Thursday, 7 November 2019

Ceisteanna (11)

Aengus Ó Snodaigh


11. Deputy Aengus Ó Snodaigh asked the Taoiseach and Minister for Defence if his attention has been drawn to the fact that members of the Defence Forces are the only soldiers in the various missions in Mali that are required to take Lariam; and when he will abide by the instructions of Dáil Éireann to cease the use of the drug of first choice in preventing malaria in view of the fact that most other military authorities have switched to alternative anti-malaria drugs and that already some of those in the latest deployment have had an adverse reaction to a drug no longer on public sale here. [45675/19]

Amharc ar fhreagra

Freagraí ó Béal (9 píosaí cainte) (Ceist ar Defence)

The Defence Forces are currently providing support to two separate missions in Mali. EU Training Mission, EUTM, Mali is part of a wider EU effort in support of international peace and security in the wider Sahel region. The mission is being undertaken at the request of the Malian Government and has the support of a UN Security Council resolution.

In addition, Government and Dáil approval was received in June of this year for the deployment of a contingent of the Defence Forces to participate in MINUSMA, the United Nations authorised operation in Mali. MINUSMA was established under UN Security Council Resolution 2100 of April 2013. The mission is tasked primarily with providing support to transitional governmental authorities in Mali in efforts to stabilise the country.

I am advised that there are three anti-malarial drugs, namely, Lariam, Malarone and doxycycline, which continue to be used in the Defence Forces. As I indicated to the Deputy in response to the Private Members' motion of 28 June 2017, 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.

I would also like to point out that there are a range of support services, both medical and non-medical, available to the Defence Forces personnel. These include access to Defence Forces medical officers as well as to psychiatric, psychological, social work and personnel support services. A strictly confidential 24-hour care line, 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. Given that there is litigation pending in these matters, the Deputy will appreciate that it would be inappropriate for me to comment further.

I did not ask the Minister of State to comment on current cases or in any way stray into those cases. I am well aware of them, as is the Minister of State, because we have raised those issues in the House.

One part of this question is to do with Mali. The information I have is that a number of the 33 members of the Defence Forces in Mali have had to switch from Lariam to doxycycline because of a reaction to Lariam. It is good that they are on a different drug, but the fact that Lariam was there in the first instance shows that a poison is being given regularly to Defence Forces members on missions overseas, endangering them and possibly also endangering civilians, as has happened in the past. We have seen that from international and parliamentary inquiries in other jurisdictions, including Canada.

The key part of this question is why the Government has not complied with the directions of the Dáil, which passed a motion acknowledging the serious side effects of Lariam on members of the Defence Forces, the failure to implement a comprehensive screening programme to monitor the effects from 2000 onwards, the fact that many world militaries have banned Lariam, and that those who take it are three to five times more likely to be at risk of suicide. A majority of the Dáil specifically called on the Government to instruct the military authorities to cease the administration of Lariam immediately. That was more than two years ago. When will the Minister of State implement those calls from this Dáil?

I have stated to the Deputy on many occasions that, fundamentally, the choice of malaria chemoprophylaxis for use in the Defence Forces is a medical matter that should be decided by qualified medical professionals. I hope the Deputy accepts that it is up to a medical professional to prescribe whatever medication anybody should take. It would be totally inappropriate to recommend that someone go to a Member of the Oireachtas, rather than a GP, for medical advice. I have stated to the Deputy, this House and many others on numerous occasions that neither I, nor Deputy Ó Snodaigh, nor the Members of this House are medically qualified to prescribe what drug anybody should take. Everybody has different circumstances depending on the mission in which they are engaged, and these factors are all carefully considered when people are prescribed any sort of medication.

I would never suggest that we should take on the role of medical professionals. I ask the Minister of State to look at the evidence throughout the world where the medical profession has told other militaries that there is a major concern over Lariam and that those who take it are at considerable risk of suicide and other mental health effects. That is why it is banned by other militaries: not on the basis of their parliaments or military authorities but on the basis of medical evidence. I have asked the Minister of State, and Ministers who have preceded him, to look again and instruct the military authorities to carry out a review. That has not been done. The Dáil passed a motion asking the Minister of State to do that and asking him to ensure that a plan of action was drawn up to help those who have suffered the consequences of taking a drug, a poison, that the Minister of State has allowed the military authorities to continue to administer. The State has, on other occasions, banned poisonous substances that were administered by the system, such as thalidomide. There have been occasions when political offices in Ireland have stepped in and demanded the end of the administration of a product that is killing people or having a severe effect on them. This is such a case.

I restate something I stated at the time of the Private Members' motion and have stated on numerous occasions in the Dáil. The prescription of drugs is a matter for the medical practitioners within the Defence Forces.

As the Deputy knows, the work of the Lariam report implementation group is ongoing. It is doing a lot of work. The group was established to implement the recommendations of the second report of the malaria chemoprophylaxis working group, which was established to review various issues, including those arising from the use of Lariam, particularly in the context of current and potential litigation. The recommendations focused on a number of-----

It was withdrawn from sale by the company.

As I have said on numerous occasions, the company did not pull out of Ireland as a result of the use of Lariam by the Defence Forces-----

Is the Government buying it off the black market then?

-----but for reasons of its own accord.

Written Answers are published on the Oireachtas website.