232. Deputy Clare Daly asked the Taoiseach and Minister for Defence if he will instigate an independent study to establish if, as per an analysis (details supplied), there was a three to five times increased risk of suicide in Irish soldiers prescribed Lariam in comparison to a similar group who also served overseas but did not take the drug. (Question 18615/16 asked on 29 Jun 2016 - Defence Forces Medicinal Products)

Taoiseach and Minister for Defence (Deputy Enda Kenny): I propose to take Questions Nos. 218 to 235, inclusive, together. 
As I have made clear, the health and welfare of the Defence Forces are a priority for me and this informs my approach to the issue of Lariam. 
I have noted from the World Health Organisation (WHO) publication regarding the number of deaths from malaria that there has been a 60 % reduction in Malaria mortality since 2000. The WHO reports that in 2015 the number of deaths w...

21. Deputy Clare Daly asked the Taoiseach and Minister for Defence when he will publish the report of the working group on Lariam; and if he will make a statement on the matter. (Question 16705/16 asked on 21 Jun 2016 - Defence Forces Medicinal Products)

Deputy Clare Daly: This is similar to the question tabled earlier by Deputy Ó Snodaigh regarding the report of the working group on Lariam, which we were promised in 2013. It was promised that it would be published in January this year but as of yet we have not seen it. Lariam continues to be prescribed as the drug of first choice and there is an urgency in dealing with this. The veterans assembled on Saturday, many of them victims of this drug. They want this to be acknowledged and they wan...

220. Deputy Clare Daly asked the Taoiseach and Minister for Defence if he accepts that unlike doxycycline and Malarone, Lariam Adverse drug reactions are predominantly neuropsychiatric in nature and that Lariam is the only one of the three drugs that carries a boxed safety warning, the most serious type of warning. (Question 18603/16 asked on 29 Jun 2016 - Defence Forces Medicinal Products)

Taoiseach and Minister for Defence (Deputy Enda Kenny): I propose to take Questions Nos. 218 to 235, inclusive, together. 
As I have made clear, the health and welfare of the Defence Forces are a priority for me and this informs my approach to the issue of Lariam. 
I have noted from the World Health Organisation (WHO) publication regarding the number of deaths from malaria that there has been a 60 % reduction in Malaria mortality since 2000. The WHO reports that in 2015 the number of deaths w...

224. Deputy Clare Daly asked the Taoiseach and Minister for Defence if the official antimalarial policy for sub-Saharan Africa is still Lariam or unfit to travel; and if so, if he will cite as many examples as possible of other armies who have the same Lariam or unfit to travel policy for that region. (Question 18607/16 asked on 29 Jun 2016 - Defence Forces Medicinal Products)

Taoiseach and Minister for Defence (Deputy Enda Kenny): I propose to take Questions Nos. 218 to 235, inclusive, together. 
As I have made clear, the health and welfare of the Defence Forces are a priority for me and this informs my approach to the issue of Lariam. 
I have noted from the World Health Organisation (WHO) publication regarding the number of deaths from malaria that there has been a 60 % reduction in Malaria mortality since 2000. The WHO reports that in 2015 the number of deaths w...

231. Deputy Clare Daly asked the Taoiseach and Minister for Defence to release the study or the raw data and methodology if no formal study exists, which shows a decreased risk of suicide in the period when Lariam was being prescribed by the Defence Forces, so that it can be subjected to independent scrutiny. (Question 18614/16 asked on 29 Jun 2016 - Defence Forces Medicinal Products)

Taoiseach and Minister for Defence (Deputy Enda Kenny): I propose to take Questions Nos. 218 to 235, inclusive, together. 
As I have made clear, the health and welfare of the Defence Forces are a priority for me and this informs my approach to the issue of Lariam. 
I have noted from the World Health Organisation (WHO) publication regarding the number of deaths from malaria that there has been a 60 % reduction in Malaria mortality since 2000. The WHO reports that in 2015 the number of deaths w...

235. Deputy Clare Daly asked the Taoiseach and Minister for Defence if the resources are available to check individual personnel files relating to the prescription and use of Lariam in the Defence Forces, thus releasing crucial information previously requested in a number of different parliamentary questions on the subject. (Question 18618/16 asked on 29 Jun 2016 - Defence Forces Medicinal Products)

Taoiseach and Minister for Defence (Deputy Enda Kenny): I propose to take Questions Nos. 218 to 235, inclusive, together. 
As I have made clear, the health and welfare of the Defence Forces are a priority for me and this informs my approach to the issue of Lariam. 
I have noted from the World Health Organisation (WHO) publication regarding the number of deaths from malaria that there has been a 60 % reduction in Malaria mortality since 2000. The WHO reports that in 2015 the number of deaths w...

