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Check-up for troops before anti-malarial drug Lariam, says MoD Check-up for troops before anti-malarial drug Lariam, says MoD
(about 7 hours later)
A controversial anti-malarial drug will now only be prescribed to service personnel after a face-to-face check-up, the Ministry of Defence has said.A controversial anti-malarial drug will now only be prescribed to service personnel after a face-to-face check-up, the Ministry of Defence has said.
In response to a Defence Select Committee inquiry into the drug Lariam, officials have also announced that troops will be offered an alternative. In response to a Defence Select Committee inquiry into the drug Lariam, officials also announced that troops will be offered an alternative.
Dozens of British troops have said they have experienced side effects including severe depression and anxiety.Dozens of British troops have said they have experienced side effects including severe depression and anxiety.
MPs said they were disappointed it was not designated a "drug of last resort".MPs said they were disappointed it was not designated a "drug of last resort".
Lariam - the brand name for mefloquine, a once-a-week anti-malarial tablet licensed for sale in 42 countries worldwide - has been given to more than 17,000 UK service personnel at least once between April 2007 and March 2015.Lariam - the brand name for mefloquine, a once-a-week anti-malarial tablet licensed for sale in 42 countries worldwide - has been given to more than 17,000 UK service personnel at least once between April 2007 and March 2015.
The Defence Select Committee's inquiry concluded in a report last May that many had not been given proper medical checks before the drug had been prescribed - claims the government said it had taken seriously.The Defence Select Committee's inquiry concluded in a report last May that many had not been given proper medical checks before the drug had been prescribed - claims the government said it had taken seriously.
The MoD has said in the past the vast majority of deployed personnel already received alternatives to Lariam. The guidelines from Lariam's manufacturer Roche state the drug should only be given after a doctor has carried out a proper medical check on the patient.
But ministers say all personnel will now be offered an alternative in case they are reluctant or averse to taking it. But the inquiry heard the MoD had in some instances used risk assessments based on medical records.
Conservative MP Jonny Mercer, a member of the select committee and former army officer, told Radio 4's Today that the guidelines should have been followed from the beginning.
"The evidence is very clear, prescribing a drug outside of the parameters clearly laid out by the manufacturers is not acceptable, and that's what they were doing," he said.
"Consequently there are a number of people in this country who feel their lives have been ruined by this drug when they shouldn't have done."
In the past the MoD has said the vast majority of deployed personnel already received alternatives to Lariam.
HelplineHelpline
The MoD said: "The revised malaria prevention policy will direct that all anti-malarial drugs are only supplied after a face-to-face travel health risk assessment performed by an appropriately trained and regulated health care professional".The MoD said: "The revised malaria prevention policy will direct that all anti-malarial drugs are only supplied after a face-to-face travel health risk assessment performed by an appropriately trained and regulated health care professional".
A new telephone and email service has also been set up for current and former members of the armed forces with concerns or questions about Lariam.A new telephone and email service has also been set up for current and former members of the armed forces with concerns or questions about Lariam.
The Defence Select Committee said the MoD response was a step in the right direction but it was unable to "pass judgement" until the changes were put in place.The Defence Select Committee said the MoD response was a step in the right direction but it was unable to "pass judgement" until the changes were put in place.
Major General Martin Bricknell, deputy surgeon general of the Armed Services, said around 120,000 prescriptions had been issued for anti-malarials.
"Clearly the vast majority of those prescriptions being issued have been done entirely correctly," he told the Today programme.
He added that any association between mefloquine and health problems "can only be determined by looking at each case".
"We will have a clear hierarchy of selection for anti-malarials... And a whole variety of checks and balances to ensure that anyone receiving mefloquine is properly informed of the benefits and risks of taking that drug."
AnalysisAnalysis
By Sima Kotecha, Today programmeBy Sima Kotecha, Today programme
For those who've taken Lariam and suffered, the government response doesn't go far enough.For those who've taken Lariam and suffered, the government response doesn't go far enough.
As one former soldier put it after seeing the statement: "They're simply covering their tracks".As one former soldier put it after seeing the statement: "They're simply covering their tracks".
