Tuesday, 27 September 2016
Defence Forces Medicinal Products
I thank the Deputy for her question. I note that she is referring to the discontinuation of the sale of Lariam in the Irish market and the recent remarks reported to have been made by a former senior UK military officer. On the first matter, Roche Products (Ireland) Limited informed the director of the Defence Forces medical branch on 7 August 2015 that it was planning a discontinuation of Lariam from the Irish market with effect from 31 July 2016. My colleague and the former Minister for Defence, Deputy Simon Coveney, brought this matter to the attention of the House in an oral parliamentary questions session on 8 October 2015. I understand Roche has indicated that its decision is based on a commercial assessment. I understand it indicated at the time that it was not aware of any withdrawal plan in other countries, particularly the United Kingdom. It was indicated that in some European countries Lariam had, however, been withdrawn in the past due to low demand.
I am advised by the military authorities that drugs are purchased by the Defence Forces under the four-year framework agreement on the supply and pricing of medicines. This agreement is between the Irish Pharmaceutical Healthcare Association, IPHA, and the HSE.
On the second matter, I have been made aware of newspaper reports that a former senior UK military officer has apologised to British troops who were given the anti-malarial drug Lariam. The choice of malaria chemoprophylaxis in use by other armed forces is an internal matter for these forces. It would not be appropriate for me to comment on the policy and practices of other states in this regard or to engage in discussion on the merits of these policies and practices. The health and welfare of the men and women of the Defence Forces are high priorities for both me and the Defence Forces. Malaria is a serious disease which killed approximately 438,000 people in 2015, with 90% of the deaths occurring in sub-Saharan Africa as reported by the World Health Organization.
The choice of medication for overseas deployment is a medical decision made by Defence Forces medical officers, having regard to the specific circumstances of the mission and the individual member involved. Significant precautions are taken by the Defence Forces medical officers in assessing the medical suitability of members of the Defence Forces to take any of the anti-malarial medications. It is the policy of the Defence Forces that personnel are individually screened for fitness for service overseas and medical suitability. I am advised by the director of the medical branch that this has been the policy since the first involvement of the Defence Forces in overseas service.
Fianna Fáil has believed for some time that the use of the drug Lariam has caused serious problems for the Defence Forces. I have raised the issue with the Minister of State previously. Serious concerns have been raised for many years about the use of Lariam as an anti-malarial drug for troops serving overseas. Last year the British Ministry of Defence acknowledged that 1,000 former service men and women suffered from severe psychiatric and mental health problems as a result of having been prescribed Lariam. These are the only people about whom we know and they are experiencing severe problems. In 2013 it was suggested in an RTE "Prime Time Investigates" programme that Defence Forces personnel who had been prescribed the drug were three to five times more likely to be at risk of suicide. This investigation was conducted in Ireland and we now have a former British army chief who has apologised unreservedly for its use. Does the Minister of State believe either he or any other Minister with responsibility for defence matters will one day have to stand up in the Dáil Chamber and apologise for the prescription of Lariam for our troops?
The medical advice I have been given by the medical corps of the Defence Forces is that Lariam is the most suitable drug for members of the Defence Forces who are going overseas. I hope the Deputy understands it is a fight against malaria, one of the ravaging diseases in sub-Saharan Africa. The Defence Forces have a very good history in malaria prevention. I have spoken to the medical officer and the Defence Forces about this matter and I am satisfied, based on the medical information and evidence I have been given, that this is the best malaria prevention method. All members of the Defence Forces are well screened and all precautions are taken before the drug is prescribed for any member.
To clarify, the Minister of State has spoken about the advice he has been given. Is he willing to provide it for the House? It appears to me that he is ignoring the facts. Across the water, where thousands have been affected, the British Ministry of Defence has acknowledged the negative impact. Should we not be taking this information on board? The Minister of State has said this is the most suitable drug. I point out, however, that Dr. Franz Humer is on record as stating science has advanced considerably since Lariam was first introduced and that there are more effective anti-malarial drugs available with reduced side effects. I ask the Minister of State to take this on board. He has said we have a very good record. There are 50 serving or former members of the Defence Forces who have lodged claims against the State because of the prescription of this drug and legal proceedings have been served against the State in 37 cases. The Minister of State may say the drug has been withdrawn from the market in this country for commercial reasons, but I disagree with him on this point and the buck stops with him.
We could be here in ten or 20 years reflecting on 1,000 former Defence Forces members suffering from a severe psychiatric condition because of this drug. The Minister of State will have to answer for that, as well other former Ministers for Defence. The buck stops with him today. He has information on his desk on negative side effects, but he is hiding behind what he says is expert medical advice which he has not provided for the House. I ask him to provide it.
I object to that comment. I will not look for the personal details of any member of the Defence Forces as that would not be appropriate. I asked for the medical advice the Minister of State has received on the drug, Lariam, not on individuals. The Minister of State should be clear about that.
When Roche informed the Defence Forces that it was pulling out of the country, it stated it was a commercial decision. If the Deputy has evidence that it pulled out for any other medical reason, I would appreciate it if she gave it to me.