Written answers

Wednesday, 18 December 2013

Department of Defence

Defence Forces Medicinal Products

Photo of Seán Ó FearghaílSeán Ó Fearghaíl (Kildare South, Fianna Fail)
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184. To ask the Minister for Defence if he will publish details of the medical risk assessment carried out by the Defence Forces in relation to the use of Lariam; and if he will make a statement on the matter. [54674/13]

Photo of Alan ShatterAlan Shatter (Dublin South, Fine Gael)
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Much of the information relevant to the answer to this question has already been given by me last Wednesday in the Dáil in answering your similar question. As I stated in my reply, I am informed by the military authorities that risk assessments are carried out for all mission areas and suitable control measures are put in place to minimise identified risks. Where a health risk is identified the control measures will include preventative medication where appropriate. Where malaria has been identified as a risk, the choice of chemoprophylaxis is dependent on a number of factors including the type of malaria in the destination, resistance to particular drugs, the profile of the traveller (contra-indications, underlying health conditions, purpose of travel), the duration of travel and adherence issues. The choice of medication is a medical decision made by Medical Officers in the Defence Forces on the basis of best international practice having regard to the specific circumstances of the mission and the individual member of the Defence Forces.

The Deputy will be aware that the Irish Medicines Board is the statutory authority with responsibility for the quality, safety and efficacy of medicines for use in Ireland. The Defence Forces’ Medical Corps complies with its guidelines on the prescription of medicines, including Lariam. As I stated in last Wednesday’s reply, I am advised that Lariam is one of the most effective medications for protection against the type of malaria prevalent in sub-Saharan Africa. It continues to be licensed by the Irish Medicines Board. The Defence Forces are fully aware of the range of reported side effects attaching to all anti-malarial medications. I am advised that protocols are in place to control the risk of side effects in individuals.

The Defence Forces follow best international practice in prescribing Lariam. It is the policy of the Defence Forces that personnel are individually screened for fitness for service overseas and medical suitability, i.e. a medical risk assessment for Lariam is carried out on an individual basis. This is intended to rule out personnel from overseas service with certain conditions, e.g. depression, anxiety, pregnancy, neuro-degenerative disorders etc. which, as has been indicated by the Irish Medicines Board, are more likely to precipitate serious adverse reactions to Lariam. This medical risk assessment is particular to an individual, forms part of the individual’s medical record and is not, therefore, publishable.

As I stated in last Wednesday’s response, 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 and Lariam 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, to ensure that our military personnel can have effective protection from the very serious risk posed by this highly dangerous disease.

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