225. Deputy Clare Daly asked the Taoiseach and Minister for Defence if Lariam or unfit to travel is no longer the policy, if he can supply a copy of the new malaria chemoprophylaxis policy for sub-Saharan Africa or individual country policies for that region; and when the changes were first implemented. (Question 18608/16 asked on 29 Jun 2016 - Defence Forces Medicinal Products)

Taoiseach and Minister for Defence (Deputy Enda Kenny): I propose to take Questions Nos. 218 to 235, inclusive, together. 
As I have made clear, the health and welfare of the Defence Forces are a priority for me and this informs my approach to the issue of Lariam. 
I have noted from the World Health Organisation (WHO) publication regarding the number of deaths from malaria that there has been a 60 % reduction in Malaria mortality since 2000. The WHO reports that in 2015 the number of deaths w...

219. Deputy Clare Daly asked the Taoiseach and Minister for Defence if he accepts that as per Food and Drug Administration and European Medicines Agency literature, Lariam can cause neurologic side effects that can last for months, years and can become permanent; and if not, if he will produce fully referenced analysis that proves otherwise in each case. (Question 18602/16 asked on 29 Jun 2016 - Defence Forces Medicinal Products)

Taoiseach and Minister for Defence (Deputy Enda Kenny): I propose to take Questions Nos. 218 to 235, inclusive, together. 
As I have made clear, the health and welfare of the Defence Forces are a priority for me and this informs my approach to the issue of Lariam. 
I have noted from the World Health Organisation (WHO) publication regarding the number of deaths from malaria that there has been a 60 % reduction in Malaria mortality since 2000. The WHO reports that in 2015 the number of deaths w...

226. Deputy Clare Daly asked the Taoiseach and Minister for Defence if he will request the Director of the Medical Corps to state the year from which prescribing doctors individually screened soldiers for Lariam suitability; and if he will provide all documentation in support of that answer. (Question 18609/16 asked on 29 Jun 2016 - Defence Forces Medicinal Products)

Taoiseach and Minister for Defence (Deputy Enda Kenny): I propose to take Questions Nos. 218 to 235, inclusive, together. 
As I have made clear, the health and welfare of the Defence Forces are a priority for me and this informs my approach to the issue of Lariam. 
I have noted from the World Health Organisation (WHO) publication regarding the number of deaths from malaria that there has been a 60 % reduction in Malaria mortality since 2000. The WHO reports that in 2015 the number of deaths w...

228. Deputy Clare Daly asked the Taoiseach and Minister for Defence the percentage of troops the director of the Medical Corps expects to be contraindicated from being prescribed Lariam; and to list the medical studies or other data used in support of this figure. (Question 18611/16 asked on 29 Jun 2016 - Defence Forces Medicinal Products)

Taoiseach and Minister for Defence (Deputy Enda Kenny): I propose to take Questions Nos. 218 to 235, inclusive, together. 
As I have made clear, the health and welfare of the Defence Forces are a priority for me and this informs my approach to the issue of Lariam. 
I have noted from the World Health Organisation (WHO) publication regarding the number of deaths from malaria that there has been a 60 % reduction in Malaria mortality since 2000. The WHO reports that in 2015 the number of deaths w...

229. Deputy Clare Daly asked the Taoiseach and Minister for Defence the percentage of the remaining troops not contraindicated to Lariam, the Director of the Medical Corps expects to then experience adverse drug reactions which mandate discontinuation of the drug as per the Health Products Regulatory Authority safety instructions and to list the medical studies or other data used in support of this figure. (Question 18612/16 asked on 29 Jun 2016 - Defence Forces Medicinal Products)

Taoiseach and Minister for Defence (Deputy Enda Kenny): I propose to take Questions Nos. 218 to 235, inclusive, together. 
As I have made clear, the health and welfare of the Defence Forces are a priority for me and this informs my approach to the issue of Lariam. 
I have noted from the World Health Organisation (WHO) publication regarding the number of deaths from malaria that there has been a 60 % reduction in Malaria mortality since 2000. The WHO reports that in 2015 the number of deaths w...

230. Deputy Clare Daly asked the Taoiseach and Minister for Defence if the director of Medical Corps accepts that Lariam can be associated with suicide. (Question 18613/16 asked on 29 Jun 2016 - Defence Forces Medicinal Products)

Taoiseach and Minister for Defence (Deputy Enda Kenny): I propose to take Questions Nos. 218 to 235, inclusive, together. 
As I have made clear, the health and welfare of the Defence Forces are a priority for me and this informs my approach to the issue of Lariam. 
I have noted from the World Health Organisation (WHO) publication regarding the number of deaths from malaria that there has been a 60 % reduction in Malaria mortality since 2000. The WHO reports that in 2015 the number of deaths w...

