VETERANS ADMINISTRATION 



Submitted by Dr. John D. Chase, Chief Medical Director 



Mission of the VA 



Role of Basic Research 



The Veterans Benefits law (Title 38 of the Unit- 

 ed States Code) defines the mission of the Veter- 

 ans Administration (VA) as "the administration of 

 laws relating to the relief and other benefits provid- 

 ed by law for veterans, their dependents, and their 

 beneficiaries" (38 U.S.C. 201). Among these bene- 

 fits is a "complete medical and hospital service . . . 

 for the medical care and treatment of veterans" 

 (38 U.S.C. 4101(a)). The law further extends this 

 function by providing that, "In order to carry out 

 more effectively the primary function and in order 

 to contribute to the nation's knowledge about dis- 

 ease and disability, the Administration (of Veter- 

 ans Affairs) shall, in connection with the provision 

 of medical care and treatment to veterans, carry 

 out a program of medical research . . . ."' (38 

 U.S.C. 4101(c)(1)). 



Stated in other terms, the mission of medical 

 research in the VA is the improvement of health 

 care, especially of veteran patients, through scien- 

 tific efforts. A part of this mission is to provide a 

 better understanding of the biological, chemical, 

 physical, and behavioral phenomena underlying 

 disease, disability, and health through a broad pro- 

 gram of investigation of life processes. 



Definition of Basic Research 



Research in the VA is chiefly "applied" in na- 

 ture but most advances in the understanding of 

 how to prevent and treat disease result from the 

 findings of basic research. Clinical observations 

 and investigations in turn raise questions that stim- 

 ulate further basic biomedical research. VA re- 

 search is almost exclusively intramural, conducted 

 within the system's hospitals by members of its 

 staff who are usually clinicians caring for patients. 

 Under these circumstances, basic research com- 

 monly arises from clinical problems and is directed 

 toward a better understanding of the fundamentals 

 of disease processes. 



Investigators within the VA include those with 

 advanced training in disciplines such as biochemis- 

 try, physiology, genetics, molecular biology, and 

 microbiology. Scientists may be recruited to pro- 

 vide research support for clinical staff members but 

 many are principal investigators of their own proj- 

 ects; some are physicians with special scientific 

 training. Since the VA's research program sup- 

 ports investigator-initiated research, most basic 

 research is proposed and pursued by this 

 specialized group. 



The VA supports and indeed encourages basic 

 research within this framework. It does not and 

 cannot undertake basic research on the broad or 

 intensive scale characteristic of special institutes, 

 nor can it support extramural programs in funda- 

 mental sciences. 



The VA considers as "basic" only research that 

 involves the testing of fundamental life science 

 concepts by the scientific methods. It tends to 

 emphasize molecular, subcellular, and cellular 

 structures and phenomena using methods derived 

 from disciplines such as biochemistry and physics. 

 The distinction between basic and applied research 

 is vague and subject to interpretation; the VA 

 tends to consider as "basic" only those investiga- 

 tions for which no practical application is imme- 

 diately evident at the outset. 



230 



Examples of Basic Research 



Following are examples of basic science re- 

 search in the VA: 



Roger H. Linger. M.D., control of carbohydrate and fat 

 metabolism by pancreatic hormones, especially glucagon. 



Andrew V. .Schally. Ph.D.. physiology and biochemistry of 

 hypothalamic neurohormones, especially thyrotropin releasing 

 hormone and luteinizing-hormone-releasing hormone. 



VETERANS ADMINISTRATION 



