I propose to take Questions Nos. 43, 53, 56, 63 and 70 together.
I am satisfied that the screening system employed by the Defence Forces adheres to international best practice. This screening system automatically rules out personnel from overseas service with certain conditions e.g. depression, anxiety, neurodegenerative disorders etc. which, as has been indicated by the Irish Medicine Board (IMB), are more likely to precipitate serious adverse reactions to Lariam. Pregnant personnel are also excluded.
In the case of overseas missions to malarious areas, this screening system also involves an assessment of the individual's suitability to be prescribed the selected anti-malarial agent in line with current IMB guidelines. This typically involves review of the individual's previous experience, if any, with the medication. The individual's medical history is also screened for those conditions which have been identified as precipitating serious side effects in association with the medication.
In addition, blood tests are carried out to ensure that the liver is healthy as liver disease is an accepted contraindication to the use of Lariam. Lariam is only dispensed by the pharmacy upon production of a prescription for same. A record of this prescription is kept by the pharmacy and the aforementioned suitability assessment is documented in the person's medical file.
I wish to reiterate that the Defence Forces take all necessary precautions in assessing the suitability of personnel before prescribing Larium in accordance with the prescribing instructions and information provided by the IMB. Personnel are screened both before and after deployments and all necessary actions are taken to ensure that those with contraindications to Larium use are deemed unsuitable for overseas service and are not prescribed the medication.
I am advised by the Military authorities that three members of Defence Forces have recently been treated for a serious symptomatology which may have been caused or contributed to by Lariam, although there is nothing conclusive in this regard. I am advised that all these personnel have made a full recovery and that, in line with the special guidelines issued by the IMB in 1996 and again in 2003, these cases have been reported to the Board.
The seven cases previously referred to with less dramatic symptomatology have not been reported to the IMB as they are still under review by the Military authorities. As yet, a definite linkage with Lariam usage has not been established.
I am advised by the military authorities that the Defence Forces Personnel Management System does not capture data on the number of suicides there have been in the Defence Forces during a specific period of time. In this context the information requested in relation to the number of suicide victims who were either taking Lariam, or who had taken Lariam prior to committing suicide, is not available.