Drug is being studied 
Tue Mar 9, 2004
 
By William Winkenwerder Jr.

Malaria is a potentially fatal infectious disease for which 40% of the world's population is at risk. It causes more than 1 million deaths annually. Because the Department of Defense (news - web sites) deploys people around the world, including in malaria-endemic areas and often on short notice, we protect those at risk with safe and effective countermeasures. The highest priority is protecting our troops.

Our health care providers always weigh the disease's threat and the benefits of preventive medications with possible adverse reactions. Certain characteristics of the patient also need to be understood: underlying diseases or conditions, other prescribed medications and the probability of a patient adhering to a prescribed drug regimen.

Additionally, there are different types of malaria, and each requires a different approach. For the prevention and treatment of chloroquine-resistant falciparum malaria, the department uses medications approved by the Food and Drug Administration (news - web sites) (FDA) and recommended by the Centers for Disease Control and Prevention (news - web sites). These are mefloquine (Lariam), doxycycline and atovaquone/proguanil, which are prescribed worldwide to civilian and military travelers who may be at risk of this serious disease.

Recently, a few servicemembers and others have raised concerns with me regarding mefloquine. Although there have been numerous studies of this FDA-approved drug, prescribed to more than 20 million travelers worldwide, I believe it is important to address perceptions and concerns in a careful, scientific manner.

Therefore, I am appointing a panel of experts in malaria treatment who can articulate the most scientifically valid approaches and methodology for a comprehensive study of anti-malarials, including mefloquine. The study will assess benefits and risks, including the possibility of serious neuropsychological events. A related concern of mine is that malaria is becoming drug resistant. Therefore, along with other organizations, the department will continue its world-class research for a malaria vaccine and other approaches to protect our forces.

The Department of Defense is committed to the health and safety of our people. While we continue our efforts to find an effective malaria vaccine, we will continue to be guided by science in providing the most appropriate medications to protect our forces.

William Winkenwerder Jr. is assistant secretary of Defense for health affairs.