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WHO Issues Warning On Lethal Cough Syrup
Tuesday, January 24th 2023 - 18:19 UTCFull article
The contaminated products have been authorized to enter other markets, although "they are not expected to be on sale," WHO Spokeswoman Margaret Harris said. The World Health Organization Tuesday issued a warning against a deadly cough syrup that has already killed some 300 children in 7 countries.
The contaminated medicine was said to contain high levels of diethylene glycol and ethylene glycol, which are toxic for human consumption.
After Indonesia, Gambia, and Uzbekistan reported the deaths of 300 people, mostly children, the WHO added the Philippines, East Timor, Senegal, and Cambodia to the list. The presence of contaminated medication has not yet been confirmed but the global agency mentioned potential risks while calling for local sanitary authorities to ban the use of certain syrups.
The contaminated products are known to have been authorized to be introduced in other markets, although "they are not expected to be on sale," WHO Spokeswoman Margaret Harris told EFE.
Diethylene glycol and ethylene glycol are chemicals commonly used as industrial solvents and antifreeze agents that can be lethal even when ingested in small amounts, making them unfit for pharmaceutical use.
Given the proliferation of cases, WHO launched an appeal for the international community to increase its efforts to detect and recall contaminated products. WHO has issued three alerts on contaminated syrups in the past: First in October when they were found in Gambia (where they are believed to have caused at least 70 deaths), the following month for Indonesia (with some 200 deaths), and this month it was the turn of Uzbekistan, where at least 21 deaths have been reported.
Exclusive: WHO Says Toxic Syrup Risk 'ongoing', More Countries Hit
LONDON, June 16 (Reuters) - There is an ongoing global threat posed by toxic cough syrups, the World Health Organization (WHO) told Reuters, saying it was now working with six more countries than previously revealed to track the potentially deadly children's medicines.
The U.N. Agency has already named nine countries where tainted syrups may have been on sale, after the deaths of more than 300 infants on three continents last year were linked to the drugs.
Rutendo Kuwana, the WHO team lead for incidents with substandard and falsified medicines, declined to name the six new countries the agency is working with, while investigations are still underway.
He warned that contaminated medicines could still be found for several years, because adulterated barrels of an essential ingredient may remain in warehouses. Cough syrups and the ingredient, propylene glycol, both have shelf-lives of around two years.
"This is an ongoing risk," said Kuwana.
Unscrupulous actors sometimes substitute propylene glycol with toxic alternatives, ethylene glycol and diethylene glycol, because they are cheaper, several pharmaceutical manufacturing experts told Reuters.
The alternatives are more commonly used in brake fluid and other products not meant for human consumption.
The WHO's working theory is that in 2021, when prices of propylene glycol spiked, one or more suppliers mixed the cheaper toxic liquids with the legitimate chemical, Kuwana said. He did not say where the suppliers were based, and added that obscure supply chains have made proving this difficult.
Pharmaceutical manufacturers, including those alleged to have produced the tainted syrups that have been found so far, typically source ingredients from external suppliers.
LIBERIA AND CAMEROONEarlier this week, Nigeria's regulator issued a warning about contaminated paracetamol syrups sold in Liberia, although no deaths have been reported there. The Nigerian regulator was testing the syrups, which were not sold in Nigeria, because Liberia has no testing facilities.
The WHO issued safety alerts last year for Indian-made products found in Gambia and Uzbekistan, and this year in Micronesia and the Marshall Islands.
It also issued an alert last year for Indonesian-made syrups that were only sold domestically. Indonesian authorities say more than 200 children were likely poisoned by these.
Three Indonesian-based manufacturers – PT Yarindo Farmatama, PT Universal Pharmaceutical Industries, PT AFI Farma – have had their licences revoked. A fourth, PT Konimex, said it had recalled all of the relevant products and its website says it was cleared by the Indonesian regulator to sell new batches as of December 2022. The Indonesian regulator did not immediately respond to a request for comment.
