Lariam

Debate between Fabian Hamilton and Madeleine Moon

Thursday 27th October 2016 Westminster Hall

[Fabian Hamilton]

My apologies for that. I obviously did not write my notes correctly. I am sorry if I misquoted the right hon. Gentleman.

As we discussed in the previous debate, we have a duty to ensure that people who put their lives on the line for the defence of this country, like hon. Members in this Chamber who have done so, do so in the knowledge that those who ask them to do it and who send them to dangerous places are looking after their interests.

We know that Lariam is the brand name of mefloquine and that it is used to treat malaria. It is most commonly administered as a prophylaxis, but the history of side effects, the evidence we have received and the evidence in the Defence Committee’s report make it clear that it is not necessarily the most appropriate prophylactic medication. I am glad we have made it clear that we do not blame the manufacturer, Roche, for the misuse of its drug. It is clearly an issue for the Army itself and we want the Army to get it right. That is why the Committee’s report was written in the first place. I myself have taken chloroquine and proguanil; I suffered some side effects, but nothing like those that have been recorded for Lariam.

We know that many countries’ military forces have used Lariam in the past, but that it is becoming increasingly uncommon because of its side effects. Some 17,000 British military personnel were prescribed Lariam between April 2007 and March 2015, and the reports of those side effects meant that many of them have discarded their Lariam tablets instead of using them. That makes them far more susceptible to malaria, which is extremely dangerous—as the hon. Member for Stafford said, it has killed 438,000 people in the last 12 months.

The summary of the Defence Committee report says:

“The evidence we received highlighted some severe examples of the possible side-effects of Lariam in a military setting. While they may be in the minority, we do not believe that the risk and severity of these side-effects are acceptable for our military personnel on operations overseas.”

When the Minister responds to the debate—I apologise that I will not be present to hear him—will he care to tell us about the handing out of Lariam to military personnel in future in the light of the report and the evidence contained within it?

In preparing for this debate, I sought the advice of a specialist—he has asked not to be named—who works at the London School of Hygiene & Tropical Medicine. His view was quite interesting. He made the point that Lariam is a cheaper medication than some antimalarials, and that it is very effective. That could be one reason why the MOD is maintaining its support for Lariam in the face of media controversy, the Defence Committee report and, of course, resistance from many military personnel. The specialist said that it is a good drug. He even gave it to his spouse when they went to west Africa a few years ago. He reported that she had had the most vivid and crazy dreams. Like most drugs, it is not good for some people, but it is good for others.

One thing in favour of Lariam is that it is administered once a week. Many other antimalarials are administered once a day. For someone in a military setting who is in a conflict situation, or who has been deployed in a remote area, it being a once-a-week drug will have a huge benefit for those administering it and those having to take it. A once-a-week dosage also increases the chances of compliance and of people actually taking the medication when they need to take it.

The specialist I mentioned noted that the number of tests on the effects of Lariam on Army personnel were small and were not done in an adequately controlled situation. I do not know whether my hon. Friend the Member for Bridgend would agree with that, given the evidence taken by the Select Committee, but there needs to be far more testing. There needs to be a much greater database of evidence to prove conclusively that so many people will not tolerate Lariam and that it should perhaps be replaced by other drugs, depending on geolocation and the individual assessment of military personnel.

[Mrs Moon]

Is my hon. Friend aware that there have been episodes in which serving personnel have murdered individuals, and in which they have deliberately carried out inappropriate acts, all because they were under the influence of Lariam? That is part of the record that the Committee looked at.

[Fabian Hamilton]

Yes, I was aware of that, but I am not aware of the details. I have heard anecdotal evidence, but it is important to hear about the actual cases and evidence.

I know that other Members wish to speak, and of course the Minister must respond, so I shall conclude. Paragraph 97 in the conclusion of the Defence Committee report states:

“The Ministry of Defence has a duty of care to protect military personnel on operations overseas. It includes ensuring that they are adequately inoculated against disease. This will never be without the risk of detrimental side-effects, and we understand that the MoD must balance those risks against the health of our Armed Forces. However, in the case of malaria, we conclude that the MoD’s current policy has got that balance wrong.”

I hope the Minister addresses that point in his response.