222. Deputy Clare Daly asked the Taoiseach and Minister for Defence if the Director of the Medical Corps accepts that as per the World Health Organisation International Travel and Health 2015, mefloquine, doxycycline and Malarone are all effective malaria chemoprophylaxis options for the various countries of Defence Forces deployments in sub-Saharan Africa. (Question 18605/16 asked on 29 Jun 2016 - Defence Forces Medicinal Products)

Taoiseach and Minister for Defence (Deputy Enda Kenny): I propose to take Questions Nos. 218 to 235, inclusive, together. 
As I have made clear, the health and welfare of the Defence Forces are a priority for me and this informs my approach to the issue of Lariam. 
I have noted from the World Health Organisation (WHO) publication regarding the number of deaths from malaria that there has been a 60 % reduction in Malaria mortality since 2000. The WHO reports that in 2015 the number of deaths w...

218. Deputy Clare Daly asked the Taoiseach and Minister for Defence if he accepts the World Health Organisation malaria unit figures of approximately 130,000 worldwide malaria deaths annually in patients over the age of five. (Question 18601/16 asked on 29 Jun 2016 - Defence Forces Medicinal Products)

Taoiseach and Minister for Defence (Deputy Enda Kenny): I propose to take Questions Nos. 218 to 235, inclusive, together. 
As I have made clear, the health and welfare of the Defence Forces are a priority for me and this informs my approach to the issue of Lariam. 
I have noted from the World Health Organisation (WHO) publication regarding the number of deaths from malaria that there has been a 60 % reduction in Malaria mortality since 2000. The WHO reports that in 2015 the number of deaths w...

221. Deputy Clare Daly asked the Taoiseach and Minister for Defence if the Director of the Medical Corps accepts that according to the Health Products Regulatory Authority’s Malarone license, the drug can be prescribed for periods of six months. (Question 18604/16 asked on 29 Jun 2016 - Defence Forces Medicinal Products)

Taoiseach and Minister for Defence (Deputy Enda Kenny): I propose to take Questions Nos. 218 to 235, inclusive, together. 
As I have made clear, the health and welfare of the Defence Forces are a priority for me and this informs my approach to the issue of Lariam. 
I have noted from the World Health Organisation (WHO) publication regarding the number of deaths from malaria that there has been a 60 % reduction in Malaria mortality since 2000. The WHO reports that in 2015 the number of deaths w...

223. Deputy Clare Daly asked the Taoiseach and Minister for Defence if the Director of the Medical Corps accepts that the absorption of Doxycycline is not notably influenced by simultaneous ingestion of food or milk. (Question 18606/16 asked on 29 Jun 2016 - Defence Forces Medicinal Products)

Taoiseach and Minister for Defence (Deputy Enda Kenny): I propose to take Questions Nos. 218 to 235, inclusive, together. 
As I have made clear, the health and welfare of the Defence Forces are a priority for me and this informs my approach to the issue of Lariam. 
I have noted from the World Health Organisation (WHO) publication regarding the number of deaths from malaria that there has been a 60 % reduction in Malaria mortality since 2000. The WHO reports that in 2015 the number of deaths w...

227. Deputy Clare Daly asked the Taoiseach and Minister for Defence the reason some troops, including those who subsequently took their own lives, were prescribed mefloquine despite clear written contraindications already recorded on their medical files. (Question 18610/16 asked on 29 Jun 2016 - Defence Forces Medicinal Products)

Taoiseach and Minister for Defence (Deputy Enda Kenny): I propose to take Questions Nos. 218 to 235, inclusive, together. 
As I have made clear, the health and welfare of the Defence Forces are a priority for me and this informs my approach to the issue of Lariam. 
I have noted from the World Health Organisation (WHO) publication regarding the number of deaths from malaria that there has been a 60 % reduction in Malaria mortality since 2000. The WHO reports that in 2015 the number of deaths w...

233. Deputy Clare Daly asked the Taoiseach and Minister for Defence if the working group on malaria prophylaxis been reconvened in the original context of current and future litigation, or if it is now instead tasked with examining best practice malaria prophylaxis in a military population with a view to making policy recommendations purely in the context of future overseas missions to sub-Saharan Africa. (Question 18616/16 asked on 29 Jun 2016 - Defence Forces Medicinal Products)

Taoiseach and Minister for Defence (Deputy Enda Kenny): I propose to take Questions Nos. 218 to 235, inclusive, together. 
As I have made clear, the health and welfare of the Defence Forces are a priority for me and this informs my approach to the issue of Lariam. 
I have noted from the World Health Organisation (WHO) publication regarding the number of deaths from malaria that there has been a 60 % reduction in Malaria mortality since 2000. The WHO reports that in 2015 the number of deaths w...