In January, the WHO named four other countries it was working with – Timor Leste, Cambodia, Senegal and the Philippines – to track whether any of the tainted syrups had reached their markets.
There is no current risk to the population in the countries the WHO has named, Kuwana said, either because contaminated medicines had been pulled from shelves or because they never reached the market in the first place.
The countries' governments either confirmed this, said there was only a minimal risk, or did not respond to requests for comment.
The WHO said it has also offered help to Liberia and Cameroon – which recently signalled that it too may have contaminated cough syrups for sale.
Cameroon's health regulator said in April it was investigating the deaths of six children linked to a cough syrup branded as Naturcold. The manufacturer named on the packet is China's Fraken Group, which did not immediately respond to requests for comment.
But the Cameroon authorities said in an alert the medicine was bought from unauthorised sources and possibly smuggled in. They did not respond to requests for more information.
Other manufacturers identified in the current spate of incidents are largely Indian-based. Two companies whose products have been linked to deaths have been shuttered by the authorities there: Maiden Pharmaceuticals, which sold syrups to Gambia, and Marion Biotech, whose syrups went to Uzbekistan.
Naresh Kumar Goyal, the founder of Maiden Pharmaceuticals, told Reuters in December his company did nothing wrong in the production of the cough syrup. Marion Biotech has not responded to requests for comment.
Besides these cases, Indian-made medicines supplied to the Marshall Islands and Micronesia have been recalled after Australian laboratory tests showing contamination prompted a WHO safety alert. The manufacturer, QP Pharmachem, told Reuters earlier this year that its own tests had found no issues.
The contaminated syrups in Liberia were made by India's Synercare Mumbai, according to the Nigerian regulator. The Liberian health regulator said it plans to incinerate the stock and will recall two other Synercare products as well, as a precaution.
Synercare did not respond to a request for comment.
NOT RECOMMENDEDSince 2001, the WHO has recommended against giving cough syrups to children aged under 5, because it says there is limited evidence of how effective they are, or what side-effects they may have.
There have also been at least five incidents in the last half century when paracetamol and cough medicines were contaminated with deadly chemicals, in countries including India and Panama, although the spate of deaths last year is the deadliest on record.
The WHO has also urged all countries to step up surveillance and offered support to concerned countries that do not have the resources to test their own medicines.
"It's not over certainly," said Kuwana. "But we don't need to panic, as a lot of countries are now being proactive."
Reporting by Jennifer Rigby; additional reporting by Krishna N.Das in Delhi, Edward McAllister in Dakar, Stanley Widianto in Jakarta, Sumit Khanna in Ahmedabad, Sophie Yu in Beijing. Editing by Sara Ledwith and Michele Gershberg
Our Standards: The Thomson Reuters Trust Principles.
Jennifer RigbyAfrican Countries On Alert After Deaths Linked To Cough Syrup
The recent deaths of over 300 children in Africa and Asia have prompted the World Health Organization (WHO) to warn about the use of "substandard and falsified" medical products. The organisation called for more efforts to protect children from contaminated medicine.
The Managing Director of the Liberia Medicines and Health Products Regulatory Authority, Dr. Keturah C. Smith-Chineh, has disclosed that the Authority that the product did not pass safety tests. 256 cartons were quarantined last year, after a failed physical inspection at a Quality Control Lab since October 2022.
Para Clear Paracetamol syrup, was manufactured in India, by a pharmaceutical company known as "Curis Life Sciences PVT. Ltd. She further informed the public that an investigation conducted by the World Health Organization (WHO) also revealed that the Para Clear medical product poses threats to the lives of children similar to the Gambian scenario.
Nigeria's National Agency for Food and Drug Administration and Control (NAFDAC) said last year that measures have been put at various ports of entry into the country to prevent entry of the contaminated cough syrups while officials at the Rwanda Food and Drug Authority (RFDA) investigated last year and found that the four paediatric medicines that were recently found unsafe by the World Health Organisation (WHO) in The Gambia have never entered the Rwandan market.
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(File photo) cough syrup, medicine, spoon, medication
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