"Presumptively Treating" Malaria
Though malaria is nonexistent in Cuba, DoD spokeswoman Maj. Tanya Bradsher told Truthout that the US government was concerned that the disease would be reintroduced into the country as detainees were transferred to the prison facility in January 2002.
A "decision was made," Bradsher said in an email, to "presumptively treat each arriving Guantanamo detainee for malaria to prevent the possibility of having mosquito-borne [sic] spread from an infected individual to uninfected individuals in the Guantanamo population, the guard force, the population at the Naval base or the broader Cuban population."
But Granger wrote in his book that a Navy entomologist was present at Guantanamo in January and February 2002 and during that time only identified insects that were nuisances and did not identify any insects that were carriers of a disease, such as malaria.
Nevertheless, Bradsher said the "mefloquine dosage [given to detainees] was entirely for public health purposes ... and not for any other purpose" and "is completely appropriate."
"The risks and benefits to the health of the detainees were central considerations," she added.
But a September 13, 2002, DoD memo governing the operational use of mefloquine said, "Malaria is not a threat in Guantanamo Bay." Indeed, there have only been two to three reported cases of malaria at Guantanamo.
The DoD memo, signed by Assistant Secretary of Defense for Health Affairs William Winkenwerder, was sent to then-Rep. John McHugh, the Republican chairman of the House Veterans Affairs Subcommittee on Military Personnel. McHugh is now Secretary of the Army.
A Senate staff member told Truthout the Senate Armed Services Committee was never briefed about malaria concerns at Guantanamo nor was the committee made aware of "any issue related to the use of mefloquine or any other anti-malarial drug" related to "the treatment of detainees."
When questions were raised at a February 19, 2002 meeting of the Armed Forces Epidemiological Board (AFEB) about what measures the military was taking to address malaria concerns at Guantanamo, Navy Capt. Alan J. Lund did not disclose that mefloquine was being administered to detainees as a form of presumptive treatment.
Yund said the military gave detainees a different anti-malarial drug known as primaquine and noted that "informed consent" was "absolutely practiced" prior to administering drugs to detainees, an assertion that contradicts claims made by numerous prisoners who said they were forced to take drugs even if they protested. Yund did not return calls for comment.
Bradsher declined to respond to a follow-up question about who made the decision to presumptively treat detainees with mefloquine.
An April 16, 2002, meeting of the Interagency Working Group for Antimalarial Chemotherapy, which DoD, along with other federal government agencies, is a part of, was specifically dedicated to investigating mefloquine's use and the drug's side effects. The group concluded that study designs on mefloquine up to that point were flawed or biased and criticized DoD medical policy for disregarding scientific fact and basing itself more on "sensational or best marketed information."
The Working Group called for additional research, and warned, "other treatment regimes should be carefully considered before mefloquine is used at the doses required for treatment."
Still, despite the red flags that pointed to mefloquine as a high-risk drug, the DoD's mefloquine program proceeded.
In fact, a June 2004 set of guidelines issued by the Centers for Disease Control and Prevention (CDC) says mefloquine should only be used when other standard drugs were not available, as it "is associated with a higher rate of severe neuropsychiatric reactions when used at treatment doses."
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