Tainted cough syrups pulled from the shelves after they were linked to dozens of deaths.
The recent deaths of dozens of children from acute kidney problems in The Gambia and Indonesia have caused alarm worldwide. They were possibly caused by harmful substances in medicinal syrups.
The first fatalities were reported in The Gambia last month, prompting authorities to launch an investigation. Separately, Indonesia this month announced a ban on all syrup and liquid medicines after the reported deaths there of dozens of children, also from acute kidney injuries.
There is no confirmed link between the cases in the two countries, but investigations are ongoing.
Here is what to know about what has happened.
The Gambia
In September, the government of The Gambia launched an inquiry into the deaths of 28 children from acute kidney problems after they took a paracetamol syrup to treat fever.
In early October, the World Health Organization (WHO) said the deaths in The Gambia may be linked to four contaminated cough and cold syrups made by Maiden Pharmaceuticals, an Indian drug manufacturer. It said an investigation was under way, together with Indian regulators and the New Delhi-based company.
The WHO said in a medical product alert on October 5 that excessive levels of diethylene glycol and ethylene glycol had been found in the four products produced by Maiden Pharmaceuticals and sold in The Gambia: Promethazine Oral Solution, Kofexmalin Baby Cough Syrup, Makoff Baby Cough Syrup and Magrip N Cold Syrup.
The agency warned that their use may result in serious injury or death, especially in children,
Diethylene glycol and ethylene glycol are alcoholic toxic chemicals used in industrial applications such as the making of paints, ink or brake fluids. Their effects reportedly include altered mental states, stomach cramps, nausea, vomiting and diarrhoea. They might cause damage to the kidney, liver and central nervous system.
Gambian authorities on Friday ordered all cough and cold syrups in circulation in the country to be recovered, extending the scope of a previous recall for medicines containing paracetamol or promethazine syrup.
Last week, police in The Gambia said in a preliminary investigative report that the number of child deaths had increased to at least 69.
The report also said the deaths from acute kidney injury were linked to four India-made cough syrups mentioned in the WHO’s alert, according to news agencies. It did not name Maiden Pharmaceuticals directly but included the company’s four liquid products in question.
Indian health authorities, who also conducted their own internal probe, halted all production at Maiden Pharmaceuticals in mid-October after discovering violations at its production facilities in Haryana state.
