By Joseph P. Lane

Imagine the following scenario. You instruct a stockbroker to invest your savings in a certain stock because you know that stock will yield the returns you seek. Once per year you check in with the stockbroker and he assures you the money is invested as you instructed and is doing fine, although he won’t give you an annual statement for verification.
 
After several years of increasing concern, you send an attorney to get a statement. Under oath, the stockbroker swears your investment is doing fine but again won’t provide a detailed statement. Finally, you receive a tip from a reliable source that your broker is lying. You call the police and they investigate. The police report is repeatedly delayed, while the police negotiate the report’s wording with the stockbroker’s firm.

The final police report acknowledges that the money was not invested as you asked, that there had been no return on the investment, and that your stockbroker had been lying all along. The report concludes that in the future every stockbroker get training on how to issue an annual statement. The police report does not charge your stockbroker with an offense. In fact, your stockbroker remains in charge of your funds! The report does not even remedy the situation because it fails to suggest that your money be recovered and invested as you had first instructed!
 
Would you be grateful to the police and satisfied with the police report?
 
Would you be wrong to demand an investigation of the police investigation, punishment for the stockbroker and a return of your funds?
 
This is essentially the position the CFIDS community is in, following the report released May 12 by June Gibbs Brown, Inspector General, Department of Health and Human Services. The report concludes that $8.8 million that the Centers for Disease Control and Prevention (CDC) was supposed to spend on research into chronic fatigue syndrome (CFS) was unequivocally charged to non CFS-related activities--a blatant violation of the wishes of Congress, our expectations and the CDC’s repeated assurances. That represented 39% of the CDC’s budget for CFS. Another $4.1 million (18%) could not be accurately accounted for, either for CFS or non-CFS-related activities. Unfortunately, the report focuses most of its attention on the internal control problems that prevented an unequivocal determination on the $4.1 million and remedial actions to correct these internal control problems.
 
Internal control problems are an important issue. The Inspector General’s report indicates that the problems are agency-wide. They should be remedied. However, internal control problems only enable improprieties such as the improper diversion and misuse of funds, by failing to detect them as they occur. Internal controls do not cause the improper diversion and misuse of funds. That is done by the willful actions of individuals in positions of authority. Dr. William Reeves did not blow the whistle on internal controls problems; he reported the deliberate misuse of funds. Unfortunately, the report is silent on the cause and effect of the misspent $8.8 million and fails to suggest any corrective action to restore the funding or sanction those responsible.
 
The Inspector General’s report states in boldface type on page 7, "Unacceptable Charges to the CFS Program: $8.8 million." Pages 7-10 detail those unacceptable charges. However, these pages do not mention cause and effect. However, on page 10 the report states in boldface type, "Undocumented Charges to the CFS Program: $4.1 million." Pages 10-12 detail those undocumented charges. In contrast to the unacceptable charges, this section does clearly state in boldface capital letters, "CAUSE--INEFFECTIVE INTERNAL CONTROLS" and later "EFFECT--CDC PROVIDED INACCURATE DATA TO CONGRESS AND DID NOT SPEND CFS FUNDS ACCORDING TO CONGRESSIONAL EXPECTATIONS."
 
The report does not clearly distinguish between the $8.8 million identified as spent on non-CFS-related research and the $4.1 million in undocumented charges. The report repeatedly refers to "questionable charges" but it is not clear to the reader if these are the total $12.9 million or only the undocumented charges. However, the remedies suggested only address the issues of internal controls, staff training and indirect cost allocation systems.
 
In short, the Inspector General’s report ignores the alleged willful actions of CDC employees to misdirect at least $8.8 million in CFS-related funds and then lie under oath to Congress.
 
Call it a whitewash, a cover-up or yet another CDC misdirection of resources. I call it an inappropriate and wholly inadequate response to the issue at hand. It is an affront to The CFIDS Association of America, which withstood abuse to expose this problem. It is an insult to the whistleblower, and it sends the wrong message to other government officials who witness violations. It is also an insult to people with CFIDS, to their families and friends, and to their elected officials who took every action to ensure funding was directed to CFS-related research.
 
The DHHS Office of Inspector General has demonstrated that it is unable to fully investigate and resolve this internal matter. In fairness, an investigation of employee actions and the restitution of funds may be beyond the Inspector General’s scope of review. Nevertheless, it is now up to the General Accounting Office to establish cause and effect concerning the $8.8 million expended in non CFS-related research, and to take appropriate action. The people responsible for the inappropriate allocation of federal funds, and for lying to Congress must be held accountable. This is the only means to safeguard our nation’s investment in CFS-related research--and in research directed to any other illness.
 
This Inspector General’s report demonstrates the necessity of a GAO audit of costs charged to the Chronic Fatigue Syndrome Program at the Centers for Disease Control and Prevention. Fortunately, the GAO has agreed to undertake this audit (see "DC Dispatch" in this issue). It should now proceed quickly, as CFIDS researchers have already lost years of valuable time. 

Joseph Lane, whose wife, Jill, has been disabled by CFIDS, is a research administrator at the State University of New York at Buffalo. He serves on the Medical Research Advisory Committee of The CFIDS Association of America.