Michael Bush believes his poor health is due to an anti-malaria drug given to him in Timor-Leste. (Supplied: Michael Bush)
Veterans who believe their severe physical and mental health conditions were caused by anti-malaria medications given to them by the Army are hoping a senate inquiry will find enough evidence to back their claims.
Almost 20 years ago more than 3,000 troops were given the experimental drug tafenoquine, or the registered medication mefloquine, while on deployments in Timor-Leste and Bougainville.
The Department of Veterans’ Affairs (DVA) told 7.30 it has received anti-malarial-related claims from 42 veterans.
Mefloquine, which is also known by the brand name Lariam, has been shown to cause neuropsychiatric side effects and has been linked to two veteran suicides.
The Australian Defence Force (ADF) and DVA recognises mefloquine can cause 14 conditions including depression, seizure, anxiety, schizophrenia and suicide.
Far fewer effects of tafenoquine are officially recognised.
In May, then-vice chief of the ADF, Ray Griggs, told a senate inquiry “its side-effects profile is much, much better than that of mefloquine”.
“There is no evidence that we know of that links it to neuropsychiatric conditions.”
‘It makes you feel real depressed’
Michael Bush has moved back in with his mother so she can provide him with support. (ABC News: Michael Atkin)
Speaking publicly for the first time, Army veteran Michael Bush told 7.30 about the severe impact he believes tafenoquine has had on his life after taking it in Timor-Leste.
The 40-year-old is unable to work after being diagnosed with chronic post-traumatic stress disorder, a form of schizophrenia and chronic gastrointestinal issues.
“For what they’ve done to my health … you can never buy that back, it’s destroyed my life,” he said.
“I’ve been diagnosed with PTSD, IBS (irritable bowel syndrome) and schizophrenia and I never had one of those before I was deployed.”
Mr Bush believes the medication has made him suicidal.
“It makes you feel real depressed and puts you to the point where you feel there’s no alternative,” he said.
He has moved back in with his mother, Mary Bush, so she can provide intensive support.
“He doesn’t have a memory, he writes everything down in a book. He finds it difficult to cope with everyday life,” she said.
Ms Bush doesn’t believe her family has been offered enough support, especially after her son’s three suicide attempts.
“It seems each episode he has, it takes longer for him to get better,” she said.
A 2016 inquiry by the Inspector-General of the ADF examined many of the veterans’ allegations and found the drug trials were legal and ethical.
But some veterans remain deeply unsatisfied.
An upcoming senate inquiry will examine their complaints, the support that’s available for them and their families, compare medical evidence about the adverse impact of the medications and consider how other governments have responded.
Experts disagree on drug’s safety
An Australian soldier talks to a local boy during deployment in Timor-Leste. (Supplied: Department of Defence)
Dr Remington Nevin, a former US Army doctor and epidemiologist who provides expert medical opinion in legal cases involving anti-malarial drugs, believes there is evidence tafenoquine causes dangerous side effects.
“In recent tests conducted at Walter Reed Army Institute of Research, tafenoquine was shown to be more neurotoxic than mefloquine,” Dr Nevin told 7.30.
However, many in the medical and scientific community support the Defence position that there isn’t enough evidence that tafenoquine causes neuropsychiatric side-effects and that it is safe and effective.
Professor James McCarthy specialises in drug development for malaria at Brisbane’s QIMR Berghofer Medical Research Institute.
“I certainly would take tafenoquine because of its great safety profile and because of its ease of use,” he said.
“We know that tafenoquine has been given to more than 4,000 people and these side-effects have been extremely rare outside of people who have pre-existing mental health conditions,” he said.
Australia’s Therapeutic Goods Administration is now considering applications to register the drug here, something Professor McCarthy supports.
“I think the best thing to do with tafenoquine, assuming that it will be licensed in Australia as well, is to have careful surveillance of those side-effects, so if in larger populations in bigger studies we see side-effects, we’re able to pick them up,” he said.
Drug approved in US
Reports of the possible long-term central nervous system effects caused by tafenoquine have been received by global pharmaceutical giant GlaxoSmithKline (GSK).
Eighteen Australian soldiers reported anger outbursts, confusional states and hallucinations, which the company said could possibly be attributed to combat stress, but that a role for the drug cannot be excluded.
“GSK is aware of safety concerns related to central nervous system effects raised in the last two years by some Australian Defence Force veterans,” GlaxoSmithKline said in a statement.
“We encourage individuals who participate in our historical, recent and ongoing studies, to report any adverse events to us so that we can continue to monitor the safety profile of our medicines.”
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Dr Nevin is calling on the Defence Department and DVA to conduct comprehensive follow-up testing of all veterans.
“I think it’s important for the Australian military to conduct universal screening of these study subjects for a history of symptomatic exposure during the use of these drugs,” he said.
Two applications for tafenoquine by GlaxoSmithKline and 60 Degrees Pharmaceuticals were recently approved by the US Food and Drug Administration (FDA), although some on the FDA expert advisory committee voted against it on safety grounds.
GSK said in its statement: “The independent panel voted positively that there was substantial evidence of effectiveness (13-0) and adequate evidence of safety (12-1) of tafenoquine.
“Dr Nevin submitted written and oral testimony … and his opinions were therefore taken into consideration.”
However, the vote on the other application made by 60 Degrees Pharmaceuticals was much closer, with nine members for it and four against on safety grounds.
‘Help is available’
The Department of Defence declined 7.30’s interview request but said in a statement it was participating in the Senate inquiry and it would be inappropriate to comment while it was underway.
“It is important that public commentary on the issue is well-informed and reflects evidence-based research,” the statement said.
“This approach avoids misleading or adding to the anxiety of a broad group of people, including current and former serving ADF personnel and the general public who have used antimalarial treatments.
“These concerns have meant Defence has been careful and thorough in its response to claims made by individuals, so as to ensure outreach activities are underpinned by a sound public health approach.
“Most importantly, help is available to any current or former serving member or their family if they need support.”
DVA said it conducted a pilot outreach program for veterans in Townsville in 2016 and is considering further outreach activities.