Question to the Ministry of Defence:

To ask the Secretary of State for Defence, whether his Department continues to apply the criteria introduced following the 2016 publication of the Defence Committee report (HC567) calling for restrictions on the prescribing of the antimalarial drug Lariam (Mefloquine) to Service personnel; if he will arrange for a consolidated table to be published of the twice-yearly data, subsequently compiled, showing the (a) number of individuals prescribed Lariam in each six-month period since such data began to be released, (b) percentages of those individuals prescribed Lariam who (i) did and (ii) did not receive face-to-face assessments, prior to the issuing of the prescriptions during each six-month period, and (c) totals of other antimalarials prescribed to Service personnel during each six-month period; whether it is his policy that the use of Lariam on a scale greater than that since 2016 should be permitted in future; and whether he accepts the original recommendation by the Defence Committee that Lariam should be designated as a drug of last resort, to be prescribed to Service personnel only (A) if an individual is unable to tolerate any of the available alternatives; (B) after a face-to-face individual risk assessment; and (C) after he or she has been made aware of the available alternatives and given the choice between such alternatives and Lariam; and whether his Department has an evidential basis for challenging evidence of serious side effects previously caused to some Service personnel when Lariam was widely dispensed within the Armed Forces.

The Ministry of Defence (MOD) revised its malaria prevention policy in response to the Defence Select Committee Inquiry. As a result, it remains the policy that mefloquine only be prescribed to Service personnel by a doctor, after a face-to-face malaria health risk assessment and alternatives to mefloquine have been identified as unsuitable. There are no plans for this policy to change in the future.

The Government publishes official statistics every six months on Mefloquine Prescribing in UK Armed Forces. All future official statistics will include the supplementary table requested.

It is admitted, on the balance of probabilities, that as a prophylactic mefloquine can cause a range of minor to moderate psychiatric symptoms in certain individuals for a limited period of time. The causal relation between mefloquine and severe or long-term symptoms has not been shown. Whether it has caused any symptoms in individual cases will be a matter for expert evidence.

The issue of longer-term sequelae is currently being litigated and the MOD has the support of eminent experts in the fields of psychiatry, neuro-psychiatry, epidemiology, neurotoxicology and psychopharmacology whose evidence is privileged and will be disclosed in due course within the litigation. Their evidence is consistent in its conclusion that there is insufficient evidence to establish a link between taking mefloquine and long-term psychiatric illness or neurological damage.