Alan Shatter (Dublin South, Fine Gael)

The reason we use the drug is not it is the cheapest on the market. Three other anti-malaria medications are available: Chloroquine, Malarone and Doxycycline. However, there are specific reasons each of these products is not suitable for use by the Defence Forces in sub-Saharan Africa, the area in which the drug has been used. Chloroquine is no longer in use because of the development of widespread resistance. Doxycycline has to be taken in the absence of dairy products and can produce sun-sensitivity skin rashes in some individuals. This is particularly significant when used in very sunny climates. For this reason, it is not recommended for first-line use by the Defence Forces in sub-Saharan Africa. Malarone is unsuitable for use as it is licensed by the Irish Medicines Board for no more than 28 days continuous use in a malarious area. Therefore, this prophylactic agent is only suitable for use when the overseas deployment does not exceed 28 days.

With regard to the extent of problems resulting from the use of Lariam, there are three members of the Defence Forces with serious symptomatology which may have been caused or contributed to by Lariam, although there is nothing conclusive in this regard. I am also advised by the military authorities that all three personnel have made a full recovery and that their cases have been reported to the Irish Medicines Board. In addition, I understand there is a further cohort of seven personnel with less dramatic symptomatology who remain under review. Again, there is no conclusive evidence that the use of Lariam was a factor in any of these cases.

I understand the United States defence forces stopped using the medication owing to concern about inadvertent prescribing of the drug to soldiers who should not take it. The United States defence forces did not carry out an assessment in advance of soldiers using Lariam of the contra-indications of use or whether its use was appropriate. Instead, the US authorities undertook mass administration of a drug, Lariam, which is, essentially, for soldiers serving in areas subject to malaria. The US defence forces have ceased using the drug. They are now using another drug, one of the ones the Irish Medicines Board has passed and to which I made reference but which is only recommended in this state for use by the Defence Forces continuously for no longer than 28 days.

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