“I can put my fingers on 2,000 well-characterized patients. The work could be done, so why haven’t we done that yet? Because – every single one of the things I have just described – not one of them is receiving federal dollars.” – Dr. Nancy Klimas – P2P Workshop
The Federal Advisory Committee for Chronic Fatigue Syndrome (CFSAC) may finally be approaching real relevance. The committee’s role is to provide advice and recommendations to the Secretary of Health on issues relating to, as the website now says, myalgic encephalomyelitis and chronic fatigue syndrome.
Until last year, however, few, if any of the major recommendations from the panel (create COE’s, produce RFA’s), had ever been acted on. (The federal government acted on CFSAC’s highest priority – creating a definition – when it authorized the P2P and IOM reports.) CFSAC was more a place to file recommendations and educate patients about the government’s programs than to get really meaningful work done.
The two federally funded reports due out this year – the P2P report and the IOM report (due Feb 1oth ) – could shift that. Both will clearly endorse actions that patients, patient groups, and advocacy organizations have been clamoring for for years. The difference is that this time new recommendations are coming from inside the NIH instead of outside it.
These two projects are the NIH’s all the way. They created them in secret – no patient advocates involved – and they picked the experts, many of whom are outsiders, to sit on the panels. That’s enormously helpful – you can’t pin the results on ME/CFS advocates. The NIH has essentially created its own monsters: two groups that are going to tell it, politely of course, that virtually everything that it’s done to this point has been insufficient, and not just a little insufficient but grossly insufficient, to help the people with this disorder. It’s time for the NIH to finally get to work.
The P2P report calls for research networks, Centers of Excellence, National Biobanks, career paths, education outreach and other programs CFSAC has been recommending for years. I imagine that the IOM panel – with the many ME/CFS experts on it – seeing a strong P2P report – is going to go for the jugular and recommend massive changes as well.
That brings us to CFSAC, the mostly ignored but nevertheless potentially very valuable resource sitting in our laps. ME/CFS is one of very few disorders in the NIH, believe it or not, that has its own federal advisory committee. The P2P report was strong but needs tightening. Neither timelines nor numerical targets were ever mentioned.
That’s a bit scary for a community that’s received the runaround from the NIH time and time again. My feelings of unease at that were amplified after hearing Deputy Director Susan Maier suggesting, at the P2P Workshop, that ME/CFS researchers find money in other fields (that have money) and then castigating ME/CFS researchers for not applying for grants. (My guess is that hearing that someone like Ian Lipkin grouse about getting rejected twice probably isn’t going to spark much enthusiasm in that area. Funding high-profile researchers like Lipkin is probably a good thing to do if you want other researchers to participate.)
She’s right, though. You can’t win if you don’t play and ME/CFS researchers, by and large, have not been playing at the NIH.
But if Maier knows the history of the disease at the NIH, she knows that simply producing some RFAs will bring old researchers and new roaring into the field. That worked wonders about ten years ago and it would do spectacularly well now. But here we have her suggesting that researchers get money from other fields – the ones the NIH is willing to fund. Not only is that scary, but it’s also really old news: the NIH was suggesting that (fruitlessly) long before Maier stepped on the scene.
Maier’s statement may, however, simply reflect the horrible position ME/CFS finds itself in at the Office of the Director and Office of Women’s Research with no budget and no credible funding mechanism. We have big structural issues that need to be taken care of.
It’s going to be up to ME/CFS advocates – and that’s us and that’s CFSAC, SolveME/CFS Initiative, PANDORA, the Simmaron Research Foundation, and everyone else – to take advantage of these opportunities. How critical our voices are going to be was made clear when the head of the Office of the Director himself, Dr. James Anderson, whom one might think could with flick of his pen throw massive resources ME/CFS patients’ way, said, “ultimately it is the voices of the patients that will help advance research on ME/CFS.” The man appears to be saying he needs backup. You want big changes, you – the patients – have to push for them.
That brings us back to special CFSAC conference call tomorrow. The P2P report had holes you could run tanks through. Hopefully, they will listen to the comments from advocates and organizations (due by the 16th) but CFSAC is a Federally sponsored group; you’ve got to think that it’s recommendations are going to carry some extra weight.
Thankfully CFSAC got its act together and called a special session to produce its own recommendations for the P2P report. It will create those during a two-hour conference call from 1-3 pm EST. Anyone can listen in.
Call-in Number for the CFSAC Teleconference Call
- Tuesday, January 13, 2015 1:00 PM – 3:00 PM EST
- 1-888-928-9122
- Participant passcode: 9898494
As the P2P and IOM reports come out, they will provide a window of opportunity that the ME/CFS community will — or will not — fully take advantage of. If we come together to produce core demands and come up with a creative strategy to maximize them, ME/CFS research could look very different in a year’s time.