234. Deputy Clare Daly asked the Taoiseach and Minister for Defence if he or any of his officials contacted persons (details supplied) with a view to them contributing to the reconvened working group on malaria prophylaxis after their very generous offer. (Question 18617/16 asked on 29 Jun 2016 - Defence Forces Medicinal Products)

Taoiseach and Minister for Defence (Deputy Enda Kenny): I propose to take Questions Nos. 218 to 235, inclusive, together. 
As I have made clear, the health and welfare of the Defence Forces are a priority for me and this informs my approach to the issue of Lariam. 
I have noted from the World Health Organisation (WHO) publication regarding the number of deaths from malaria that there has been a 60 % reduction in Malaria mortality since 2000. The WHO reports that in 2015 the number of deaths w...

35. Deputy Clare Daly asked the Taoiseach and Minister for Defence if the Defence Forces prescribing policy in regard to lariam as the first choice anti-malarial will change in view of the recent substantial settlements in cases here and in the United Kingdom for army lariam damage. (Question 3349/18 asked on 24 Jan 2018 - Defence Forces Medicinal Products)

Minister of State at the Department of Defence (Deputy Paul Kehoe): I propose to take Questions Nos. 16 and 35 together.
As I have indicated to this House in the past, fundamentally the choice of malaria 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 t...

309. Deputy Clare Daly asked the Taoiseach and Minister for Defence the number of persons who died through suicide or self-inflicted injuries with regard to deaths of Defence Forces personnel in the period 2000 to 2012 inclusive; of these deaths, the number that had previously been prescribed Lariam; and of those who had been prescribed lariam, the number that were reported to the IMB and HPRA. (Question 31317/16 asked on 20 Oct 2016 - Defence Forces Personnel Data)

Minister of State at the Department of Defence (Deputy Paul Kehoe): I am advised that the Defence Forces Personal Management System does not capture data on the number of suicides of serving members of the Defence Forces. However, I have been further advised that a review by the Defence Forces into 179 non-service related deaths among members of the Defence Forces in the period 2000 to 2012 shows that 30 were apparently of self-inflicted injuries. Of these 30 deaths by apparent self-inflicted ...

16. Deputy Clare Daly asked the Taoiseach and Minister for Defence if his Department has reviewed the recent settlement in a Defence Forces lariam damages case and is giving consideration to a redress and compensation scheme for members of the Defence Forces harmed by lariam in view of the outcome of that case. (Question 3350/18 asked on 24 Jan 2018 - Defence Forces Medicinal Products)

Minister of State at the Department of Defence (Deputy Paul Kehoe): I propose to take Questions Nos. 16 and 35 together.
As I have indicated to this House in the past, fundamentally the choice of malaria 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 t...

18. Deputy Clare Daly asked the Taoiseach and Minister for Defence further to Parliamentary Question No. 683 of 18 October 2016, if he will address allegations that members of the Defence Forces not only did not receive a face to face consultation to assess their suitability to take Lariam but in some cases Lariam was also prescribed to persons who had a history of anxiety and depression recorded on their written medical files. (Question 33809/16 asked on 09 Nov 2016 - Defence Forces Medicinal Products)

Deputy Clare Daly: This again relates to the use of Lariam and the fact that it is widely known and was for decades that certain people should not be prescribed it. What is the response of the Minister of State to many members of the Defence Forces who state they did not have a face to face consultation to assess their ability to take Lariam? In this sense, what they are stating is the State did not protect their interests and failed in its duty of care to them.
 ...

74. Deputy Clare Daly asked the Taoiseach and Minister for Defence further to Parliamentary Question No. 1459 of 2 May 2017, the current position regarding the prescribing of Lariam to the Defence Forces; the reason there is no plan at this time to withdraw Lariam from the range of anti-malarial medications available to the Defence Forces; and if he will make a statement on the matter. (Question 23972/17 asked on 17 May 2017 - Defence Forces Medicinal Products)

Deputy Niamh Smyth: My question is to ask the Taoiseach and Minister for Defence if the medical service of the Defence Forces is continuing to prescribe the anti-malarial drug Lariam for members of the Defence Forces, and if he could make a statement on the matter.
 ...

678. Deputy Clare Daly asked the Taoiseach and Minister for Defence if the broad range of studies demonstrating the neurotoxic effects of mefloquine, Lariam, (details supplied) have been reviewed and taken into account by the chief medical officer in coming to the conclusion that the benefits of Lariam as a first line anti-malarial for the Defence Forces outweigh the costs. (Question 39772/16 asked on 13 Dec 2016 - Defence Forces Medicinal Products)

Minister of State at the Department of Defence (Deputy Paul Kehoe): The Director Medical Branch provides military medical advice to the Chief of Staff and the General Staff and is responsible for clinical governance and the development of clinical policy, medical education and training in the Defence Forces. In this context, I am advised that the Director Medical Branch is aware of a broad range of studies relating to Lariam and indeed he is also aware of studies relating to the alternative ant...

