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The Peace Corps and anti-malaria drugs: What you need to know

Now, mefloquine is no longer required weekly for volunteers, but is among a list of medications volunteers may choose from to prevent malaria.
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WASHINGTON -- Dozens of Peace Corps volunteers deployed all over the world say they suffered devastating side effects from an antimalarial drug, mefloquine, that they were told to take or be set home.

Now, mefloquine is no longer required weekly for volunteers, but is among a list of medications volunteers may choose from to prevent malaria.

Here's what the Peace Corps says about mefloquine:

How many Peace Corps Volunteers were told to take mefloquine and over what period of time?

Malaria kills nearly 500,000 people a year. The Peace Corps provides healthcare for its more than 7,000 Volunteers and is committed to malaria prevention. Peace Corps Volunteers have never been compelled to take any specific antimalarial medication. Peace Corps Volunteers have a choice of medications that are recommended by the FDA for use to prevent malaria. Currently, 13% of Peace Corps Volunteers choose to take mefloquine based on individualized assessments and choice.

RELATED: Former Peace Corps volunteers: Malaria meds caused devastating side effects

Were they offered an alternative?

Before beginning any kind of anti-malaria regimen, every Volunteer has an individual, one-on-one consultation with his or her Peace Corps Medical Officer (PCMO) to discuss the pros and cons of each medication and all possible risks and side effects. Unless contraindicated, the choice of medication is solely up to the Volunteer.

Available medications recommended by the FDA for use to prevent malaria include doxycycline and Malarone, which are taken daily, and mefloquine and chloroquine (not for use in Africa), which are taken weekly. If a Volunteer suffers side effects, they have the option to immediately change to the remaining medications.

Were they warned of side effects?

The Peace Corps takes the risk of side effects from mefloquine, or any medication, very seriously. The Peace Corps does not provide mefloquine to Volunteers for whom it is medically contraindicated based on the Volunteer’s health history. Furthermore, before mefloquine is provided to Volunteers, possible side effects, including the possible long-term side effects mentioned in the FDA’s warning, are discussed with the Volunteer. The Peace Corps has a physician or nurse on call 24 hours a day, 7 days a week to assist with questions about medication side effects should they subsequently arise.

Ultimately, the risk of side effects from mefloquine must be weighed against other factors, including the ease of taking medication on a weekly rather than daily basis, medical contraindications, interactions with other medications, and the risk of death or permanent disability as a result of contracting malaria. The Peace Corps takes FDA warnings very seriously and has taken proactive steps to ensure Volunteers have all of the information they need to make an informed decision about the anti-malaria medication that is right for them, in collaboration with their PCMO.

Is the PC still prescribing mefloquine today? Why or why not?

Mefloquine continues to be an FDA-approved medication for malaria prevention, 60% of patients experienced no side effects from mefloquine in multiple large clinical trials. The Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO) and the U.S. Department of State continue to recommend mefloquine as an effective medication for malaria suppression. Several studies have shown Volunteers have the best adherence to mefloquine of all the available anti-malarials, making it an option for some Volunteers who may be struggling with medication adherence. The Peace Corps relies on the guidance of medical experts to ensure Volunteers are receiving the best care.

How many PC volunteers were medically evacuated because of mefloquine-related issues?

Over the past three years, one Peace Corps Volunteer was medically evacuated because of psychiatric symptoms attributed to mefloquine. The Volunteer was able to return to service.

What recourse is there for volunteers who suffered lifelong physical or psychological side effects? If monetary compensation, how much? And what is the statute of limitations?

Returned Volunteers who sustained an injury or illness during service and require ongoing medical treatment may be eligible for workers’ compensation benefits under the Federal Employees' Compensation Act (FECA) administered by the U.S. Department of Labor (DOL).

In general, FECA claims must be filed within three years of a Volunteer’s close of service or early termination. For latent conditions, a FECA claim should be filed within three years of recognition that the condition is Peace Corps service-related.

How much has the PC spent in mefloquine-related claims?

The Peace Corps has no records of compensation payments to DOL for mefloquine-related claims.

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