Let me turn the question around. Health Canada and the product manufacturer very clearly state you must discontinue this drug at the onset of any psychiatric or neurological symptoms. This means that Health Canada is telling us if you develop anxiety, depression, restlessness, confusion, insomnia, nightmares or abnormal dreams you must immediately stop taking the drug.
Let's look back and ask if the Department of National Defence has been seeing this happening in practice. We know from carefully designed and implemented randomized control studies that symptoms of anxiety or depression, for example, will occur in 4% of those taking mefloquine prophylactically. Abnormal dreams and nightmares will occur in over 10% of individuals taking mefloquine. We should be seeing a sizable minority of our deploying forces given mefloquine presenting to their doctors and stating they are having those symptoms and requesting that the drug be discontinued. For the last 25 or 30 years of this drug's use in operational settings in militaries around the world, we weren't seen anywhere near 10% or more of troops presenting, requesting that the drug be switched.
We've known all along, or we should have known all along, that this drug was not being used operationally in accordance with the manufacturer's guidance.
You said that if a soldier becomes ineffective due to malaria that's a bad thing. Granted it is, but if a soldier becomes ineffective due to permanent disability as a result of misuse of mefloquine, that's also bad. It would be nice if we had a safe and effective anti-malarial that we could dose weekly or monthly. That would be very good. We don't have that drug. We've never had that drug. Mefloquine is not that drug.