Gambia Acts Against Indian Pharma for Lethal DEG and EG Contamination in Cough Syrup

US: According to the justice minister's statement, Gambia has engaged a US law firm to investigate legal courses of action following a government-led inquiry that discovered Indian medicines contaminated with toxins were "highly likely" responsible for the tragic deaths of numerous children last year. The fatalities which occurred between June to October and affected children under 5 years, led to at least 70 deaths in Gambia due to acute kidney injury.

After local physicians suspected that cough syrups imported from India were the probable reason behind the outbreak, with the World Health Organization (WHO) verifying the existence of deadly toxins in the medication, a global exploration for polluted medicines was initiated. According to the Justice Minister, Dawda Jallow, the Gambian government is contemplating various possibilities, including legal action, which is the first sign of potential international litigation concerning the fatalities. Jallow refrained from disclosing who would be the target of potential legal proceedings or the name of the law firm hired to assist in this matter.

Indian manufacturer, Maiden Pharmaceuticals, which denied any wrongdoing, produced the medications that were associated with the children's deaths. WHO Tests Confirm Presence of Diethylene Glycol (DEG) and Ethylene Glycol (EG) - Lethal Toxins in Maiden Cough Syrup Resembling Car Brake Fluids

India's government stated that their own tests did not reveal any toxins in the drugs. Both India's health ministry and Maiden remained silent on Gambia's probable legal action. Meanwhile, the WHO declined to comment on the issue. Indian officials claimed that the WHO failed to establish a causal link between the Gambian fatalities and accused the agency of disparaging its $41 billion pharmaceutical industry. However, cough syrups produced by another Indian drugmaker have also been linked to the deaths of 19 children in Uzbekistan. As a result, the Indian government has made drug testing mandatory for cough syrups before exporting them.

As per Jallow's statement, Gambia's justice ministry is examining its alternatives after a recent causality assessment commissioned by the government and conducted by an international panel of experts. While the report was delivered to President Adama Barrow in April, it has not been made public. The experts analyzed 56 cases of acute kidney injury and found that 22 of them were "very likely" to have died from DEG or EG poisoning after ingesting Maiden products. The panel could not validate the cause of death in another 30 cases but claimed that it was "highly suggestive" that they were caused by DEG and EG. There was insufficient evidence in four of the cases, as per the report's findings.

The report stated that autopsies could be conducted on only two of the patients, and the pathology of both was consistent with DEG and EG poisoning. Furthermore, Maiden's medications were the only ones found to be toxic among all the medications evaluated after the deaths. As per several pharmaceutical manufacturing experts, unscrupulous actors use DEG and EG as an inexpensive alternative to Propylene Glycol, a key ingredient in syrupy medications. It is the most recent update in the months-long investigation into the fatalities, which has raised concerns among global health officials about insufficient regulation in India's drug sector and oversight of pharmaceutical raw materials worldwide. Several of the countries that receive supplies from India, including Gambia, do not have the means to examine imported drugs.

The WHO is still investigating the origin of contaminated cough syrups in several countries, including Gambia and Uzbekistan; however, they have encountered difficulties due to insufficient information about Maiden's drugs. The Minister of Gambia, Dawda, has declared that the Justice Ministry's recommendations and causality assessment will be made available to the public in six months. The World Bank has declared its support for Gambia's plan to establish a testing facility for imported drugs.