This is my recommendation; stop mefloquine use completely. I disagree with Dr. Nevin. I don't think it should be used as a drug of last resort. I don't think it should be used at all. If somebody can't tolerate mefloquine, don't send them to a malarious area, send them to Antarctica. You have lots of cold weather up in Canada, I hear, where there are no bugs. Don't send them to that area.
Secondly, screen for mefloquine exposure. This should be done by civilians. You don't have the same Veterans Health Administration as we do in the U.S., so a lot of civilians are treating veterans. This should be part of a national discussion. Again, it's easy to do once a week versus once a day.
And then finally, the treatment part is harder, but we do need to get there. Just briefly to touch on the question of female service members' pregnancy and mefloquine, we probably need to do a better job of ensuring that female service members are on long-acting contraception before they deploy—for all kinds of reasons—because we don't know the effect of mefloquine on the developing fetus. Even if sex is banned in a combat zone, it happens, whether consensual or non-consensual, so we need to make sure that people are not pregnant on mefloquine.