Aengus Ó Snodaigh (Dublin South Central, Sinn Fein)
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22. To ask the Taoiseach and Minister for Defence if his attention has been drawn to the fact that the anti-malaria drug, Lariam, was taken off the market here by its manufacturer in July 2016; that the acknowledged side effects of Lariam include anxiety, depression, paranoia and suicidal behaviour; that 50 serving or former members of the Defence Forces have lodged claims against the State having been given the drug; and if he will instruct the Defence Forces to immediately end the use of this controversial drug. [27230/16]

Aengus Ó Snodaigh (Dublin South Central, Sinn Fein)
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The reason I raise this issue, similar to the previous question, is I have tabled questions about use of the anti-malaria drug, Lariam, since 2008. Seven Ministers of Defence have taken the same position as the Minister of State, including a number of Fianna Fáil Ministers. It is high time that he instructed the Defence Forces to cease administering the drug to those who are deployed in sub-Saharan Africa.

Paul Kehoe (Wexford, Fine Gael)
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I am aware that Lariam has now been discontinued in the Irish market. Roche Products (Ireland) Limited informed the Defence Forces director of the medical branch on 7 August 2015 that it was planning a discontinuation of Lariam from the market with effect from 31 July 2016. My colleague and former Minister for Defence, Deputy Simon Coveney, brought the matter to the attention of the House during an oral parliamentary questions session on 8 October 2015. I understand Roche has indicated that its decision is based on a commercial assessment. I also understand it indicated at the time that it was not aware of any withdrawal plans in other countries, particularly the United Kingdom. It was indicated that in some European countries Lariam had been withdrawn in the past owing to low demand.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 between the Irish Pharmaceutical Healthcare Association, IPHA, and the HSE.

The Defence Forces are aware of the range of reported side effects of anti-malarial medications. Significant precautions are taken by 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. The choice of medication for overseas deployment, including the use of Lariam, is a medical decision made by medical officers in the Defence Forces. They have regard to the specific circumstances of the mission and the individual member of the Defence Forces.

The Deputy is correct that a total of 50 claims have been received to date in respect of current or former members of the Defence Forces who allege personal injury as a consequence of their consumption of Lariam. Proceedings have been served in 38 of these cases. The State Claims Agency advises that, for whatever reason, seven individuals did not progress their cases. They were discontinued and are now statute barred. Regarding the remaining five cases, while claims have been received, High Court proceedings have not yet been served. Given that proceedings have been served in a number of these cases, it would be inappropriate to comment further on these matters.

Aengus Ó Snodaigh (Dublin South Central, Sinn Fein)
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While I understand the Minister of State cannot comment on individual cases or even the 50 cases that have been taken, does he seriously believe Roche when it states it is withdrawing on commercial grounds? There is no way the company would admit it was withdrawing on medical grounds because that would open it up to a huge number of claims not only in Ireland but also throughout the world. It has not sold Lariam in America since 2009. The drug has huge implications which have been exposed in Ireland, Australia, America and elsewhere. Approximately 15 years ago American soldiers were operating in Somalia and Lariam was withdrawn because of the serious effects it was having on those in charge of heavy goods vehicles. There has been a question about the drug for many years, so much so that the Irish Army bulk bought other anti-malarial drugs. We do not know what happened to them because most soldiers seem to have been given Lariam. The Army bought 20,000 Malarone and Doxycycline tablets. What happened to them? Why were they not administered instead of Lariam which is open to question and which has serious side effects that have been documented throughout the world?

Paul Kehoe (Wexford, Fine Gael)
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I have to believe Roche when it informed the former Minister for Defence that it was pulling out of Ireland for a commercial reason. I have been given no information or evidence to state otherwise. The choice of medication for overseas deployment, including the use of Lariam, is a medical decision made by medical officers in the Defence Forces. The best advice given to me is that Lariam is the most suitable drug to take in sub-Saharan Africa.

Lisa Chambers (Mayo, Fianna Fail)
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We would like to see the advice.

Paul Kehoe (Wexford, Fine Gael)
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I am not a medical practitioner, but I accept the advice of the Defence Forces medical corps. The choice of medication for a mission is a medical decision based on best advice. I reiterate that the most comprehensive screening is carried out on every member of Defence Forces.

Aengus Ó Snodaigh (Dublin South Central, Sinn Fein)
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Previous parliamentary questions I have tabled have exposed the fact that there is not comprehensive screening of men and women deployed abroad. I ask the Minister of State to review these replies. Mr. Tony Killeen was Minister for Defence at the time. The Minister of State does not have to believe Roche, but he should believe his own soldiers. Four years ago I sought documentation through a parliamentary question, some of which was not supplied, including a fax that had been sent to Chad to warn that Lariam should be administered for more than four months. The deployment was four months. One had to take Lariam for a month before and after deployment, which gives a total of six months. The Defence Forces have, therefore, issued contradictory advice to their own medical corps in the past. Will the Minister of State review the file to see why one of the faxes sent to Chad was not included in the material supplied to me?

Paul Kehoe (Wexford, Fine Gael)
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I am not hiding behind any evidence. I believe absolutely that the medical corps of the Defence Forces gave me the best evidence when I questioned it on this issue. It is not giving me false information. I refute one of the Deputy's comments. I have been informed by the Defence Forces that its members are individually screened prior to the administration of Lariam before they go on an overseas mission and I have to believe them. Each individual is medically screened prior to Lariam being used.

Lisa Chambers (Mayo, Fianna Fail)
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It would be quite remarkable for a pharmaceutical company to say it was taking a drug off the shelf because it was bad for people.