The World Health Organization (WHO) has issued a warning about the continued global threat posed by toxic cough syrups.
According to Reuters, the WHO revealed that it is now collaborating with six additional countries to track these potentially deadly children’s medicines, expanding its efforts beyond what was previously disclosed.
Last year, over 300 infant deaths on three continents were linked to tainted syrups, prompting the WHO to identify nine countries where these products may have been available.
However, the organization has refrained from disclosing the names of the six new countries it is currently working with, citing ongoing investigations.
Rutendo Kuwana, the WHO team lead for incidents involving substandard and falsified medicines, emphasized the possibility of contaminated medicines persisting for several years.
This is due to the presence of adulterated barrels of propylene glycol, a crucial ingredient with a typical shelf-life of approximately two years, which may still be present in warehouses.
Kuwana highlighted the ongoing risk of these dangerous products, explaining that unscrupulous actors often substitute propylene glycol with cheaper, toxic alternatives such as ethylene glycol and diethylene glycol.
These substances are commonly used in non-consumable products like brake fluid, posing a significant threat to human health if ingested.
The WHO’s current working theory is that during a period of propylene glycol price inflation in 2021, one or more suppliers mixed the cheaper toxic substances with the legitimate chemical.
Kuwana refrained from disclosing the location of these suppliers and mentioned the challenges of tracing obscure supply chains, which have hindered efforts to gather conclusive evidence.
It is worth noting that pharmaceutical manufacturers, including those allegedly involved in the production of the tainted syrups identified thus far, typically source their ingredients from external suppliers.
The WHO continues to collaborate with international partners to address this ongoing global health crisis and mitigate the risks associated with toxic cough syrups.
Contaminated syrups spark health alerts in multiple countries
In a recent development, Nigeria’s regulatory authority issued a warning regarding contaminated paracetamol syrups sold in Liberia.
Although no deaths have been reported in Liberia thus far, the Nigerian regulator took the initiative to test the syrups, which were not distributed in Nigeria, due to the absence of testing facilities in Liberia.
The World Health Organization (WHO) has been actively monitoring and issuing safety alerts for similar incidents involving Indian-made products.
Last year, alerts were issued for products found in Gambia and Uzbekistan, followed by alerts this year in Micronesia and the Marshall Islands.
In Indonesia, an alert was raised for domestically sold syrups, which reportedly poisoned over 200 children.
The regulatory authorities in Indonesia took action against the manufacturers involved.
PT Yarindo Farmatama, PT Universal Pharmaceutical Industries, and PT AFI Farma had their licenses revoked, while PT Konimex recalled the implicated products and resumed selling new batches with clearance from the Indonesian regulator as of December 2022.
The WHO has also been collaborating with several countries to track the distribution of tainted syrups. In January, they announced their cooperation with Timor Leste, Cambodia, Senegal, and the Philippines to assess the presence of contaminated syrups in their markets.
According to Mr. Kuwana, there is currently no risk to the populations in these countries. This is due to either the removal of contaminated medicines from shelves or their failure to reach the market in the first place.
The governments of these countries either confirmed this, stated a minimal risk, or did not respond to requests for comment.
Furthermore, the WHO has offered assistance to Liberia and Cameroon, the latter of which recently signaled potential contamination issues with cough syrups being sold.
In April, Cameroon’s health regulator reported investigating the deaths of six children associated with a cough syrup branded as Naturcold.
The manufacturer listed on the packaging is China’s Fraken Group, which has not yet responded to requests for comment.
The Cameroonian authorities mentioned in an alert that the medicine was purchased from unauthorized sources, possibly through smuggling.
Further details have not been provided by the authorities in response to requests for additional information.
Many of the manufacturers implicated in these incidents are based in India. The authorities in India have taken action against two companies: Maiden Pharmaceuticals, which supplied syrups to Gambia, and Marion Biotech, whose syrups reached Uzbekistan.
Both companies have been ordered to cease operations. Naresh Kumar Goyal, the founder of Maiden Pharmaceuticals, denied any wrongdoing related to the production of the cough syrup. Marion Biotech has not responded to requests for comment.
Additionally, Australian laboratory tests revealed contamination in Indian-made medicines supplied to the Marshall Islands and Micronesia, leading to their recall following a WHO safety alert.
However, the manufacturer, QP Pharmachem, stated earlier this year that their own tests did not identify any issues.
The contaminated syrups discovered in Liberia were manufactured by India’s Synercare Mumbai, as confirmed by the Nigerian regulator.
The Liberian health regulator intends to incinerate the stock and initiate a recall of two other Synercare products as a precautionary measure. Synercare has not responded to requests for comment.
Cough syrups for children under 5 years not recommended
For over two decades, the World Health Organization (WHO) has advised against administering cough syrups to children under the age of 5.
The organization has cited limited evidence on their effectiveness and potential side effects. This cautionary measure has been in place since 2001.
Tragically, there have been multiple incidents in the past 50 years involving the contamination of paracetamol and cough medicines with hazardous chemicals.
India and Panama, among other countries, have experienced such incidents. However, last year’s series of deaths connected to contaminated syrups stands as the deadliest on record.
In response to these concerning events, the WHO is calling for heightened surveillance and vigilance across all nations.
The organization is also offering support to countries lacking the necessary resources to conduct their own medicine testing.
Mr. Kuwana emphasized the ongoing nature of the issue, stating, “It’s not over certainly.” However, he also urged against panic, as many countries are now taking proactive measures to address the situation.