2104. Deputy Clare Daly asked the Taoiseach and Minister for Defence his views on the WHO advice that Lariam, Malarone and doxycycline are all equally effective in preventing malaria in sub-Saharan Africa in view of the fact that in 2015 and 2016 20 to 25% of troops in sub-Saharan Africa were prescribed one of the alternatives to Lariam and there were no cases of malaria during that period. (Question 37839/17 asked on 11 Sep 2017 - Defence Forces Medicinal Products)

Minister of State at the Department of Defence (Deputy Paul Kehoe): The Deputy will be aware that this matter was the subject of discussion at a Private Member’s Motion in the Dáil on 28th June last. As I indicated to the House at that time, Malaria is a serious disease and is a threat to any military force operating in areas where the disease is prevalent. It must be emphasised that the reason Defence Forces use a malaria chemoprophylaxis in the first instance is to protect personnel. 
In the...

110. Deputy Clare Daly asked the Taoiseach and Minister for Defence the recommendations of the 2013 Lariam report that are repeated in the latest report of the working group on Lariam. (Question 6585/18 asked on 08 Feb 2018 - Defence Forces Medicinal Products)

Minister of State at the Department of Defence (Deputy Paul Kehoe): I propose to take Questions Nos. 109 to 111, inclusive, together.
As stated previously, the two reports of the Working Group were produced in the context of current and potential litigation and are legally privileged. Therefore, it would be inappropriate to comment in any detail in relation to these reports.  It would also be inappropriate to comment in relation matters such as any papers published by Defence Force Medical Offi...

47. Deputy Clare Daly asked the Taoiseach and Minister for Defence further to Question No. 262 of 30 March 2017 and the clarification of 13 June 2017 (details supplied), the year in which the Defence Forces was first of the view that the specific reactions of anxiety, restlessness or confusion, if declared by a member of the Defence Forces to be present, would necessitate withdrawal of mefloquine. (Question 32348/17 asked on 11 Jul 2017 - Defence Forces Medicinal Products)

Deputy Clare Daly: This follows a previous question that was answered thanks to the good offices of the Ceann Comhairle, about listed side effects of Lariam. We asked the Minister of State to say whether they were deemed minor, tolerable or intolerable. This is important because that is the basis upon which the Defence Forces define whether someone can serve or not, and whether Lariam should be withdrawn.
 ...

129. Deputy Clare Daly asked the Taoiseach and Minister for Defence the terms of reference provided to the working group on Lariam established in 2011. (Question 9544/18 asked on 27 Feb 2018 - Defence Forces Medicinal Products)

Minister of State at the Department of Defence (Deputy Paul Kehoe): A Malaria Chemoprophylaxis Working Group was established in January 2011 and reported in April 2013. The Group was re-convened in August 2015 and reported in October 2017. The purpose of the Group was to review, inter alia, issues arising in relation to the use of Lariam, particularly in the context of the current and potential litigation. 
Both reports were produced by the Working Group in the context of current and potential l...

52. Deputy Clare Daly asked the Minister for Defence further to Parliamentary Question No. 69 of 24 November 2015, if he is concerned that Lariam is a third-line drug for the US military in sub-Saharan Africa and is only issued for personnel who are unable to receive either of the other anti-malarial regimens; that its issue is accompanied by a wallet card containing current safety information from that country’s Food and Drug Administration indicating the possibility that the neurological side effects may persist or become permanent; and, given this, why, as noted in his reply to Parliamentary Question No. 12 of 14 January 2015, the malaria chemoprophylactic agent of choice of the Irish Defence Forces for use in sub-Saharan Africa continues to be Lariam. (Question 2952/16 asked on 26 Jan 2016 - Defence Forces Medicinal Products)

Deputy Clare Daly: This follows on from a number of parliamentary questions from Deputies and the Minister’s meeting with individuals in the campaign for action on Lariam. It is in light of the fact that the rest of the world is moving and rowing back on the use of Lariam. We know it has been completely abandoned in the UK, and in the United States it is only used in the defence forces as the third choice and only if the other options are not suitable - it is very much a last resort. Why, aga...

231. Deputy Clare Daly asked the Taoiseach and Minister for Defence if he will investigate if the human rights of members of the Defence Forces are breached when a choice of malaria prophylaxis is denied to them and they are required to take Lariam, given that a choice of malaria prophylaxis is available to all other citizens; and if he will make a statement on the matter. (Question 13917/16 asked on 01 Jun 2016 - Defence Forces Medicinal Products)

Minister of State at the Department of Defence (Deputy Paul Kehoe): I do not consider actions taken to protect the health and welfare of the men and women of the Defence Forces are a breach of their human rights. As the Deputy will be aware, there are three anti-malarial drugs in use by the Defence Forces, namely Lariam (mefloquine), Malarone and Doxycycline. The choice of medication for overseas deployment, including the use of Lariam, is a medical decision which is made by Medical Officers i...

