Tuesday, 24 September 2019

Ceisteanna (10)

Seán Crowe


10. Deputy Seán Crowe asked the Taoiseach and Minister for Defence the reason the Defence Forces increased spending on the anti-malaria drug, Lariam, by 50% in 2018, despite the fact that more than 85 soldiers are taking legal action against the Defence Forces over the devastating mental health side effects they claim they have suffered as a result of taking Lariam while serving abroad; if his attention has been drawn to the fact that a motion was passed in Dáil Éireann on 28 June 2017 calling for an end to the use of Lariam by the Defence Forces; the steps he is taking to end the use of Lariam by the Defence Forces. [38460/19]

Amharc ar fhreagra

Freagraí ó Béal (3 píosaí cainte) (Ceist ar Defence)

The increase in expenditure on Lariam in 2018 and 2019 is explained by a cost-per-tablet increase of €1.75, and is not related to any change in the manner or frequency of its use. While the headline percentage price increase appears high, this translates into a modest increase in total expenditure on Lariam in 2018 of €1,399 over the 2017 figure. Prior to 2017, Lariam was purchased by the Defence Forces under a four-year framework agreement between the Irish Pharmaceutical Healthcare Association, IPHA, and the HSE. As the product is no longer covered by the terms of the IPHA-HSE framework agreement, however, there has been a resulting knock-on effect on cost. This accounts for the increased spend on Lariam in 2018 and to date in 2019. 

As I have outlined to the House on many occasions, 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 organisation. The Deputy will be aware that ongoing litigation regarding this matter is being handled by the State Claims Agency, SCA. It has advised that it has received 225 claims alleging personal injury as a result of the consumption of Lariam by current and former members of the Defence Forces. 

Additional information not given on the floor of the House

He will appreciate, therefore, that it would be inappropriate for me to comment further. I assure the House that the health and welfare of the men and women of the Defence Forces is a high priority for me, my Department and the Defence Forces.

The Minister of State has explained the increase in cost. I am concerned, however, that the Defence Forces still use Lariam. That is what baffles me. Other countries have stopped prescribing this drug and have apologised to the members of their respective defence forces for prescribing it to them in the first place. Why is Ireland not following suit? There are concerns regarding Lariam. I have spoken to personnel who have taken the drug. I have also spoken to people who have taken the drug and experienced no side effects, but that is no reason its use should not be stopped. My concern is that clear evidence is building up that this drug has caused problems for some personnel. Lariam should not be used if there is any possibility that it is going to have the adverse effects that it has had on many members of the Defence Forces. Those have included suicidal tendencies and breakdowns.

The Minister of State says he is acting on the 2013 recommendation of the working group on the issue but I have never seen those reports so I cannot make a call on them. Will the Minister of State agree to release those reports at some stage so we can understand why he is adopting the position he is?

I will not be releasing those reports because they were prepared for litigation. The Defence Forces continue to use three antimalarial drugs. These are Lariam, Malarone and Doxycycline. The selection by a medical officer of the most appropriate drug for use is complex and dependent on a number of factors. All of these antimalarial drugs have contraindications and side-effects. Significant precautions are taken by the Defence Forces' medical officers in assessing the medical suitability of members of the Defence Forces to take any of the antimalarial medication. It is the policy of the Defence Forces to screen personnel individually for fitness for service overseas and medical suitability. Fundamentally, the choice of malarial chemoprophylaxis 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.

Written Answers are published on the Oireachtas website.