Lupus and the Military – A New Kind of Mission
As the military has seen an increase in the number of women in active duty the last 40 years, there has been a significant increase in the prevalence of lupus in the ranks. Out of the over 200,000 women who serve, over 50% are women of color, mostly black and Hispanic. We already know that women in general and specifically women of color experience the highest incidences of lupus, so it’s no wonder the military has seen an increase in the number of its members and veterans being diagnosed with this chronic illness. So, how has the military responded?
The increase in lupus diagnoses among its personnel has not gone unnoticed by the military. As the face of the military changes, attitudes towards military personnel and how we take care of those who bravely serve are changing. Since women face some medical issues that men rarely – if at all – face, the military has found itself having shift its focus to accommodate these differences. Subsequently, since 2005, the Department of Defense (DOD) has responded to the growing need for more creative and innovative lupus research in order to improve the quality of life of its members, veterans and the American public. Two of its most powerful forces are the Congressionally Directed Medical Research Programs (CDMRP) and the Lupus Research Program (LRP).
The Department of Defense’s Response to the Increase in Lupus Diagnoses
Congressionally Directed Medical Research Programs (CDMRP)
Rest assured, whether you are actively serving in the military, are a veteran, or are a member of the general public, the DOD is looking out for everyone by bringing awareness to chronic illness and the need for effective treatment options and eventual eradication of these diseases. In 1992, the Congressionally Directed Medical Research Programs (CDMRP) were created which partners the DOD with the public and Congress in order to “transform healthcare for Service Members and the American public through innovative and impactful research.” According to their mission statement, the CDMRP’s primary role is to “manage collaborative research that discovers, develops, and delivers health care solutions” not only to members of the armed forces, but veterans and the general public as well.
The Lupus Research Program (LRP)
Quickly acknowledging that as more women enter the armed forces and are subsequently being diagnosed with lupus either during active duty or after discharge, the CDMRP first funded lupus research in fiscal year (FY) 2005 as a Topic Area in the Peer Review Medical Research Program (PRMRP). Lupus research remained Topic Area until FY2016. From FY 2005-2016, 21 lupus research awards were granted totaling just over $20 million.
Starting in FY 2017, the Defense Appropriations Act provided $5 million to the CDMRP to fund the Lupus Research Program (LRP) and make it more than a Topic Area. The mission of the LRP is to “fund research to understand, prevent, and diagnose lupus and to improve treatments and quality of life of patients including Service Members, veterans, and beneficiaries.” As of FY2021, the DOD increased the fund, yet again to $10 million.
The LRP has three funding mechanisms:
The Idea Award, to fund innovative, untested and potentially groundbreaking concepts in lupus research.
The Impact Award, to fund “high risk / high reward” research that will have a great impact on lupus research itself.
The Transformative Vision Award, to fund research that will have an “intervention at the individual and/or healthcare system level, with in near-term impact on the health-related quality of life of persons living with lupus.”
For FY2021 in order to be considered for an award, grant applications must address at least one of these five areas of focus for the LRP:
- Understand lupus disease heterogeneity in risk of disease, presentation, clinical course, and outcomes including, but not limited to, biopsychosocial studies, personalized medicine, variation in treatment and its effects on patient outcomes, health economics, socioeconomic studies, environmental studies, and epidemiological.
- Understand lupus disease heterogeneity including, but not limited to, progressive stages of lupus over time, strategies and technologies to subtype patients, and understanding lupus disease mechanisms.
- Improve quality of life of patients with lupus.
- Understand how the underlying genetic components and gene environment interactions of lupus disease relate to clinical disease characteristics using functional genomic studies.
- Determine the pathobiology of lupus in target human tissues including, but not limited to, imaging studies, genomics of lupus disease in particular tissues, and metabolomics and how understanding the underlying pathobiology will improve quality of life of patients.
As you can see, the DOD through the CDMRP and LRP take lupus very seriously and are striving to develop better tools that can help diagnose and treat – and maybe eliminate – this often elusive chronic disease.
We deeply thank all those who are now or who have in the past courageously served our country. Their efforts and the efforts of those who have kept and continue to keep us safe have resulted in more awareness of the health issues that plague all individuals and the need to develop tools to fight against the ravages of these illnesses with lupus being no exception. While many of you continue the daily struggle of coping with flares, fog, fatigue and pain, the CDMRP, LPR and the DOD are bringing us one step closer to potentially finding a cure in order to eventually win the battle against lupus.
Chappell, B. (2015). Pentagon says women can now serve in front-line ground combat positions. Retrieved from: https://www.npr.org/sections/thetwo-way/2015/12/03/458319524/pentagon-will-allow-women-in-frontline-ground-combat-positions
Defense health program Department of Defense Lupus Research Program funding opportunities for fiscal year 2019. (2019). Retrieved from: https://cdmrp.army.mil/pubs/press/2019/19lrppreann
Lupus Research Program. (2018). Retrieved from: https://cdmrp.army.mil/lrp/pbks/LRPpbk2018.pdf
Lupus Research Program strategic plan. (n.d.). Retrieved from: https://cdmrp.army.mil/lrp/pdfs/LRP%20Strategic%20Plan.pdf
Shendruk, A. & Reynolds, G. (2018). Demographics of the U.S. military. Retrieved from: https://www.cfr.org/article/demographics-us-military
Author: Liz Heintz
Updated in 2021
Liz Heintz is a technical and creative writer who received her BA in Communications, Advocacy, and Relational Communications from Marylhurst University in Lake Oswego, Oregon. She most recently worked for several years in the healthcare industry. A native of San Francisco, California, Liz now calls the beautiful Pacific Northwest home.
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