7Conclusion
97.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.
98.While it is clear to us that there are significant risks attached to the use of Lariam for military personnel, we accept that there are a very limited number of occasions when its prescription may be necessary. However, we conclude that the MoD should designate Lariam as a ‘drug of last resort’ and that prescribing it should be restricted by the following conditions:
- Only to those who are unable to tolerate any of the available alternatives;
- Only after a face-to-face Individual Risk Assessment has been conducted; and
- Only after the patient has been made aware of the alternatives and has been given the choice between Lariam and another suitable anti-malarial drug.
99.Lariam is a drug whose own manufacturers have laid down stringent conditions which must be met if it is to be prescribed safely. We see no reason to disbelieve the very strong anecdotal evidence that such conditions have been ignored in dispensing it to large numbers of troops about to be deployed. Indeed, it is hard to see how they could ever be met except when the numbers to be individually assessed are few and far between.
100.It is our firm conclusion that there is neither the need, nor any justification for continuing to issue this medication to Service personnel except when the three conditions listed above have been met.
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19 May 2016