RPCV Sara Thompson (Burkina Faso 2010-12) Sues The Peace Corps Over Malaria Drug

Wall Street Journal

By JOE PALAZZOLO

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Sara Thompson (Burkina Faso 2011-13) sometimes wakes up in the middle of the night and finds her balance has left her. She stumbles to the kitchen. Or to the bathroom. She suffers spells of dizziness when she tilts her head just so, and sometimes for no reason at all.

Ms. Thompson, 32, said the symptoms began during her Peace Corps service in Africa, where she took the antimalarial drug mefloquine. In a lawsuit filed earlier this week in Washington, D.C., Ms. Thompson alleges the federal volunteer program negligently provided her the drug without warning her of all the possible dangers.

In 2013, the year after she returned from her two-year service in Burkina Faso, a landlocked West African country, the Food and Drug Administration required makers of the drug to add a warning label about potential neurological and psychiatric side effects, including loss of balance, dizziness, ringing in the ears, anxiety, depression and hallucinations. The black-box warning says the neurological side effects can take hold for months, years or even permanently.

A spokeswoman for the Peace Corps said the agency has a long-standing policy of informing volunteers of possible side effects before they begin a medication, but she declined to address Ms. Thompson’s case, citing privacy. Drug company Roche, which made Lariam, the brand name mefloquine that Ms. Thompson said she took, didn’t immediately respond to a request for comment Friday.

Ms. Thompson says in her lawsuit that she was given concentrated doses of mefloquine after arriving in the country, though the Centers for Disease Control and Prevention recommends that the drug be administered at least two weeks prior to travel and notes that side effects are “more frequent with the higher doses used for treatment.” She is asking for $1 million in damages.

Ms. Thompson received a two-page medication guide from the Peace Corps that warned the drug could cause “serious mental problems in some patients,” including anxiety, depression or feeling disoriented. She told Law Blog the warning was an “inadequate representation of the several medical and psychiatric issues surrounding mefloquine use.”

For most people, the drug has been proven effective in preventing malaria. It is also less expensive than other treatments and has to be taken less often.

The U.S. military developed the drug about 40 years ago, but the Pentagon in recent years labelled mefloquine as a “last resort” for the prevention of malaria, as moreevidence of its possible side effects surfaced. Some branches have banned it entirely. Ms. Thompson requests in her lawsuit that the Peace Corps also use mefloquine only as a drug of last resort.

Since the FDA required the new warning on mefloquine, the Peace Corps said it has provided one-on-one consultations with volunteers to discuss the pros and cons of each medication, including potential side effects. The choice of medication is the volunteer’s, according to the Peace Corps.

“We take concerns raised regarding the use of Mefloquine very seriously, and we have taken proactive steps to ensure our volunteers have all of the information they need to make an informed decision about the anti-malaria medication that is right for them,” the Peace Corps spokeswoman said.

Ms. Thompson, who specialized in girls’ education and empowerment while in Africa, was frequently sick during her service and slept more than 16 hours a day, according to her lawsuit, which she filed in U.S. District Court for the District of Columbia. She became convinced other volunteers were stealing from her. Sometimes, while making dinner or reading in her hut, she saw things out of the corner of her eye, she said.

“The Peace Corps gave me mefloquine, despite the overwhelming evidence of the huge risk and health side effects, and the Peace Corps still uses the drug,” Ms. Thompson said.

4 Comments

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  • I’m glad Ms. Thompson has the wherewithal to file suit but it should be directed at forcing the FDA to do its job of protecting the health and safety of its citizens. How many citizens should sue the FDA for failing to protect them from dangerous pharmaceutical concoctions but can’t afford to? Comprehensive independently-financed research on new products is necessary to protect the citizenry, instead of coming to the rescue after the damage has been done, as in Ms. Thompson’s case. FDA has been failing for decades if one were to examine the battle over pesticides and most especially over efforts to corral Roundup…Could the rise in transgender births be the culprit?

    mefloquine sounds like it was derived from quinine, found occurring naturally in the bark of a Peruvian tree. Of course, Roche couldn’t patent the organic tree bark, so tweak here, tweek there, make it inorganic and patent it. It’ll be years before the FDA figures it out.

    We need a government for the people; we don’t need one to exploit the people. If you can afford to sue without jeopardizing your home, follow Ms. Thompson’s lead and sue for responsible government oversight, anywhere and everywhere till we turn this sucker around.

    JFK knew the 3rd Goal of the Peace Corps was the ultimate reward of the idea. Yet he knew it would take “a million” of us back home before we would have enough people to get our government off our backs and on track in creating a government for the people.

    Thank you John Coyne for keeping us informed and together.

  • Our thanks to John for spotting this interesting and somewhat disturbing item and posting it for us. A number of points immediately come to mind.

    First I’m a bit tired of PCVs or RPCVs complaining (much less suing) about some mishap or inconvenience they suffered while in Peace Corps. When we signed up for Peace Corps we were not volunteering to go for a walk though the Philadelphia Garden Show. We were agreeing to go to places that had problems with health, politics, climate, terrain. And sometimes with nasty people. We knew the risks. And embraced them. Things can go wrong and they did, but that was part of the deal.

    Second, Peace Corps tries to minimize those risks, sometimes to a fault. In these days of terrorism and fear of congressional backlash, Peace Corps seems to err on the side of excess caution, controlling, for example, the movements of PCVs to a degree beyond the imagination of those of us who served in the early days.

    Finally, I’m puzzled by William’s urging the FDA, a government agency, to take vigorous action to control drugs and pesticides — and then turning around and suggesting that a mission for RPCVs is to get government off our backs. Undoubtedly the drug and chemical companies would welcome help getting the FDA off their backs. Interesting.

  • And I, am tired of what appears to be incompetence on the part of medical personnel in some instances that harms Volunteers, being rationalized as “I never promised your a rose garden.” or “Peace Corps is risky business.”

    I knew the risks when I signed up. I also knew that there were risks that could not be anticipated. I did not agree to sloppy or inadequate medical care because I was in a position, as are all Volunteers, where I had no other options.

    I also am tired of those Volunteers who come forth to confront what they had to go through are dismissed or belittled by fellow RPCVS, PCVs and staff. Granted, that does not happen all the time. But they should be respected and their concerns taken seriously. Ultimately, their intent is to change policy and practice so that other Volunteers don’t have to suffer the same as they did.

    In the early days of Peace Corps, Volunteers did not take
    mefloquine. We took chloroquine; but, that is no longer effective. It did not have the same side effects. I knew Volunteers who got excellent care and Volunteers who did not.
    That kind of inequity is not fair. The main changes to Peace Corps policy and practices have begun within the RPCV community. I support the courage of those PCVs and RPCVs and wish them well.

    I also believe that Peace Corps is strong enough to change.

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