National Defence committee  There are different side effects. One of the numbers that I spoke to was a number related to significant neuropsychiatric side effects and prolonged neuropsychiatric side effects. The number that we have is somewhere between one in 10,000 and one in 12,000 who may have that significant neuropsychiatric side effect.

National Defence committee  Yes, we've always had a program for those who get into financial difficulty to have the opportunity to seek financial counselling through our SISIP financial counselling program. When it comes to legal problems, we've identified one thing that is really important. When we know someone has gotten into some legal difficulty, there is a handover of that person to their chain of command so that the chain of command is aware and they aren't able to go off on their own.

National Defence committee  To my knowledge, there has never been an order as to which medication needs to be taken for anti-malarials. I'm sorry; the first part of your question was...?

National Defence committee  They do, yes. We have had patients that come in.... We have benefited more from the MOU in that when we had a problem with psychiatry in Shilo, we were able to use the operational stress injury clinic that Veterans Affairs has in Winnipeg to get good care for our military members.

National Defence committee  Every time we go on a deployment into a region, we will look at whether or not malaria is a threat. We don't know where we're going yet, so when that is determined, we'll do an evaluation. If malaria is a risk to our members, then we will recommend anti-malarial medications. At the present time, we are using the current recommendations, but as I said, I'm studying a report right now to look at what my policy recommendation is going to be.

National Defence committee  We have, in the past, looked at mefloquine as having a benefit in that it is a once-a-week medication, and what we knew of its side effect profile compared favourably—before malarone was available—to the doxycycline, which has problems with sun sensitivity and people getting significant sunburns if they take it.

National Defence committee  Colonel Downes may be better placed to answer the question of how often people are getting exposed to the road to mental readiness training right now.

National Defence committee  Yes, it's a very large decrease in use. In 2003, the medication called malarone became licensed. Starting in 2003, we started to see a decrease in mefloquine use. It had been sitting around 85% of prescriptions for anti-malarial medications, and it has decreased down to less than 5% today.

National Defence committee  I'm sorry, but I don't remember the date when we actually formalized the process. However, for many years now, before a member is given an anti-malarial medication and if there are a large number going out, they may receive a briefing on each of the anti-malarial medications, informing them about the potential side effects and the potential contraindications to using those medications.

National Defence committee  That's correct.

National Defence committee  I haven't made a formal policy recommendation yet. The report from the task force is under study right now. I anticipate that before the end of March I will be able to formulate a policy recommendation with respect to our anti-malarial use.

National Defence committee  Yes, that's correct.

National Defence committee  To my knowledge, there are no medications that don't have any potential side effects. If you look at all three of the choices that we have for anti-malarials right now, you see that there is a long list of potential adverse effects from each of them. All of them have gone through the Health Canada licensure process and have met the Health Canada regulatory requirements for marketing within the country with respect to safety and effectiveness.

National Defence committee  The cost is—

National Defence committee  Malarone is the most expensive medication of the three choices. I can't remember.... Mefloquine may be a little bit more expensive than doxycycline on a per-person basis, but cost has never been a factor in our recommendation.