Paul Kehoe (Wexford, Fine Gael) | Oireachtas source

I apologise for my late arrival in the Chamber. Lariam is one of the most effective medications for protection against the type of malaria prevalent in sub-Saharan Africa. Malaria is a serious disease that kills approximately 1 million people per year in sub-Saharan Africa alone. It is a serious threat to any military force operating in the area. The anti-malaria regime in place in the Defence Forces, including the use of lariam, has worked. In the decade of deployment to sub-Saharan Africa by the Defence Forces, not a single member of the Defence Forces has died from malaria and there are only three documented cases of personnel getting malaria.

The Irish Medicines Board, IMB, is the statutory body that regulates medicines available in Ireland. I am advised the three anti-malarial medications licensed by the IMB, namely, lariam or mefloquine, malarone and doxycycline all can have significant side effects. The assertion that any one is automatically a more effective or safer alternative to the others is a grossly misleading oversimplification. Each of the three drugs has been used by the Defence Forces, depending on individual circumstances including the type of malaria in the destination, the duration of travel and so on.

I am further advised the Defence Forces are fully aware of the range of reported side effects attaching to all anti-malarial medications. Protocols are in place to control the risk of side effects in individuals. Up to September 2012, malarone was only licensed for up to 28 days continuous use and was not an option, as the usual duration of deployment for the Defence Forces is six months. The 28-day limit was removed in September 2012. However, there is limited evidence as to the safety and effectiveness of malarone usage for longer periods. The position is currently being reviewed by the Medical Corps of the Defence Forces.

The Minister had the various allegations surrounding the use of lariam investigated thoroughly and has obtained the advice of leading medical experts, who concur with the prescribing practices followed by the Defence Forces.

Additional information not given on the floor of the House

On 1 July 2013, the Irish Medicines Board and Roche Products (Ireland) issued a letter to all general practitioners, GPs, concerning lariam. The Director of the Defence Forces Medical Corps, DMC, has circulated the letter to all medical officers. The DMC is considering its content and whether it has policy implications. lariam remains licensed by the IMB and must remain in the formulary of medication prescribed by the Medical Corps for Defence Forces personnel on appropriate overseas missions, particularly those in sub-Saharan Africa. This is necessary to ensure military personnel can have effective protection from the serious risks posed by this highly dangerous disease.

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