I assure the Deputy that I have an open mind on this matter. The Deputy will be aware that malaria is a very serious disease which kills approximately 1 million people every year in sub-Saharan Africa alone. It is a grave threat to any military force operating in the area. 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. The anti-malaria regime in place in the Defence Forces, including the use of Lariam, is working.
The Health Products Regulatory Authority, HPRA, formerly the Irish Medicines Board, is the statutory authority with responsibility for the quality, safety and efficacy of medicines in Ireland. The Defence Forces policy on the use of anti-malarial medication is in line with current HPRA guidelines.
The Defence Forces are fully aware of the range of reported side effects attached to all anti-malarial medications. Significant precautions are taken by the Medical Corps in assessing the medical suitability of members of the Defence Forces to take any of the anti-malarial medications. As the Deputy will be aware, there are three anti-malarial drugs, all licensed by the HPRA, in use by the Defence Forces: Lariam, Malarone and doxycycline. It is the policy of the Defence Forces that personnel are individually screened for fitness and medical suitability for service overseas, including a medical risk assessment for Lariam.
Where malaria has been identified as a risk in a particular mission area, the choice of medication is dependent on a number of factors, including the type of malaria in the destination, its resistance to particular drugs, the profile of the traveller, and the duration of travel. The choice of medication 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.
I can assure the Deputy that there is no loyalty to Lariam in the Defence Forces and that there is an open mind towards the use of alternatives, which we do use in many cases. The overarching priority has to be the safety of our Defence Forces personnel abroad in ensuring that they do not get malaria. We treat them accordingly, in line with medical advice.
Additional information not given on the floor of the House
Former Ministers for Defence have had the various allegations surrounding the use of Lariam investigated thoroughly and obtained the advice of leading medical experts, who concur with the prescribing practices followed by the Defence Forces. Anti-malarial medications, including Lariam, must 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.