The Surgeon General announces findings from the Review on the Operational Use of Mefloquine in the Canadian Armed Forces
June 1, 2017 – Ottawa – National Defence / Canadian Armed Forces
The Government of Canada is committed to protecting and enhancing the health and well-being of Canadian Armed Forces (CAF) members. Today, the Department of National Defence and the CAF announced the release of the findings from the Surgeon General’s Review on the Operational Use of Mefloquine. The review looked at available literature on mefloquine use and how it is used in an operational setting.
Mefloquine will now only be recommended for use if a CAF member requests it, or if there are contraindications to the member being prescribed other anti-malarials.
“The health and well-being of our people is directly linked to the operational effectiveness of the Canadian Armed Forces. Because of this, I have a duty to ensure everyone under my command has access to the best options for medical care currently available. I am confident the Surgeon General’s recommendations, which are supported by third-party evidence, are consistent with ensuring the overall health of our women and men.”
General Jonathan Vance, Chief of the Defence Staff
“We are recommending mefloquine as a second line drug only, because of the unique operational environment that we work in. This direction should not be applied to a non-military environment. We will continue to monitor and review all relevant scientific literature on mefloquine.”
Brigadier-General Colin MacKay, Surgeon General
Canadian Clinical Practice Guidelines for malaria prevention are consistent with other national and international guidelines in that mefloquine is considered a first-line option.
Compared to currently recommended alternatives, the body of evidence suggests mefloquine is not consistently associated with an excess overall risk of adverse effects, nor is it associated with an excess risk of not being able to perform occupational duties.
No evidence was found (that met the inclusion criteria) that would suggest potential long-term adverse effects of mefloquine on human health.
The report also recommended caution for the CAF, because the deployment of large numbers of personnel within a short period of time can pose challenges for adequately screening individuals for potential contraindications. Additionally, the dispersed deployment of personnel, limiting access to physicians on operations, may reduce opportunities to assess for adverse effects and if necessary to provide alternative medications to CAF personnel taking mefloquine. Also, the nature of the short term side effects associated with mefloquine could impact an individual’s performance and could be confused with usual responses to operational situations, which would in turn complicate the management of adverse effects.
Department of National Defence
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