What is killing the children in the Gambia has been found to be a cough syrup. That cough syrup was imported and distributed by an American company. We hear from the World Health Organisation that do the cough syrup was produced by India’s Maiden Pharmaceuticals Company Ltd and it has killed over 60 children. Associated the name ‘Indian’ with the death seems like fair game, but to even mention that the cough syrup was imported and distributed by an American company, not only into The Gambia but into many other African countries, seems to be taboo.
It took almost a month to discover that it was the cough syrup that was killing like Jack the Ripper. At first major news organisations reported that paracetamol was killing the children in The Gambia. Around early to mid-September Reuters and Al Jazeera reported that some paracetamol supplies had caused the death of children in The Gambia. And the government of the Gambia went ahead to ban the distribution of this paracetamol. Then about three weeks later the more widespread story came that some batches of cough syrups had killed children in the same country. There was no reference at all made to the fact that there was an earlier report of paracetamol. Was the small West African nation experiencing a fake drug problem in which over-the-counter medications were causing the death of children? None of the reports made reference to this possibility and this was worrisome to some of us that such basic questions never reflected in any report or analysis.
In fact when the world Health Organisation themselves weighed in by announcing that the cough syrup that killed 66 children and that the supply of the sysrups was widespread people got more worried and the worries spread more because there was no mention of paracetamol. Was the product a combined preparation that had the two active ingredients? They say it has been widespread but how many more countries had the product being distributed to? And why were they quicker to make reference to the India company that made the products but not the company that distributed the products, which often if the company were third world country would have gotten the bad rap first?
In reporting the story from the WHO, one newspaper said “
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Laboratory analysis found “unacceptable amounts of diethylene glycol and ethylene glycol” and that “[D]espite the agency’s concerns around the product being a common export, specifically to African nations, the drugmaker’s corporate office in New Delhi did not immediately comment on the situation.” There was no mention of the American distributors of rhe products. In fact, the story skipped straight to India and stopped there, saying,
“Indian authorities in response have sent the cough syrup for testing, adding that, “Strict action will be taken if anything is found wrong”.
Why do Third World countries love to do this to themselves? The Gambia’s Medicines Control Agency (MCA), while responding to the paracetamol story, said World Health Organisation officials said the evidence pointed not to paracetamol but to some possible infection through contaminated water, but emphasised there were many unanswered questions, including the fact that the children died from cases of kidney diseases that spiked suddenly around July. No one knew whether it could be linked to the period when the pharmaceuticals came into the country. And then, boom, it was India, like a movie.
No one is trying to exonerate country or production company in this case. One is trying to say that we are quick to blame Third World nations when we see that there’s even a direct responsibility that can be attributed to the company that originates from a First World nation. We get to read about Maiden Pharmaceuticals a hundred times without any mention of the American company, Atlantic Pharmaceuticals Company Ltd, that conducted the importation and distribution of the syrups in The Gambia, which any fair investigation should indict the company first. The logic is that there could be poison lying anywhere but the person or institution that causes it to be distributed, supplied and ingested holds immediate responsibilty before the one that manufactured it.
That said Nigerians should be on the lookout for the medicines in question: Promethazine Oral Solution, Kofexmalin Baby Cough Syrup, Makoff Baby Cough Syrup and Magrip N Cold Syrup. They are said to contain “unacceptable amounts of diethylene glycol and ethylene glycol”, colourless and odourless ingredients, so no one can tell which product they are included in. These medicines appear to be really a problem now but they may be more. Already there are reports of increased cases of cough and flu in many parts of the Nigeria at this moment. Many people are reporting anecdotally that they had cough and treated all catarrh and flu, but no one knows what they used to treat them. It will be important for NAFDAC, Nigeria’s National Agency for Food and Deugs Administrationand Control, to stay on guard and ensure that every cough syrup is given a lot of attention and scrutinized. It may also be important to look at the medicines that are likely to contain those active ingredients that have been identified as problematic. They could be present in other medicines and have been distributed across the country’s chaotic drug distribution system where recalls are almost impossible. In The Gambia, a large proportion of what was distributed has been recalled. Of course, we can argue that they are a smalll country, but that is neither here nor they. In Nigeria, to organise a recall of medicines would be akin to organising free, free and credible elections in the year 2023: that will will be some heaven of an assignment!
