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Soldiers to be offered choice of malaria drug after Lariam controversy

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Defence Minister Paul Kehoe. Photo: Colin Keegan, Collins Dublin

Defence Minister Paul Kehoe. Photo: Colin Keegan, Collins Dublin

Colin Keegan

Defence Minister Paul Kehoe. Photo: Colin Keegan, Collins Dublin

Irish peacekeeping troops deployed to sub-Saharan Africa will no longer be required to take the controversial anti-malaria drug Lariam.

Troops have been using Lariam since it was first prescribed to peacekeepers for a United Nations mission in Eritrea in 2001.

Now, instead of being restricted to one drug, peacekeepers will be able to select from three medications, although it is unlikely many, if any, will opt for Lariam, given the controversy over its use.

The Department of Defence faces more than 160 compensation claims from serving and former military personnel who claim they are suffering after using Lariam.

Side effects can include depression, insomnia, anxiety, suicidal thoughts and other psychiatric problems.

Military medical policy for the past two decades directed that Lariam, officially known as mefloquine, was the default malaria medication for missions in sub-Saharan Africa.

Members of the defence forces who had sensitivities or intolerance to Lariam had to be stood down from a mission and were not allowed to deploy, except in limited circumstances or where a derogation had been sought to provide an alternative medication.

A full review of prescribed medications for such missions has now been carried out by the military organisation's medical branch following on from two unpublished reports from working groups set up to examine the issue and aid the department in forthcoming court cases.

This review has resulted in instructions being issued by the medical branch director that the recommended anti-malaria medication can be Lariam or two other products, Malarone or Doxycycline.

The Department of Defence told the Sunday Independent last night that the amended instructions were a medical matter, which was determined by medical professionals in the Defence Forces.

It said the decision on which agent to prescribe would be made by the medical officer following consultation with the individual during their deployment assessment.

The department said the minister with responsibility for defence, Paul Kehoe, had been informed by the military authorities that the instructions issued by the director of the medical branch had been amended and that personnel, who had "contraindications" to mefloquine (Lariam), or who had a sensitivity or intolerance to that medication, would now be allowed to deploy to sub-Saharan Africa on an alternative drug, subject to their suitability to take it.

All claims against the State for personal injury, including related to the consumption of Lariam, taken by current and former members of the Defence Forces, are handled by the State Claims Agency.

The first report commissioned by the Department of Defence on the use of Lariam has remained unpublished since it was delivered in 2013.The department has claimed "legal professional privilege" over the document and would not release it under the Freedom of Information Act.

A second working group was set up in 2017 and it set out a number of recommendations, which were not disclosed publicly.

Two of the compensation cases before the courts have been settled, although the details have not been disclosed, and a third has been withdrawn.

Lariam has not been available for sale here since 2016 after the manufacturer, Roche, said it was discontinuing the supply of the drug to the Irish market, based on commercial assessment. Its use by the UK military forces has also been heavily scaled back.

However, successive governments here have made it clear over the past decades that medical advice consistently recommended that Lariam was the most suitable drug for members of the Defence Forces being deployed overseas in malaria-affected areas.

Sunday Independent