Lost in India: passengers on an Indian railway platform. Photo: Getty
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Why did a man wake up on an Indian train platform with no idea who he was?

When David Stuart MacLean woke up in India with amnesia he assumed he was an addict who had overdosed. In fact, the only chemical he’d been taking was the prescribed antimalarial drug Lariam.  

On 17 October 2002, David Stuart MacLean woke up on a train platform in India with no idea who he was. “There, there,” a man dressed like a police officer said. “I have seen this many times before. You foreigners come to my country and do your drugs . . . It will be all right, my friend.”

David followed the man to a safe house for troubled foreigners, run by a Chinese woman whose son had overdosed in Singapore. “You have no idea what you do to your mother when you put these drugs into your body,” she said, crying as she told her story. David cried, too.

Later, he was taken to a neuropsychiatry centre in Hyderabad where a doctor administered antipsychotic drugs to stop the hallucinations that were keeping him awake at night. He managed to remember his parents’ phone number. “I’m so sorry,” he wept down the line. “I’ve been a terrible person. An awful son.” An Indian friend rounded up every American he knew in the city and brought them to the hospital. They arrived with newspapers and cigarettes, which David began to chain-smoke, despite never having touched a cigarette in his life.

As far as he knew, he was a junkie who had got himself into trouble. “I assembled a working self out of the behaviour of others,” he recalls in his memoir The Answer to the Riddle Is Me. In reality, he was a bright American student on a Fulbright scholarship suffering from amnesia, insomnia and convulsions. The only drug he had been taking was the antimalarial Lariam.

Lariam was developed by the US army with the Swiss pharmaceutical company F Hoffman-La Roche in the 1970s. It was approved by the US Food and Drug Administration in 1989. When a randomised double-blind study was conducted in 2001 – a study that should have been completed years earlier – researchers found 67 per cent of patients suffered at least one adverse affect; 6 per cent required medical treatment. If this data had been available, the drug may not have been approved.

Between 2002 and 2004 the journalists Mark Benjamin and Dan Olmsted filed more than 40 reports on US soldiers who had returned from malarial countries such as Rwanda, Liberia and Afghanistan and killed themselves. Sometimes they killed their wives and children, too. The murder of 16 Afghan civilians by Staff Sergeant Robert Bales in 2012 has been linked to Lariam. For those with susceptible brain chemistry (or who have suffered brain injuries, as in the case of Bales), the drug can pool in the brain, inflicting irreversible damage.

When David returned to Ohio, he was confronted by photographs of a stranger bearing his name. He met a woman named Anne, who told him they had been in love. He couldn’t picture the two of them together and ended the relationship. Over time, most of David’s memories returned but he still lives with the threat of relapse, unable to prove that Lariam caused his condition.

The US military stopped the procedural use of Lariam in 2009. Roche has ceased marketing it in the US (though it is still available to British soldiers and on the NHS). An army epidemiologist told the US Senate that it was the Agent Orange of our generation. In 1994, a Roche safety report noted that Lariam could cause depression, which may involve suicidal ideation in a few cases. That it could lead to suicide was harder to prove. The cause was more likely “the progressive breakdown of traditional values”, the company wrote. It had nothing to do with its drug.

Philip Maughan is a freelance writer in Berlin and a former Assistant Editor at the New Statesman.

This article first appeared in the 11 June 2014 issue of the New Statesman, The last World Cup

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Stability is essential to solve the pension problem

The new chancellor must ensure we have a period of stability for pension policymaking in order for everyone to acclimatise to a new era of personal responsibility in retirement, says 

There was a time when retirement seemed to take care of itself. It was normal to work, retire and then receive the state pension plus a company final salary pension, often a fairly generous figure, which also paid out to a spouse or partner on death.

That normality simply doesn’t exist for most people in 2016. There is much less certainty on what retirement looks like. The genesis of these experiences also starts much earlier. As final salary schemes fall out of favour, the UK is reaching a tipping point where savings in ‘defined contribution’ pension schemes become the most prevalent form of traditional retirement saving.

Saving for a ‘pension’ can mean a multitude of different things and the way your savings are organised can make a big difference to whether or not you are able to do what you planned in your later life – and also how your money is treated once you die.

George Osborne established a place for himself in the canon of personal savings policy through the introduction of ‘freedom and choice’ in pensions in 2015. This changed the rules dramatically, and gave pension income a level of public interest it had never seen before. Effectively the policymakers changed the rules, left the ring and took the ropes with them as we entered a new era of personal responsibility in retirement.

But what difference has that made? Have people changed their plans as a result, and what does 'normal' for retirement income look like now?

Old Mutual Wealth has just released. with YouGov, its third detailed survey of how people in the UK are planning their income needs in retirement. What is becoming clear is that 'normal' looks nothing like it did before. People have adjusted and are operating according to a new normal.

In the new normal, people are reliant on multiple sources of income in retirement, including actively using their home, as more people anticipate downsizing to provide some income. 24 per cent of future retirees have said they would consider releasing value from their home in one way or another.

In the new normal, working beyond your state pension age is no longer seen as drudgery. With increasing longevity, the appeal of keeping busy with work has grown. Almost one-third of future retirees are expecting work to provide some of their income in retirement, with just under half suggesting one of the reasons for doing so would be to maintain social interaction.

The new normal means less binary decision-making. Each choice an individual makes along the way becomes critical, and the answers themselves are less obvious. How do you best invest your savings? Where is the best place for a rainy day fund? How do you want to take income in the future and what happens to your assets when you die?

 An abundance of choices to provide answers to the above questions is good, but too much choice can paralyse decision-making. The new normal requires a plan earlier in life.

All the while, policymakers have continued to give people plenty of things to think about. In the past 12 months alone, the previous chancellor deliberated over whether – and how – to cut pension tax relief for higher earners. The ‘pensions-ISA’ system was mooted as the culmination of a project to hand savers complete control over their retirement savings, while also providing a welcome boost to Treasury coffers in the short term.

During her time as pensions minister, Baroness Altmann voiced her support for the current system of taxing pension income, rather than contributions, indicating a split between the DWP and HM Treasury on the matter. Baroness Altmann’s replacement at the DWP is Richard Harrington. It remains to be seen how much influence he will have and on what side of the camp he sits regarding taxing pensions.

Meanwhile, Philip Hammond has entered the Treasury while our new Prime Minister calls for greater unity. Following a tumultuous time for pensions, a change in tone towards greater unity and cross-department collaboration would be very welcome.

In order for everyone to acclimatise properly to the new normal, the new chancellor should commit to a return to a longer-term, strategic approach to pensions policymaking, enabling all parties, from regulators and providers to customers, to make decisions with confidence that the landscape will not continue to shift as fundamentally as it has in recent times.

Steven Levin is CEO of investment platforms at Old Mutual Wealth.

To view all of Old Mutual Wealth’s retirement reports, visit: www.oldmutualwealth.co.uk/ products-and-investments/ pensions/pensions2015/