ARMY POSITION: The US Army Medical Research and Materiel Command (USAMRMC) manages biomedical research programs that are part of the Department of
Defense (DOD) and Army budget submission. In addition, as directed by Congress, the USAMRMC manages congressionally targeted biomedical research
programs.
One of the congressional research programs managed by the USAMRMC Office of the Congressionally Directed Medical Research Programs (CDMRP) is the
National Prion Research Program (NPRP). The primary goals of the NPRP are to support the development of diagnostic tests and means to prevent and
manage transmissible spongiform encephalopathies (TSE).
KEY FACTS:
Congress directed the DOD's involvement in the NPRP in fiscal year 2002 (FY02).
The USAMRMC was tasked by Congress to manage the $42.5 million (M) NPRP appropriation, which was received by the USAMRMC in February 2002.
TSE are of military relevance due to their potential threat to food and blood supplies, and the health threats posed by TSE put military beneficiaries
in affected areas overseas at risk.
The NPRP is conducted according to the two-tier review model recommended in 1993 to the USAMRMC by the National Academy of Sciences Institute of
Medicine (IOM); this model has received high praise from the scientific community, advocacy groups, and Congress.
The USAMRMC negotiated with the IOM to assess the field of TSE, focusing specifically on prion detection and disease diagnosis. A progress report was
received in August 2002, an interim report was received in January 2003, and the final report was received in November 2003.
A meeting was held May 22-23, 2002 in which military, scientific, regulatory, and public health stakeholders provided input on the major issues in TSE
research and received an overview of the USAMRMC science management processes. Based upon the stakeholders' recommendations, a smaller programmatic
advisory group (Integration Panel), composed of TSE experts from the military, scientific, regulatory, industry, and public health communities, was
selected.
The FY02 NPRP investment strategy was determined by the Integration Panel at a vision setting meeting held June 24-25, 2002. A request for proposals
was released on August 2, 2002, and 136 proposals were received by the proposal submission due date of October 30, 2002. Peer review was conducted
December 4-6, 2002, and programmatic review was conducted February 27-28, 2003. Programmatic review deliberations were supported by an IOM interim
report on prion detection and diagnosis.
The Integration Panel submitted a recommended for funding list of 38 proposals to the Commanding General, USAMRMC for approval. The Commanding
General, USAMRMC approved the award recommendations on March 10, 2003. Award negotiations have been completed.
Congress has not provided any follow-up appropriations for this research.
BACKGROUND:
Disease Background. TSE refers to several apparently related diseases including Creutzfeltd-Jacob disease (CJD) and its new variant (nvCJD), kuru,
bovine spongiform encephalopathy ("mad cow disease"), and others. Except for nvCJD, the TSE appear to develop progressively over many years, lead to
extensive central nervous system vacuole formation, and are invariably fatal. At present, definitive diagnosis can only be made at autopsy. The
diseases are relatively rare in humans but have been documented most extensively in hoofed mammals. The current disease theory attributes TSE to
"prions," normal cell membrane proteins with atypical three-dimensional configurations, transmitted by ingestion or blood transfer. Although a Nobel
Prize was awarded for the work underlying this proposed mechanism (Prusiner, 1997), it remains controversial because disease transmission
traditionally is associated with an agent capable of replication.
cdmrp.army.mil...
[edit on 31-1-2005 by DrHoracid]
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