During the period 1999-2001 the Australian Army Malaria Institute (AMI) conducted a series of tafenoquine drug trials involving Australian Defence Force (ADF) personnel deployed on peacekeeping operations. The published trial reports include those involving members of the Peace Monitoring Group in Bougainville and the 1st Battalion, Royal Australian Regiment (1 RAR) in Timor Leste. Reports on several other AMI tafenoquine trials remain unpublished.
Tafenoquine is now known to be neurotoxic, with scientists at the U.S. Walter Reed Army Institute of Research having found in 2009 that “tafenoquine is more neurotoxic than mefloquine”. Many of the ADF survivors of the AMI tafenoquine trials have since been afflicted by serious neuropsychiatric illnesses consistent with chronic quinoline toxicosis, similar to the experiences of thousands of mefloquine veterans. One of the survivors of the 1 RAR tafenoquine trial in 2000-01 recently wrote a personal account of his psychoses, chronic depression, bipolar disorder, and the rejection of his disability claim by the Veterans Review Board after being medically discharged by the Army:
I was put on leave and sent home to be treated as my family tried to piece together what was happening. My memory of this time is hazy as I was heavily sedated and physically unable to get out of bed at times from the medication. After four or five visits to a psychiatrist I was diagnosed with bipolar disorder. I didn’t know what that was and to this day I think doctors have a hard time understanding it themselves but the diagnosis lead me to understand that my future in the services was over. I lived and breathed the Army so this was very hard to take. The day I was told that I would be medically discharged was probably the most I’ve ever felt ashamed and lost.
Prior to the 1 RAR trial, tafenoquine was also tested on a group of 3 RAR soldiers returning to Australia from Timor Leste. This was a similar to the trial conducted in Bougainville the previous year, in which “volunteers” were administered very high doses of tafenoquine over a three day period, as an alternative to the registered drug primaquine. The results of this 3 RAR trial are unpublished, but its conduct is mentioned in a series of journal articles on the history of AMI:
The deployment of the ADF to Timor Leste … commencing in September 1999, provided a further opportunity to assess the value of tafenoquine in another area with falciparum and vivax malaria. Volunteers from the Third Battalion, Royal Australian Regiment preparing to return to Australia following InterFET service in February 2000, were randomly allocated to receive a 3-day tafenoquine course (either 400mg or 200mg daily) or the standard 14-day primaquine course. As observed in Bougainville, comparable episodes of vivax malaria were documented over the ensuing 12 months in the 3 groups of volunteers.
The Australian Mefloquine and Tafenoquine Veterans group has asked us to share this information with 3 RAR veterans from this period. They would like to hear from those who experienced adverse effects from tafenoquine as a result of this trial. Please see our contacts page.