I beg to move,
That this House
has considered the Fourth Report from the Defence Committee of Session 2015-16, An acceptable risk? The use of Lariam for military personnel, HC 567, and the Government response, HC 648.
Before I turn to the overview of the report and the conclusions of the Select Committee on Defence, I want to put on record our thanks to those who gave us the impetus to investigate the issue and contributed their knowledge and their time. I apologise if I leave anyone out. Our thanks go to Trixie Foster and the retired Colonel Andrew Marriott for their persistence in raising the issue and co-ordinating a detailed submission; to defence correspondents who took the matter up; and to Forces TV whose work brought in more evidence. I thank the Library for its research and our Clerks, who do a magnificent job, as well as the witnesses who appeared at our three evidence sessions, including from the drug’s manufacturer, Roche.
I would also like to put on record my personal thanks to the Committee for agreeing to pursue the issue for the sake of the approximately 25% to 35% of personnel who have taken Lariam who have been directly affected. The Committee was determined to ensure that the Ministry of Defence would examine the damage to lives and the failure of the duty of care, and to make the necessary recommendations to protect our armed forces personnel in the future.
Lariam is one of several antimalarial drugs that the MOD uses to protect military personnel against malaria. None of the alternatives is without its problems, but Lariam has been the subject of concern for a long time. The inquiry set out to establish a clear picture of the impact of its use in the UK armed forces. I think it is fair to say that the Committee was shocked and surprised by what we found. I will leave others to go into details, as it is my role to give an overview of our principal conclusions and recommendations.
From the evidence we received from individuals and the statistics that the MOD provided, we were shocked that Lariam is still being used so often despite the well-known problems. We were told by the drug’s manufacturer that the MOD accounts for one fifth of all its UK sales. At a minimum, 17,368 personnel were prescribed the drug between 2007 and 2015. There may well be more, but one of our findings was the haphazard nature of MOD medical record keeping. Note to the Minister: it was particularly unhelpful when the MOD published its first 10-page statistical bulletin on Lariam on the day we took evidence from the Minister.
The MOD receives advice from the Advisory Committee on Malarial Prevention alongside the advice from the manufacturer. Roche is clear in its guidance that every individual who is prescribed Lariam should undergo an assessment with a medical professional to identify any contra-indications that might make them more susceptible to side effects. We questioned whether the ACMP’s advice was appropriate. It was clear to us that the general advice that it offered was not tailored to the specific needs and circumstances of the military. It fell short and put military personnel at risk. We concluded that the MOD should work with the ACMP to develop specific guidelines, similar to the US so-called “Yellow Book”.