Thank you Cort!! It is very true that we must work together.
Cort, thank you as always for reporting and clarifying the news in such a balanced way. Happy to read that you’re optimistic about the IOM report. I’ve read so much anger and despair, really glad to see a different perspective. What makes you think that things will be well on the 15th? (Not meant to sound like a challenge — just really looking forward to good news — it finally seems after decades that we could be turning a corner — yeah, work to be done — but it would be so good to turn that corner.)
Two things – I actually heard it was going to be good from someone much closer to the action than me plus I just can’t imagine that, given the panel there – from Dr. Klimas to Dr. Bateman to Ron Davis – that, given what happened with the P2P report – with no ME/CFS experts – that the IOM report won;’t be really good 🙂
I’m predicting a big success – we’ll see!
Awesome — thank you!!
Yes, yes! Thank you Cort! Have others written in P2P comments requesting/demanding deadlines and timelines for steps forward in funding, research centers, etc? Or about the chair’s ME/CFS economic impact quoted figure being WAYY off?…she said 1 billion and it’s closer to 20 bil (18.7 bil based on community sample and 23.9 bil based on a tertiary sample) based on Dr. Lenny Jason’s more current study (he presented also of course). Obviously she was a little off! Robert Miller, the patient advocate and speaker said he passed the updated figures along to the chair…hopefully that gets counted in and not only emailed in comments. On the topic of researchers who have applied for NIH funding and who’ve been denied…does anyone have a list (even a short one!)? I know one is Ian Lipkin as the article states (he even has the blessing of the director of…?..maybe even Francis Collins). Also, names of great researchers who have LEFT the ME/CFS research field b/c they were so frustrated b/c of applying and applying and not getting federal funding? I know there is one mentioned in the HPA Axis presentation by Kathleen Light on OFFER’s Youtube…a researcher she mentioned, male…I read elsewhere he left the field b/c of not being able to get funded though he wanted to do the work. He was a prof I believe. I’ve already written the P2P once quoting Dr. Jose Montoya on the significance of study on the nervous system/brain in ME/CFS…I can write again…just need a little more info!
Cort,
Thank you for this excellent overview. I live in hope something at NIH/HHS is actually going to shift to take this illness seriously. We shall see.
Thanks – I think we’re going to have to push them hard for substantial changes to take. We’re bucking decades of embedded neglect….
Is there a plan how to push them?
Not that I know of 🙁
I was very pleased listening to CFSAC discuss and decide on their reply to the P2P draft report today. They did not lean towards hedging their responses politically with whatever they may have supposed that P2P would accept or end up using, but rather agreed upon a reply based on what all the science so far shows, not just that which passed through the ARQ review, as well as what they community of patients and experts have been asking for.
Agreed…I thought it was good – altho I wished they had pressed for numerical targets. I don’t know if they specifically recommended RFA’s either. Other than that – quite impressivie 🙂
The NIH is so full of it. They are/have suggested that the reason that funding for CFS research is low is because there aren’t enough high quality grant proposals being sent. Then they suggest that CFS researchers look for money in other areas that are already being funded. Well… Columbia University (Dr. Lipkin), who I am sure can write a high quality grant, got rejected by the NIH for a proposal to study the micro biome–which is an “other area” that is being heavily funded.
Actually the reality in this situation is even more twisted if you think about it. Patients, many of who get federal disability benefits turned around and donated upwards of $200,000 to his study. So I guess, in a round about way, the federal government is funding this study indirectly through SSDI payments.
What a crazy world we live in, eh?
Indeed! It demonstrates what we’re up against as well…It’s not going to be easy.
Cort,
Thank you for all your work in the CFS/FM field. I’ve pretty recently been diagnosed and from the research I have found, you are involved in just about all the informative articles and the only recent and up to date fibro site. I appreciate you! I’ll keep following…
Thanks – I’m trying to keep up!
Thanks, Cort. I thought CFSAC did good this time, too.
I hope you’re right that Dr. Anderson needs input about the money. Of course, CFSAC has been saying this for years. But I have heard from another org that they needed to hear from the end users; maybe lots of patients writing in about funding could help. Surely it couldn’t hurt.
best,
Janelle
I think I was a bit confusing above. By “another org” I mean a totally unrelated type of organization.
I was a bit confusing above. By “another org” I meant a totally unrelated type of organization. Sorry. 🙂
Cory, are there specific actions you recommend we take? Would be nice to focus our energies at one or two place to get the most impact. Do you have links or email addresses you could recommend?
I don’t know. I think after the IOM report we should all make a serious attempt at getting together and driving for change.