The military alternative to mefloquine is doxycycline, which has its own can of worms, most seriously that it is given daily vice weekly.
It is interesting that aviators must take doxy; even before this controversy they would be grounded for taking Lariam. The docs considered putting those of us who must retain FAA medicals on doxy, and decided after consulting FAA aeromedical that it would not have an impact on our physicals, as long as we were off the stuff before resuming flying. (My advice to anyone is do not tell your AME you have been on it).
If the guy is not targeting SF then why doesn't he acknowledge that a million Joes and Janes have been on mefloquine for months and years, and apart from the known side effects (particularly the nightmares), most have no problem, and suicide rates are in the normal range?
As far as Vet Centers are concerned... I dunno what yours is like there, but around here they are wall to wall wannabees and phonies, encouraged by lefty shrinks full of Lifton's tendentious drivel. There's one a few miles from my house -- it treats a bunch of bums with war stories they got from the TV in a homeless shelter somewhere. I wouldn't **** on it if it was on fire!
Anyway, the basic reason that the troops on the ground take Lariam is that it is easy to administer. My personal observation in Afghanistan was that in the low country, malaria was widespread among the locals and a common cause of child mortality. Of course they had everything else too: worms, meningitis, TB, bizarre suppurating abscesses; you name it. Other teams encountered cholera and typhus, presumably vectored by returning refugees; we did not. But I would place no stock in CDC statistics from Afghanistan, which has not had any kind of functioning public health system for 25 years, or Iraq, which was isolated for ten.
It's my impression that chloroquine-resistant malaria is becoming the dominant strain. It's not isolated in black Africa any more. (For instance, Indonesia has had cases on Java).
d.o.l.
Criminal Number 18F
"If the guy is not targeting SF then why doesn't he acknowledge that a million Joes and Janes have been on mefloquine for months and years"
Mark has acknowledged this in many of his previous pieces on the military and Lariam. He also acknowledged this on the CNN segment. If you watched the segment, Paula Zahn wanted to go down the "cover-up" path, but he did not give her what she was looking for. The current suicide rate in Iraq is currently at its lowest point ever and whether or not that is due to the stoppage of mefloquin or implementation of a mental health program, who knows at this point. I'm just damn glad the rate has dropped.
"As far as Vet Centers are concerned"
I should've been more clear in the terminology. The Gulf War Resource Center headed by Steve Robinson has done a significant amount of work on behalf of the veterans in getting many "unexplained" illnesses and the associated problems in front of Congress in order to receive benefits for the soldiers and their families. Lariam toxicity is the latest illness to be recognized by the VA and has awarded the first claim (80%) several weeks ago. This is no small feat considering how long it took the Army to acknowledge the problems associated with the first Gulf War as well as with Vietnam.