Dáil Éireann Debate, Thursday - 18 September 2014
17. Deputy Clare Daly asked the Minister for Defence in relation to previous parliamentary question responses, if he will specify the international best practice that he was referring to in relation to prescribing Lariam to the Irish Defence Forces, in view that Ireland is the only country which prescribes Lariam as the only drug of choice. [34549/14]
View answerIn January 2011 the Department established a working group to examine the use of Lariam and other anti malarial drugs in the Defence Forces. I am advised that the Group investigated all the various issues surrounding the use of Lariam and obtained advice from leading Domestic and International medical experts.
Experts advise the need for:
- individual assessment on a clinical basis in relation to their suitability for any chemoprophylaxis;
- good screening procedures in relation to mental health;
- careful prescribing with attention to contra-indicators is essential;
- commencement of medication in advance of travel so that any adverse effects can be reported;
- early detection of adverse effects
I am advised the Defence Forces policy with regard to the prescribing of Lariam is compliant with the said expert advices. The Defence Forces policy is also in line with current Health Product Regulatory Authority (HPRA) guidelines, formerly the Irish Medicines Board. The HPRA is the statutory authority with responsibility for quality, safety and efficacy of medicines in Ireland.
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.
The Defence Forces are fully aware of the range of reported side effects attaching 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. The choice of chemoprophylaxis is dependent on a number of factors. These include 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 having regard to the specific circumstances of the mission and the individual member of the Defence Forces.
The Irish Defence Forces are not the only Defence Force using Lariam. I am advised that Lariam is also used by Sweden, Israel, Greece, Canada and Slovenia.
Anti-malarial medications 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.
