spending bills, it has received only a fraction of its usual funding in congressional earmarks.
The MFEL program currently has centers at Massachusetts General Hospital, Duke University, Stanford University, the University of California at Irvine and Vanderbilt University. It started in 1986 as Congress and the Department of Defense became concerned about the use of high-pulse light lasers as a weapon to blind pilots.
Since then, much of the program has focused on developing advanced procedures for rapid diagnosis and treatment of battlefield-related medical problems, such as soft tissue repair, hard tissue surgery, therapies for thermal and chemical burns, vision correction, and enhanced medical imaging.
Free electron lasers (FELs) provide unique pulse features and tunable wavelength characteristics that are unavailable in other laser devices. In effect, they broaden the experimental options for the development of new laser-based medical technologies, according to the Pentagon’s own program description. The lasers are tested in medical centers before they head for FDA approval, leading to potential dual use for civilian medicine.
MFEL, a peer-reviewed, merit-based and competitive program, has been funded at an average of $17 million a year. For the past few years, the Pentagon provided around $10 million annually while supporters in Congress would add about another $10 million in earmarks.
Over the past 22 years, the Pentagon has poured approximately $400 million into the program, which has been able to mature and receive FDA approval for several discoveries, according to supporters. By comparison, the pharmaceutical industry spends about $1 billion over several years to get one drug to market.
Among the program’s dual-use discoveries are laser surgery for severe skin burns and scars; laser treatment for kidney stones (lithotripsy), which are a common result of dehydration for military personnel serving in desert environments; and a light-activated drug used to treat macular degeneration.
Despite strong support from Congress, however, the program this year has only secured plus-up funds, or earmarks, worth $2 million in the House defense appropriations bill and $3 million in the Senate’s bill. Supporters say those funds are too little to keep the program going, effectively halting research that is nearing delivery.
As the Senate defense appropriations bill comes to the floor, the universities will look to their congressional supporters to try and boost funding.
Meanwhile, House authorizers, with strong backing from the California, Massachusetts and Tennessee delegations, approved $18 million for the program, while their Senate counterparts settled on $8 million.
“There are a fair number of promising efforts that would die,” said Dr. Rox Anderson, director of the Wellman Center for photo-medicine at Massachusetts General Hospital. “[It’s like] a farmer walking away before the harvest.”
The university labs are ready for military and clinical trials for nerve and blood vessel bonding for limb repair; remote diagnosis and treatment for blast injuries and head trauma; and a cure for Leishmaniasis, commonly known as the Baghdad boil, a parasitic disease transmitted by sand flies.
What makes MFEL unique compared to other research programs within the Pentagon is that it gathers a group of high-level scientists and doctors that otherwise would have not focused their efforts on solving battlefield medical problems, Anderson said. Cutting off funds would divert the expertise of some top biomedical labs from that mission, he added.
In anticipation of the 2008 Pentagon budget process, Sens. Elizabeth Dole (R-N.C.), Richard Burr (R-N.C.), Edward Kennedy (D-Mass.), John Kerry (D-Mass.), Lamar Alexander (R-Tenn.), Barbara Boxer (D-Calif.) and Dianne Feinstein (D-Calif.) wrote to Deputy Secretary of Defense Gordon England urging the Pentagon to fund the program at $20 million. A short letter from the Pentagon’s comptroller, Tina Jonas, informed the senators that the Pentagon has to fund other priorities.
The lawmakers requested $20 million for the program in earmarks and ultimately received $3 million. Amy Auth, Dole’s spokeswoman, said that MFEL continues to be one of the senator’s top priorities.
Pentagon’s Young — a former Appropriations defense subcommittee staff member with a master’s degree from Stanford — so far has not accepted to meet with any of the universities, according to several sources. Among the reasons he and England gave for the cancellation is that the program is mature and could be transferred to the National Institutes of Health (NIH) or other programs within the Pentagon.
But critics say that the Pentagon already is strapped for cash when it comes to funding combat casualty medicine, and that the NIH does not fund programs specifically dedicated to combat casualties. A provision in the 2003 defense authorization act prohibits the transfer of the program to NIH.
An official request for comment from the Pentagon was not returned by press time.
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