During Advocacy Week 2026, we asked Congress to keep ME/CFS as an eligible topic area in the Congressionally Directed Medical Research Program (CDMRP) — the Department of Defense’s primary mechanism for funding research into conditions that affect military readiness.
Here’s the case we made for why ME/CFS is a military issue:
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS):
Studies in Military Behavioral Health Journal and elsewhere estimate that one in six veterans have chronic fatigue syndrome[1] [2]. A study of 2,000 Gulf War veterans found that the odds of developing chronic fatigue syndrome for deployed veterans were 40 times as much as those for undeployed veterans [3]. Active-duty personnel who develop ME/CFS may become incapacitated and ineligible for deployment or even routine duties. ME/CFS is a serious and often debilitating disease characterized by severe fatigue, cognitive impairment, and post-exertional malaise (profound exhaustion following physical or mental effort that would not typically affect healthy people).
The disease burden of ME/CFS (years lived with disability/100,000 adults) exceeds that of stroke and is comparable to that of anxiety disorders and migraine [4]. Before the COVID-19 pandemic, about three million adults in the US were affected by ME/CFS; but because many people with Long Covid subsequently develop ME/CFS, the current prevalence is likely much higher, with estimates of over 71.2 million afflicted worldwide[5] [6]. Despite its high disability burden, ME/CFS remains severely underfunded, receiving less than 1% of the NIH funding warranted by its burden (one study lists it as the most underfunded disease) [7].
Thus, support from other funding agencies, like the Congressionally Directed Medical Research Programs (CDMRP), is critical for helping people with ME/CFS. In particular, there is an urgent need to find reliable biomarkers for diagnosis and to develop effective treatments, as there are currently no FDA-approved biomarkers or therapies for people with ME/CFS.
Research on ME/CFS is also valuable for understanding other CDMRP-prioritized “low-energy” conditions, like Long COVID, lupus, multiple sclerosis, psychological health disorders, and Gulf War illness[8], since ME/CFS symptoms and pathological mechanisms substantially overlap with these other diseases, as discussed in Military Medicine and elsewhere[9]. In some cases, individuals with these similar disorders are at significantly increased risk of later developing ME/CFS. For example, both ME/CFS and Gulf War illness are associated with initial infections or environmental stressors, and their symptom profiles substantially overlap [10] [11] [12]. These shared features suggest that advances in diagnostic tools and therapeutic strategies for ME/CFS will have broader clinical relevance to the overall “low-energy” conditions community.
[1] Kipen HM, Hallman W, Kang H, Fiedler N, Natelson BH. Prevalence of chronic fatigue and chemical sensitivities in Gulf Registry Veterans. Arch Environ Health. 1999;54(5):313-318.
[2] McAndrew LM, Chandler HK, Serrador JM, Quigley KS, Natelson BH, Lange G. Comparison of the functional health limitations of Iraq or Afghanistan Veterans to Desert Shield/Storm Veterans with chronic fatigue syndrome. Mil Behav Health. 2016;4(3):299-306.
[3] Eisen SA, Kang HK, Murphy FM, et al. Gulf War veterans’ health: medical evaluation of a U.S. cohort. Ann Intern Med. 2005;142(11):881-890
[4] Bonuck K, Gao Q, Congdon S, Kim RS. Long COVID disability burden in US adults. Commun Med (Lond). 2026;6(1):177.
[5] Eckey M, Li P, Morrison B, Bergquist J, Davis RW, Xiao W. Patient-reported treatment outcomes in ME/CFS and long COVID. Proc Natl Acad Sci U S A. 2025;122(28):e2426874122.
[6] Vardaman M, Gilmour S. Letter: Time to correct the record on the global burden of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). J Transl Med. 2025;23(1):331. Published 2025 Mar 14.
[7] Bonuck K, Gao Q, Congdon S, Kim RS. Long COVID disability burden in US adults. Commun Med (Lond). 2026;6(1):177.
[8] Mantle D, Domingo JC, Golomb BA, Castro-Marrero J. Gulf War Illness, Fibromyalgia, Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Long COVID Overlap in Common Symptoms and Underlying Biological Mechanisms: Implications for Future Therapeutic Strategies. Int J Mol Sci. 2025;26(18):9044.
[9] Bast E, Jester DJ, Palacio A, Krengel M, Reinhard M, Ashford JW. Gulf War Illness: A Historical Review and Considerations of a Post-Viral Syndrome. Mil Med. 2026;191(1-2):e7-e11.
[10] Kipen HM, Hallman W, Kang H, Fiedler N, Natelson BH. Prevalence of chronic fatigue and chemical sensitivities in Gulf Registry Veterans. Arch Environ Health. 1999;54(5):313-318.
[11] Mantle D, Domingo JC, Golomb BA, Castro-Marrero J. Gulf War Illness, Fibromyalgia, Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Long COVID Overlap in Common Symptoms and Underlying Biological Mechanisms: Implications for Future Therapeutic Strategies. Int J Mol Sci. 2025;26(18):9044.
[12] Bast E, Jester DJ, Palacio A, Krengel M, Reinhard M, Ashford JW. Gulf War Illness: A Historical Review and Considerations of a Post-Viral Syndrome. Mil Med. 2026;191(1-2):e7-e11.