Wednesday, 21 March 2018

Questions (37)

Aengus Ó Snodaigh

Question:

37. Deputy Aengus Ó Snodaigh asked the Taoiseach and Minister for Defence his views on the development of a new anti-malarial drug, Tafenoquine (details supplied); the measures he will take to ensure that this drug is safe; and his plans to ensure that it is not prescribed to Defence Forces personnel unless it has been established that it is appropriate for prescription. [10200/18]

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Oral answers (10 contributions) (Question to Defence)

This question is a follow up on an issue I have been raising for a number of years in this Chamber, namely, the administration of anti-malarial drugs by the Defence Forces on unsuspecting soldiers. Following on from the withdrawal of the sale of Lariam in Ireland by Roche Products (Ireland) Limited, I am seeking a commitment from the Minister of State that no new drug will not be provided to the Defence Forces unless it has been deemed safe, taking into account the experience of armies abroad.

I am advised that Tafenoquine is being developed for the prevention of relapse of Plasmodium vivax malaria and is currently not available in Ireland. As I have indicated to the House in the past, fundamentally the choice of medications for use in the Defence Forces is a medical matter that should be decided by qualified medical professionals. In the Defence Forces, these are decisions for highly qualified medical officers having regard to the specific circumstances of the mission and the individual member of the Defence Forces. I have been advised by the military authorities that currently the Defence Forces has no plans to include Tafenoquine in its formulary of medication.

I am not a medical expert and I cannot make findings in regard to new or previously used drugs, but I have seen the affects of a drug that was previously deemed fit for purpose but has had devastating affects in defence forces across the world, namely, Lariam, or mefloquine as it is medically known, which it is now proposed to replace with a sister drug, Tafenoquine. I am asking that at the very least an instruction be given that this drug be tested for prolonged use in military circumstances. We know only too well the detrimental effect that the use of Lariam has had not only on Irish soldiers but on others in larger military organisations around the world which no longer prescribe Lariam. Before we go down the road of even looking at any new drug, we should look at the experiences of larger defence forces.

On the Deputy's point regarding the withdrawal from sale in Ireland of Lariam by Roche Products, I understand that decision was based on a commercial assessment. As Minister with responsibility for defence, my first priority is to ensure that Irish personnel deployed to missions where malarial issues arise are given the best medication possible, and in this regard I am dependent on the advice of medical personnel. The advice I have been given on this occasion is that they are supportive of the medication that is currently being prescribed.

We have massive problems in this country arising out of the prescription of Lariam. Even with international evidence mounting, the withdrawal of the drug from the market for ordinary consumers, the admission of the UK armed forces that they made a mistake in prescribing it and that it has caused serious harm to soldiers, we still have not made any moves to address the issue. That is remarkable. The issue has been raised many times in this Chamber, including by others before this Dáil was constituted. Why are we are ignoring the evidence that people's health is being severely harmed by this particular drug and why is it not the drug of last resort? There is always an argument for retaining it lest nothing else works, but something needs to be done.

The Minister of State has been to countries where there is a malaria threat. Has he ever taken Lariam?

There is a Dáil motion which instructs the Government to end the use of Lariam. In withdrawing the sale of Lariam from the Irish market, Roche Products (Ireland) Limited has taken that decision for the Government. I do not foresee the Defence Forces trying to source Lariam on the black market when soldiers are being sent abroad. My question is in regard to Tafenoquine which is being touted around the world as a replacement for Lariam. According to the experts in medicine, medicines ending in "quine" are not suitable for prolonged use. We are not medical experts but we can make findings based on the evidence presented to us, not only in this House but from inquiries in Canada, England, Australia and the United States. I ask the Minister of State to heed those findings, please.

I thank the Deputies for their questions. In response to Deputy Wallace's question, I have not taken Lariam. I was not prescribed Lariam for my visit to Mali or other missions because Lariam is not suitable for short-stay visits. I can give the Deputy the name of the medication that I was prescribed.

On the issues raised by Deputies Chambers and Ó Snodaigh, we are not ignoring any evidence. Medical experts make the decisions.

I accept that they are making the right decisions. They have the training, expertise and qualifications to prescribe. If I, as a political representative or Minister of State, were to tell the Defence Forces it could not prescribe Lariam, it would be to reject the medical advice provided to me by the medical experts. I have to accept the advice given to me by the medical experts.

I am not sure where we get the Lariam from but I can find out for Deputy Ó Snodaigh.

The Minister of State does not know. He has 400 in stock.

I do not micromanage. I leave that matter totally up to the medical experts.

Question No. 38 replied to with Written Answers.