113. Deputy Clare Daly asked the Taoiseach and Minister for Defence the qualifications of the medical experts consulted as part of the work of the working group on Lariam; and the medical qualifications of members of the working group. (Question 54747/17 asked on 16 Jan 2018 - Defence Forces Medicinal Products)

Minister of State at the Department of Defence (Deputy Paul Kehoe): As previously advised the report of the Working Group on Malaria Chemoprophylaxis was convened in the context of current and potential litigation and is legally privileged, as is all the information about the group to include consultations and deliberations.
 ...

57. Deputy Clare Daly asked the Taoiseach and Minister for Defence the position regarding progress toward the discontinuance of the use of Lariam in the Defence Forces following the passage of a motion in the Houses of the Oireachtas calling for same in June 2017; and if he will make a statement on the matter. (Question 43977/17 asked on 18 Oct 2017 - Defence Forces Medicinal Products)

Minister of State at the Department of Defence (Deputy Paul Kehoe): I propose to take Questions Nos. 57 and 59 together.
As I stated in my reply to the Private Members’ Motion, which was before the Dáil on 28 June, fundamentally the use of anti-malarial drugs 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 me...

122. Deputy Clare Daly asked the Taoiseach and Minister for Defence if his attention has been drawn to the fact that more than 3,000 serving Army personnel and veterans who were prescribed Lariam have approached one law firm (details supplied) in the UK with a view to taking cases; and if he will make a statement on the matter. (Question 4724/18 asked on 31 Jan 2018 - Defence Forces Medicinal Products)

Minister of State at the Department of Defence (Deputy Paul Kehoe): It would not be appropriate for me to comment in relation to litigation matters arising in another jurisdiction.
 ...

57. Deputy Clare Daly asked the Minister for Defence given evidence presented at the United Kingdom Parliament Defence Committee’s inquiry on Lariam on 13 January 2016 that noted the impossibility of being 100% certain that in every case, an individual is in fact individually assessed prior to being prescribed Lariam, how certain he is that every member of the Defence Forces is individually assessed prior to being prescribed Lariam; in what year did individual assessment became Defence Forces policy; and the operational procedures in place to both facilitate and ensure individual assessment prior to prescribing Lariam. (Question 2793/16 asked on 26 Jan 2016 - Defence Forces Medicinal Products)

Minister for Defence (Deputy Simon Coveney): As I have already indicated to the House, the choice of medication for overseas deployment, including the use of Lariam, is a medical decision made by Medical Officers in the Irish Defence Forces, having regard to the specific circumstances of the mission and the individual member of the Irish Defence Forces. Significant precautions are taken by Irish Defence Forces Medical Officers in assessing the medical suitability of members of our Defence Force...

109. Deputy Clare Daly asked the Taoiseach and Minister for Defence the number of recommendations the 2013 report of the working group on Lariam contained. (Question 6584/18 asked on 08 Feb 2018 - Defence Forces Medicinal Products)

Minister of State at the Department of Defence (Deputy Paul Kehoe): I propose to take Questions Nos. 109 to 111, inclusive, together.
As stated previously, the two reports of the Working Group were produced in the context of current and potential litigation and are legally privileged. Therefore, it would be inappropriate to comment in any detail in relation to these reports.  It would also be inappropriate to comment in relation matters such as any papers published by Defence Force Medical Offi...

137. Deputy Clare Daly asked the Minister for Defence if he is aware of any under-reporting to the Health Products Regulatory Authority of the suspected adverse effects of the use of Lariam by members of the Defence Forces; and if he will make a statement on the matter. (Question 21354/15 asked on 09 Jun 2015 - Defence Forces Medicinal Products)

Minister for Defence (Deputy Simon Coveney): As the Deputy will be aware, the Health Products Regulatory Authority (HPRA) formerly the Irish Medicines Board is the statutory authority with responsibility for the quality, safety and efficacy of medicines in Ireland. The Defence Forces policy in regard to the prescribing of Lariam is in line with current HPRA guidelines.
While there is no mandatory legal requirement on an individual or medical practitioner to report adverse reactions to any medic...

75. Deputy Clare Daly asked the Taoiseach and Minister for Defence if his attention has been drawn to the six monthly progress report on the use of Lariam for military personnel issued by the House of Commons Defence Committee (details supplied); and if he will make a statement on the matter. (Question 52734/17 asked on 12 Dec 2017 - Defence Forces Medicinal Products)

Taoiseach and Minister for Defence (Deputy Leo Varadkar): I am aware of the Ministry of Defence’s six-monthly progress report on the use of Lariam for military personnel, published by the House of Commons Defence Committee. The choice of malaria chemoprophylaxis in use by other armed forces is an internal matter for those forces. It would not be appropriate for me to comment on the policy and practices of other States in this regard . 
 ...