But it would be wrong to ignore the fact the Ministry of Defence is changing its malaria prevention policy as a result of the inquiry.But it would be wrong to ignore the fact the Ministry of Defence is changing its malaria prevention policy as a result of the inquiry.
And promising to carry out robust medical risk assessments prior to prescribing Lariam could be interpreted as an admission they were not following proper protocol.And promising to carry out robust medical risk assessments prior to prescribing Lariam could be interpreted as an admission they were not following proper protocol.
The inquiry was partly triggered by reports on BBC Radio 4's Today which raised questions about the suitability of the drug in a military setting, where psychological illnesses could be exacerbated by the environment in which personnel sometimes operate.The inquiry was partly triggered by reports on BBC Radio 4's Today which raised questions about the suitability of the drug in a military setting, where psychological illnesses could be exacerbated by the environment in which personnel sometimes operate.
A document from a senior military medic seen by the programme called on the government to use an alternative until it was clear Lariam was safe. Ministers now say one will always be offered.A document from a senior military medic seen by the programme called on the government to use an alternative until it was clear Lariam was safe. Ministers now say one will always be offered.
Follow Sima on Twitter @sima_kotechaFollow Sima on Twitter @sima_kotecha
Duty of careDuty of care
The guidelines from Lariam's manufacturer Roche state the drug should only be given after a doctor has carried out a proper medical check on the patient. But the inquiry heard the MoD had in some instances used risk assessments based on medical records.
In its written response to the committee's report, the MoD said: "Malaria is a deadly disease and we have a duty of care to protect our deployed personnel from it. [Lariam] continues to be recommended as a safe and effective form of malaria prevention by Public Health England, the World Health Organization, and other respected bodies who take account of the body of global evidence."In its written response to the committee's report, the MoD said: "Malaria is a deadly disease and we have a duty of care to protect our deployed personnel from it. [Lariam] continues to be recommended as a safe and effective form of malaria prevention by Public Health England, the World Health Organization, and other respected bodies who take account of the body of global evidence."
The Defence Select Committee said the MoD had accepted of a number of its recommendations.The Defence Select Committee said the MoD had accepted of a number of its recommendations.
But it said: "The committee is disappointed that the MoD has yet to designate Lariam as a drug of last resort as the report recommended. This would have sent out a clear message that the MoD has acknowledged and accepted the high risks associated with the use of Lariam."But it said: "The committee is disappointed that the MoD has yet to designate Lariam as a drug of last resort as the report recommended. This would have sent out a clear message that the MoD has acknowledged and accepted the high risks associated with the use of Lariam."
It is not clear how many service personnel have experienced side effects after taking the drug but according to evidence given to the Defence Select Committee inquiry, between 25% and 35% of those who took it, were affected.It is not clear how many service personnel have experienced side effects after taking the drug but according to evidence given to the Defence Select Committee inquiry, between 25% and 35% of those who took it, were affected.
Last month, former Army chief Lord Dannatt told the BBC he had refused to take Lariam and personally believes the drug can have "catastrophic" mental health effects.Last month, former Army chief Lord Dannatt told the BBC he had refused to take Lariam and personally believes the drug can have "catastrophic" mental health effects.
Retired Lt Col Andrew Marriot, who gave evidence to the inquiry about the side effects he suffered including sleep deprivation and memory loss, told the BBC: "It is good to see that new processes are going to be implemented and personnel should, in future, be protected".Retired Lt Col Andrew Marriot, who gave evidence to the inquiry about the side effects he suffered including sleep deprivation and memory loss, told the BBC: "It is good to see that new processes are going to be implemented and personnel should, in future, be protected".
But he said the MoD response on Lariam use in the past appeared to be "evasive and misleading" and his experience with the new helpline was not positive as "they will not discuss individual cases... they advise veterans to approach their GPs".But he said the MoD response on Lariam use in the past appeared to be "evasive and misleading" and his experience with the new helpline was not positive as "they will not discuss individual cases... they advise veterans to approach their GPs".