STATEMENT OF
 
DR. FRED S. WRIGHT

ASSOCIATE CHIEF OF STAFF FOR RESEARCH

VA CONNECTICUT HEALTHCARE SYSTEM 

DEPARTMENT OF VETERANS AFFAIRS

ON THE VA MEDICAL AND PROSTHETIC RESEARCH PROGRAM

BEFORE THE SENATE COMMITTEE ON VETERANS' AFFAIRS

April 27, 2006
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Thank you for the opportunity to discuss the importance of the VA research program in general, the research program at VA Connecticut Healthcare System (VACHS), and the facility infrastructure.  Our program has more than 350 active projects led by more than 100 principal investigators. The majority of our investigators are clinicians who also provide patient care in Internal Medicine, Surgery, Mental Health, or Neurology. The topics of VACHS research include basic science (including molecular biology, cell biology, and genetics) and clinical research (clinical trials, health services, epidemiology, and rehabilitation).  Approximately two thirds of the projects are clinical research studies involving human subjects.  Of the remainder, about half are investigations using animal subjects, and half involve data analysis or cell lines.  Last year the competitively awarded funding for these projects exceeded $40 million.  Most of this research activity is concentrated at the West Haven campus.
The program centers on research to improve the health of and healthcare for veterans, including our newest returning veterans from Operation Iraqi Freedom and Operation Enduring Freedom (OIF/OEF).  For example, our investigators in the National Center for PTSD seek ways to improve treatment for post-traumatic stress disorder and associated depression.  A current project, in collaboration with Department of Defense, is studying PTSD in soldiers returning from Iraq to correlate specific genetic information with response to a newly developed treatment.  Another group of investigators, in our Neuroscience Research Center, are combining efforts in basic molecular biology, clinical trials and clinical rehabilitation to treat spinal cord injury.  Current work is using tissue transplant procedures to insert healthy myelin producing cells into damaged spinal cords in order to restore function. 

Attracting, hiring, and retaining high quality clinical researchers are crucial to advance the research agenda.  These are individuals, who are committed to academic medicine, and are attracted to work in VA by the combination of providing care for veterans, teaching trainees, and conducting research in an environment enhanced by the resources of the nearby medical school.  Without a robust research program, we would not be able to recruit the nationally recognized clinician investigators who also serve as attending physicians, clinical leaders, and specialist-consultants to whom our primary care physicians refer patients.

 Our affiliations with Connecticut's two medical schools?the Newington campus with the University of Connecticut Health Center and the West Haven campus with the Yale University School of Medicine?are also important to the success of VACHS research. Nearly all members of the VACHS medical staff have dual appointments as both VA physicians and medical school faculty members.  In addition to their VA patient care activities, VACHS physicians have responsibilities in teaching and research. For example, the VA's West Haven campus is an important site for clinical rotations by Yale medical students, residents, and fellows in specialty training programs.  They contribute to the care of VA patients and are taught by Yale faculty who are based at the VA medical center.  VA's ability to recruit physicians to the VACHS medical staff is greatly enhanced by the associated appointment to the Yale faculty, the opportunity to serve as a teacher for Yale medical students and residents, and the chance to carry out independent research in an environment enriched by the proximity of the medical school.

Approximately one third of the direct cost funding for VACHS research comes from the VA Research appropriation while nearly one-half of our funding is provided by grants from the National Institutes of Health (NIH).  VA research funds provide the necessary core support for veteran-centric research.  However, we are able to supplement this funding by competing successfully for funds from NIH and other non-VA sources.  This allows us to leverage what we are doing to increase VA research.

In the non-VA research world of public and private universities and medical schools, facilities for research (whether in laboratories, offices, or patient care settings) are maintained, replaced or expanded by a combination of funds from state governments, private philanthropy, and Federal agencies such as the NIH.  These sources of funds are not generally available to VA medical centers. 

To ensure that VA investigators have the equipment and facilities necessary to conduct cutting-edge research in the twenty-first century, the Office of Research and Development has initiated a review of VA's research facilities.  We believe that maintaining the proper research infrastructure is necessary in facilitating cutting edge research, and will enable us to attract outstanding clinician-investigators to our medical staff.

Thank you again for the chance to describe our research program at VACHS.  I am ready to respond to any questions that you may have.