Clare Daly (Dublin Fingal, Independent)
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46. To ask the Taoiseach and Minister for Defence if he will remove Lariam from the Defence Forces' formulary and cease its use as a first-line anti-malarial by the Defence Forces at least until such time as he has had time to review the report of the malaria chemoprophylaxis working group, both in order to safeguard Irish troops and to protect the State against future litigation. [27094/16]

Paul Kehoe (Wexford, Fine Gael)
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The health and welfare of the men and women of the Defence Forces is a high priority for both myself and the Defence Forces. There are three anti-malarial drugs, in use in the Defence Forces; Lariam (mefloquine); Malarone and Doxycycline. The choice of medication for overseas deployment, including the use of Lariam, is a medical decision made by Medical Officers in the Defence Forces, having regard to the specific circumstances of the mission and the individual member of the Defence Forces.

Significant precautions are taken by the Defence Forces Medical Officers in assessing the medical suitability of members of our 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 Defence Forces first involvement in overseas service to malarial areas.

Malaria is a serious disease which killed approximately 438,000 people in 2015, with 90% of deaths occurring in sub-Saharan Africa as reported by the World Health Organisation.  It is a serious threat to any military force operating in the area.

Anti-malarial medications, including Lariam, remain in the formulary of medications prescribed by the Medical Corps for Defence Forces personnel on appropriate overseas missions, to ensure that our military personnel can have effective protection from the very serious risks posed by this highly dangerous disease. It is notable that no member of the Defence Forces, despite the numbers who have served in malarial areas, have died from Malaria.

There are no plans at this time to withdraw Lariam from the range of anti-malarial medications available to the Defence Forces.  The use of and the information on medications is kept under ongoing review.

A working group is currently reviewing developments arising in relation to the use of malaria chemoprophylaxis.  In its earlier work in 2013, the Group investigated all the various issues surrounding the use of Lariam and obtained advice from leading medical experts. Those experts concurred with the practices followed by the Defence Forces in prescribing Lariam.  

The Group is examining developments in the context of the Defence Forces use of malaria chemoprophylaxis with particular focus on updated patient safety information, changes to Summary Product Characteristics, changes in product licensing/authorisation, identification of any new anti-malarial medications on the market and national and international expert advices on the use of malaria chemoprophylaxis and its usage in other Armed Forces. The Group is continuing to engage with international experts with a view to concluding its report shortly.

As I already indicated, the health and welfare of the Defence Forces is a priority for myself and the Defence Forces and this will continue to inform the approach to the issue of Lariam.