Thursday, 13 June 2019

Questions (2)

Aengus Ó Snodaigh


2. Deputy Aengus Ó Snodaigh asked the Taoiseach and Minister for Defence the action he has taken to implement the Dáil Éireann motion (details supplied) passed on 28 June 2017 to draw up a plan of action to help alleviate and address the ongoing concerns regarding the anti-malaria drug Lariam issued to military personnel serving on overseas missions in sub-Saharan Africa in the past other than fighting legal cases of victims of Lariam. [24568/19]

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Oral answers (6 contributions) (Question to Defence)

What action has the Minister for Defence taken to implement the motion regarding Lariam passed in this House on 28 June 2017?

As I indicated to Deputy Ó Snodaigh in response to the Private Members' motion of 28 June 2017 regarding the anti-malarial drug Lariam, the use of anti-malarial drugs is a medical matter that should be decided by qualified medical professionals. In the Defence Forces, these are matters for highly qualified medical officers having regard to the specific circumstances of the mission and the individual member of the Defence Forces.

As Deputy Buckley will be aware, the Lariam report implementation group, LRIG, was established following the completion of the report of the malaria chemoprophylaxis working group in 2017, which set out a number of recommendations.

This group has met on a number of occasions and is progressing its work through the formation of a structured plan to implement these recommendations, as outlined in the terms of reference. These recommendations include planning, training and education-information sharing, as well as the establishment of a medical advisory group that will formalise the provision of ongoing expert medical advice, including external expert medical advice, to the Defence Forces on a range of medical matters, including malaria chemoprophylaxis.

I would also like to point out that there is a range of support services, both medical and non-medical, available to the Defence Forces personnel. These include access to Defence Forces medical officers, psychiatric, psychological, social work and personnel support services. A strictly confidential 24-hour careline, manned by trained counsellors, is also available to Defence Forces personnel.

The Deputy will be aware that the State Claims Agency manages personal injury claims, including personal injury claims relating to the consumption of Lariam taken by current and former members of the Defence Forces. The next case is listed for hearing in the High Court on 21 June 2019. Given that there is litigation pending in relation to these matters, the Deputy will appreciate that it would be inappropriate for me to comment further on this issue.

I thank the Minister of State for his reply. The working group that was established to deal with this issue has completed two reports, neither of which has been published. Why has that not happened? The Minister of State advised that the routine anti-malarial drug that has been prescribed to personnel serving Mali is Lariam. This was confirmed to my colleague, Deputy Ó Snodaigh, a few weeks ago. There are reports in the media that the Minister intends to deploy a contingent of the Army Ranger Wing to Mali. Will they also be prescribed Lariam?

The side effects of Lariam have been well rehearsed in this House. The Members of the House made their position clear on these issues two years ago and we have not heard anything further since then. It is baffling that the drug is still being prescribed to Defence Forces personnel. Will the Minister of State outline the actions that have been taken on foot of the motion that was passed in the House two years ago?

As the Deputy will understand, the working group report was prepared in the context of litigation and it will not be published for that reason. I have stated that in the House previously. I am sure everybody will understand the reasons that will not be published.

As I have stated, I am not a medical expert. I am not a trained doctor and it would be totally inappropriate for me or for any Member of this House to recommend what anti-malarial drug would be used in sub-Saharan Africa or on some of the missions in which our personnel are participating. That is a matter for the health experts within the Defence Forces. They are the people who make the recommendation. They have responsibility for this area. They consider the mission our personnel will participate in and take into consideration the individual members who will be deployed on a mission and their medical circumstances at that time.

I thank the Minister for his frank response. I am not a doctor either but it has been well documented that the side effects of Lariam are very advanced and adverse. We know of many other countries that have stopped prescribing this anti-malarial drug. We also know that many countries have apologised to their defence forces for having prescribed it. What solace or guarantees will the Defence Forces get from this process? If Lariam is a cheap version of an anti-malarial drug for soldiers, will officers be prescribed a better brand? We mentioned in the debate on the motion on the Defence Forces in the House yesterday that the use of this drug causes major stress within in the family unit among the wives and partners of the members of the Defence Forces. We do not have to be medical experts to know that Lariam is not a good product. We certainly should not be prescribing it to the members of our Defence Forces. Would it be possible for us to have access to those reports or would Deputy Ó Snodaigh be entitled to have sight of them?

I hope the Deputy understands that a number of litigation cases are going through at the moment. I made it quite clear in previous discussions in the House and through oral and written parliamentary questions on this general matter that, fundamentally, the use of anti-malarial drugs is a medical matter that should be decided by qualified medical professionals.

Those are decisions for highly qualified medical officers having regard to the specific circumstances of the mission and of the individual member of the Defence Forces.

I accept the concerns raised by the Deputy and I hope he understands that the report carried out in the Department was in preparation for the litigation cases. Accordingly, it would be wrong of me to publish the report that has been prepared prior to the cases being heard. It would also be wrong of me to comment on any of the cases.

Deputy Buckley referred to the decision made by the Cabinet on Tuesday last about the Army ranger wing's participation in the Multidimensional Integrated Stabilization Mission in Mali, MINUSMA, and the use of Lariam there. That is a matter for the medical branch of the Defence Forces. The branch will take into account the mission, the local conditions in Mali, which is sub-Saharan, and the personnel participating in the mission.