I am surprised. That number seems a little high. Five per cent is much higher than the rate of use in other countries. For example, in the United States military—the United States developed mefloquine—we use mefloquine so rarely now that it accounts for, I believe, less than one half of one per cent of new anti-malarial prescriptions. That change is a result of a number of policy changes beginning in 2009, when the U.S. Army began to move away from mefloquine and, by 2013, the other services had agreed to that policy, and mefloquine was formally declared a drug of last resort. Funding became available to pay for the more expensive, generally better tolerated daily drug atovaquone proguanil.
As I mentioned, there are individuals who have previously tolerated mefloquine and who prefer it. I suppose, as long as the drug is available, indicated and licensed for prevention, if those individuals have an informed discussion with their physician and are aware of the risks, they can continue taking the drug. I would not recommend that, and I would not recommend that service members taking an anti-malarial for the first time take mefloquine, because of the inherent risks involved with using mefloquine and the unique risks of using mefloquine in an operational environment where one needs to identify the onset of any psychiatric or neurological symptom as being potentially prodromal to the development of permanent disability. That is a risk I just don't think can be justified in any setting.