59. Deputy Clare Daly asked the Taoiseach and Minister for Defence the number of experts being referred to in the responses to Parliamentary Question No. 11 of 18 June 2013 and No. 69 of 24 November 2015, in which it is stated that those experts concur with the prescribing practices for Lariam followed by the Defence Forces; and the names of the experts involved. (Question 39703/16 asked on 13 Dec 2016 - Defence Forces Medicinal Products)

Minister of State at the Department of Defence (Deputy Paul Kehoe): The Working Group on Malaria Chemoprophylaxis was established in January 2011 and reported in April 2013. The purpose of the Group is to review, inter alia, issues arising in relation to the use of Lariam, particularly in the context of the current and potential litigation. The Group was re-convened in August 2015 and is due to complete its report shortly. As with the Group’s original report, the current report is being produ...

396. Deputy Clare Daly asked the Minister for Health if consideration will be given to extending the free cervical smear testing programme to include persons under 25 years of age or to extending the scheme such that a person under 25 years of age who requires a smear test, based on family history, can receive one through the scheme. (Question 5570/17 asked on 07 Feb 2017 - Cancer Screening Programmes)

Minister for Health (Deputy Simon Harris): CervicalCheck, the National Cervical Screening Programme, was introduced in 2008 and offers free smear tests to women aged 25-60. This is in line with international best practice.
Invasive cervical cancer is extremely rare in women aged under 25, with less than 5 women in this age group being diagnosed with this condition in Ireland each year. While changes in the cells of the cervix are very common for those under 25, in the vast majority of cases th...

53. Deputy Aengus Ó Snodaigh asked the Taoiseach and Minister for Defence if he has instructed the military authorities to cease issuing lariam to soldiers as per the Dáil Éireann’s instructions on 28 June 2017; and if he has begun the preparations for consultation with soldiers’ representative groups in conjunction with the HSE to help alleviate the ongoing effects on some soldiers that were issued the anti-malaria drug lariam. (Question 32261/17 asked on 11 Jul 2017 - Defence Forces Medicinal Products)

Minister of State at the Department of Defence (Deputy Paul Kehoe): As I stated in my reply to the Private Member s’ Motion which was before the Dáil on 28 June, fundamentally the use of anti-malarial drugs 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. I have already indicated ...

1387. Deputy Clare Daly asked the Taoiseach and Minister for Defence further to Parliamentary Question No. 59 of 13 December 2016, when the report of the working group on Lariam will be published in view of the recent publication of the Air Corps toxic chemicals report notwithstanding the fact that litigation has been launched by a number of persons. (Question 46878/17 asked on 07 Nov 2017 - Defence Forces Medicinal Products)

Minister of State at the Department of Defence (Deputy Paul Kehoe): As I indicated to the Deputy in my reply to your Parliamentary Question on 15 February 2017, the Malaria Chemoprophylaxis Working Group was first established in January 2011 and reported in April 2013. The Group was re-convened in August 2015. The purpose of the Working Group is to review, inter alia, issues arising in relation to the use of Lariam, particularly in the context of the current and potential litigation. Therefor...

301. Deputy Clare Daly asked the Taoiseach and Minister for Defence further to parliamentary Question No. 262 of 30 March 2017 and the clarification to same of 13 June 2017 (details supplied), the year in which the Defence Forces were first of the view that the specific reactions of abnormal dreams, nightmares or insomnia, if declared by a member of the Defence Forces to be present, would necessitate withdrawal of mefloquine. (Question 30568/17 asked on 29 Jun 2017 - Defence Forces Medicinal Products)

Minister of State at the Department of Defence (Deputy Paul Kehoe): In 2013, the manufacturers of Lariam (mefloquine) issued a “Direct Healthcare Professional Communication on Lariam for malaria chemoprophylaxis and the risk of neuropsychiatric adverse reactions” and “Guide for Healthcare Professionals” to healthcare professionals. The relevant wording in the Guide for Health Professionals issued by Roche is as follows: “Psychiatric symptoms such as nightmares, acute anxiety, depression, restle...

56. Deputy Clare Daly asked the Taoiseach and Minister for Defence if the subject of informed consent has been considered by the working group on Lariam, specifically whether Defence Forces members were in a position to give their informed consent to the taking of the drug; and if he will make a statement on the matter. (Question 7341/17 asked on 15 Feb 2017 - Defence Forces Medicinal Products)

Minister of State at the Department of Defence (Deputy Paul Kehoe): As the Deputy is aware the Malaria Chemoprophylaxis Working Group was established in January 2011 and reported in April 2013. The Group was re-convened in August 2015.
The purpose of the Group is to review, inter alia, issues arising in relation to the use of Lariam, particularly in the context of the current and potential litigation. It is to review the Defence Forces approach in relation to the use of malaria chemoprophylaxis...

