Mefloquine and Tafenoquine use by the Australian Defence Force 1990 – 2017

Mefloquine and Tafenoquine are two different types of anti-malarial drugs that have been prescribed to deploying troops as far back as 1990 but trialled extensively by the Australian Defence Force at the turn of the century. The Australian Broadcasting Corporation wrote. Defence force admits soldier shouldn’t have been included in East Timor anti-malaria drug trial. Excerpt:

The Australian Defence Force has acknowledged it accidentally exposed one of its soldiers to controversial anti-malarial drugs during trials in East Timor, despite the soldier having a medical history of mental illness which should have precluded his involvement.

The soldier, Chris Salter, developed chronic depression and psychosis after inclusion in the Timor trials of psychoactive drugs mefloquine and tafenoquine.His illness has led to repeated suicide attempts and more than a dozen stays in psychiatric hospitals. He is unable to work or care for his family.

Since the trials, which included thousands of Australian soldiers between 2001 and 2003, a small group of veterans have developed severe mental illnesses. They believe the ADF erred by giving them the drugs even though there was a significant body of research which pointed to the drugs’ side effects, which in some cases are permanent.

I just wanted to get a chart posted which highlighted the use of Mefloquine and Tafenoquine in Australian soldiers over the past 30-years. Currently most of the documentation concentrates on the trial periods (1998 – 2002) yet deploying forces were exposes to the risks of these drugs prior to that with deployments to Cambodia, Rwanda, Somalia and Papua New Guinea. I’ll update the chart as new information comes to hand.

Mefloquine~TafenoquineUsebyADF1990-2017

Explanatory Notes:

1992: Somalia – Awaiting more information
1993: Cambodia – Awaiting more information
1994: Rwanda – One confirmed mefloquine dosage. Awaiting more info
1997: PNG – One confirmed mefloquine dosage. Awaiting more info
1998: Bougainville – Peace Monitoring Group – 201 troops given Tafenoquine (note: Stuart McCarthy’s notes state 374 troops were given Tafenoquine).
2000: East Timor – 639 troops given Tafenoquine during trials.
2000: East Timor – 162 troops given Mefloquine during the Double-Blind trial
2000: East Time – 492 troops given Tafenoquine during the Double-Blind trial
2001: Australia – 31 troops given Tafenoquine to test for Relapse Prevention
2001: East Timor – 1,157 troops given Mefloquine during the last major trial of the drug

An excellent resource for understanding the trial intensity of both anti-malarial drugs is Stuart McCarthy’s Summary of ADF Mefloquine and Tafenoquine Clinical Trials 1998 – 2002. See attached:

150724_Summary_SMcCarthy_ClinicalTrials

Data Sources

  1. Mefloquine http://www.defence.gov.au/Health/HealthPortal/Malaria/Anti-malarial_medications/Mefloquine/default.asp
  2. Randomized, double-blind study of the safety, tolerability, and efficacy of tafenoquine versus mefloquine for malaria prophylaxis in nonimmune subjects https://www.ncbi.nlm.nih.gov/pubmed/19995933
  3. Summary of ADF Mefloquine and Tafenoquine Clinical Trials 1998 – 2002 https://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Foreign_Affairs_Defence_and_Trade/Mefloquine/Submissions