Okay.
Evidence of meeting #118 for Veterans Affairs in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was australia.
A recording is available from Parliament.
Evidence of meeting #118 for Veterans Affairs in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was australia.
A recording is available from Parliament.
4:45 p.m.
Conservative
Cathay Wagantall Conservative Yorkton—Melville, SK
Thank you.
In trying to determine who has taken mefloquine, I tabled an Order Paper question asking specifically about Canadian Armed Forces members who were required to take mefloquine since 1990. I asked how many were required to take mefloquine by deployment, country of deployment, dates and whatnot.
I got the results of individuals who were required to take it by the Canadian Armed Forces from 2003 up to 2018. They indicated that “we now recommend it as a second line medication.”
What I've heard today is that it shouldn't be in a line of medication choices at all. Correct? Just a quick yes or no, please.
4:45 p.m.
Prof. Jane Quinn
I agree.
4:45 p.m.
Conservative
Cathay Wagantall Conservative Yorkton—Melville, SK
They said, “The Canadian Armed Forces (CAF) continue to review all relevant scientific literature on mefloquine to ensure our policy remains current.”
Clearly they didn't, because as was mentioned in the meeting that we had with our top bureaucrats, they weren't aware of the Australian report.
They added that “Antimalarial medication is recommended when CAF personnel deploy to areas where there is a concern for contracting malaria.”
They named some countries. Afghanistan isn't on this list. It's a desert country, and our armed forces were required to take it there. Does that make sense to you? Just a yes or no.
4:45 p.m.
Prof. Jane Quinn
No.
4:45 p.m.
Conservative
Cathay Wagantall Conservative Yorkton—Melville, SK
There are shaking heads. No.
They said, “The CAF has recommended mefloquine as an option for malaria prevention since the early 1990s.” It was an option and they note that “Other options were available”. They indicate further that it was “the patient's choice”, but we know that in 1992 tens of thousands of free mefloquine tablets were made available to the Canadian Armed Forces troops deployed in Somalia as part of a clinical trial.
Our surgeon general in his 2017 report said that “The CAF members deploying to Somalia did not participate in the SMS study, since the guidelines of the study were not compatible with the operational requirement to deploy to Somalia”. Yet that was the drug they were ordered to take and had to use the entire time they were there.
Is that not in your mind some kind of a moral or legal breach when you are requiring and demanding that they take that drug, and yet it was not followed through with as a study in a way that it was intended to be used?
Are there any comments on that?
4:45 p.m.
Professor Emeritus, University of Toronto, As an Individual
I'm not familiar with the details of that particular study or the circumstance. I did read that in the report. It did strike me as a bit unusual because of the absence of any detail about why it was incompatible and so forth.
It seems a bit unusual, but I have no knowledge of it.
4:45 p.m.
Conservative
Cathay Wagantall Conservative Yorkton—Melville, SK
So it wasn't compatible to go ahead with the study regardless?
Dr. Quinn, do you have anything to add?
They were still given a drug that was not licensed and was supposed to be used as a—
4:45 p.m.
Prof. Jane Quinn
I think it's an extremely extraordinary situation and obviously has had significant and lasting ramifications for the Canadian military and all those involved at that time.
I think the other point is there is no such thing as informed consent in military populations, and, therefore, the use of military veterans or military members in clinical trials is a significant issue.
4:45 p.m.
Conservative
Cathay Wagantall Conservative Yorkton—Melville, SK
Whereas we were told that they made it a last line of defence, and in here they say it's a second line of defence, our surgeon general also made it clear in his report that their decisions in regard to the military in no way implicated or impacted the use of mefloquine amongst civilians in Canada in any way.
This deeply disturbs me. You mentioned that drug labelling isn't a good way to inform people. We know that a lot of our medical practitioners are not informed about the dangers of this drug. All kinds of Canadian civilians travel internationally to areas where there is malaria.
What would your perspective be on this drug being used within our civilian population?
4:45 p.m.
Prof. Jane Quinn
It's becoming a drug that is less and less prescribed by general travel doctors and other general practitioners. I think the international exposure of mefloquine's impact on individuals has caused a significant downturn in its use, but that should really have been driven by the drug regulators from a safety perspective. I think there has been a significant shortfall in the way the drug's history has played out over time, in that the regulators have not performed their duties appropriately.
4:50 p.m.
Conservative
4:50 p.m.
Professor Emeritus, University of Toronto, As an Individual
If you go on the Internet or you look at any of the guidelines, the drug of first choice is Malarone. It's a combination drug. It's also quite expensive.
4:50 p.m.
Conservative
Cathay Wagantall Conservative Yorkton—Melville, SK
That's interesting, because cost seems to have been a factor, at least a partial factor, even with our Armed Forces. The cost of a once-a-week mefloquine pill versus the cost of the others is significantly different, correct? Just a yes or no?
4:50 p.m.
Professor Emeritus, University of Toronto, As an Individual
Yes, it is.
4:50 p.m.
Conservative
Cathay Wagantall Conservative Yorkton—Melville, SK
I want to bring attention to Australia again, because I had a friend, a veterans' advocate, on mefloquine. She and her husband took it when they went on a trip as civilians to Thailand. She had trouble before she even left home, and the doctor told her to just keep taking it, that she would get used to it, and Australian backpackers told them to get off this drug. She suffered all of her life, and we lost her last December.
This is why its use among the civilian population concerns me as well, because that education needs to be out there.
4:50 p.m.
Professor Emeritus, University of Toronto, As an Individual
There's ample evidence that the civilian population is affected by this drug. It's just as Professor Quinn said.
4:50 p.m.
NDP
Rachel Blaney NDP North Island—Powell River, BC
I just want to go back to Dr. Quinn to clarify something for the record. In Australia now there's an official diagnosis for mefloquine use. Is that the case?
4:50 p.m.
Prof. Jane Quinn
Mefloquine is identified as a causal factor in 15 statements of principles for the Repatriation Medical Authority, which is the basis on which they apply principles through the Department of Veterans' Affairs for treatment and compensation. However, that's not the same as its being recognized as a particular disease, syndrome or having a defined diagnosis.
4:50 p.m.
NDP
Rachel Blaney NDP North Island—Powell River, BC
Thank you so much. I appreciate that.
The last thing I want to come back to is the lack of conferences or work being done on this internationally. What we're often seeing here in Canada, and what it sounds like you're seeing there in Australia as well, is that veterans are coming together and leading these conferences, doing this at that grassroots level—and, of course, probably working towards having that sense of acknowledgement.
I'm just wondering if you could speak to the challenges. How do we support these folks so that their voices are heard? It sounds like you've done a lot in Australia, but I'm wondering about specific recommendations for this country and those veterans who are working so hard to be acknowledged and recognized here.
Thank you.