46. Deputy Clare Daly asked the Taoiseach and Minister for Defence if he will remove Lariam from the Defence Forces’ formulary and cease its use as a first-line anti-malarial by the Defence Forces at least until such time as he has had time to review the report of the malaria chemoprophylaxis working group, both in order to safeguard Irish troops and to protect the State against future litigation. (Question 27094/16 asked on 27 Sep 2016 - Defence Forces Medicinal Products)

Minister of State at the Department of Defence (Deputy Paul Kehoe): The health and welfare of the men and women of the Defence Forces is a high priority for both myself and the Defence Forces. There are three anti-malarial drugs, in use in the Defence Forces; Lariam (mefloquine); Malarone and Doxycycline. The choice of medication for overseas deployment, including the use of Lariam, is a medical decision made by Medical Officers in the Defence Forces, having regard to the specific circumstances...

308. Deputy Clare Daly asked the Taoiseach and Minister for Defence the number of Irish soldiers taking Lariam as a malaria prophylactic who have contracted malaria since Irish soldiers first started taking it as a malaria prophylactic. (Question 14176/16 asked on 02 Jun 2016 - Defence Forces Medicinal Products)

Minister of State at the Department of Defence (Deputy Paul Kehoe): Information in relation to illnesses contracted by Defence Forces Personnel including instances of malaria is maintained on each individual’s medical file. While there is no way of providing the exact information sought by the Deputy without examining every medical record of each member who served overseas in sub-Saharan Africa, I am advised by the Medical Corps that the number of incidences of malaria among Defence Forces Pers...

5. Deputy Clare Daly asked the Minister for Defence if he has followed the recent discussions in the Australian Parliament and in the British Parliament in relation to the impact of lariam on the mental health of defence forces personnel; the action he proposes to take as a result; and if he will make a statement on the matter. (Question 34755/15 asked on 08 Oct 2015 - Defence Forces Medicinal Products)

Deputy Clare Daly: This question follows on the earlier question put by Deputy Crowe on Lariam. It is not a question of making a choice between malaria and a debilitating life, and death through suicide. It is about listening to the best medical information that is available. We are joined in the Visitors’ Gallery by Mark O’Sullivan, who served 18 years in the Defence Forces and is facing medical discharge in approximately three weeks. He has served three times overseas and experienced very ...

23. Deputy Clare Daly asked the Minister for Defence the number of soldiers that have been discharged on the grounds of mental health problems, per year, over the past ten years; the number of these been given Lariam; and the studies that have been undertaken by his Department of problems experienced by those who were administered this drug. (Question 25795/14 asked on 18 Jun 2014 - Defence Forces Medicinal Products)

The Taoiseach: I am advised that the Medical Module of the Personnel Management System does not provide the specific medical reasons why personnel were discharged from the Defence Forces. Therefore, there is no way of providing this information without examining every medical record of every person discharged. In January 2011 the Department established a working group to examine the use of Lariam and other anti-malarial drugs in the Defence Forces. The Group comprises military and civil offic...

128. Deputy Aengus Ó Snodaigh asked the Taoiseach and Minister for Defence the legal costs to the State in respect of a case (details supplied) relating to the anti-malaria drug Lariam; and if he will make a statement on the matter. (Question 4407/18 asked on 30 Jan 2018 - Legal Costs)

Minister of State at the Department of Defence (Deputy Paul Kehoe): The Deputy will be  aware that the State Claims Agency manages Personal Injury claims on behalf of the Department. The case referred to by the Deputy was settled on 30th November 2017 without admission of liability. The Plaintiff withdrew any part of his claim in relation to the choice by the Defendants of Lariam as a chemoprophylactic. All other matters are settled and the case was struck out. You will appreciate that it would ...

26. Deputy Jonathan O’Brien asked the Minister for Defence the number of legal proceedings that have been initiated against his Department concerning the prescription of Lariam to members or former members of the Defence Forces. (Question 39496/12 asked on 20 Sep 2012 - Defence Forces Medicinal Products)

Deputy Paul Kehoe: I propose to take Questions Nos. 8 and 26 together.
Malaria is a serious disease which can cause serious complications and death. It is estimated by the World Health Organization that approximately 1 million people die every year from malaria in sub-Saharan Africa alone. It has long been recognised as being a serious threat to any military force operating in a malarious area.
Lariam is a malaria chemo-prophylactic agent first authorised for use in 1989 by the Irish Medicines...