The World Health Organization (WHO) has revealed that it is working with six additional countries to track the distribution of toxic cough syrups, which pose a global threat to children’s health. This comes after the deaths of over 300 infants across three continents last year were linked to tainted medicines. Although the WHO has not disclosed the names of the new countries it is working with, investigations are still ongoing. The organization warned that contaminated medicines could continue to be found for several years due to the presence of adulterated barrels of a key ingredient in warehouses. The WHO’s theory is that during a spike in the prices of propylene glycol in 2021, suppliers mixed cheaper toxic alternatives, ethylene glycol and diethylene glycol, with the legitimate chemical. Unscrupulous actors substitute propylene glycol with these toxic alternatives because they are cheaper. Pharmaceutical manufacturing experts have said that these alternatives are often used in products not meant for human consumption, such as brake fluid. The WHO has issued safety alerts for Indian-made products found in Gambia, Uzbekistan, Micronesia, and the Marshall Islands. Last year, an alert was also issued for Indonesian-made syrups that caused over 200 children to be poisoned. Three Indonesian-based manufacturers have had their licenses revoked, while a fourth, PT Konimex, claims to have recalled the relevant products and received clearance to sell new batches. The WHO has named four other countries – Timor Leste, Cambodia, Senegal, and the Philippines – as places it is working with to track the presence of tainted syrups in their markets. Currently, there is no immediate risk to the populations of the named countries, as either contaminated medicines have been removed from shelves or have not reached the market. The WHO has offered assistance to Liberia and Cameroon, which recently indicated that they may have contaminated syrups for sale. In April, Cameroon reported the deaths of six children linked to a cough syrup called Naturcold, which they said was bought from unauthorized sources and possibly smuggled in. The authorities did not provide further information. Maiden Pharmaceuticals and Marion Biotech, both Indian-based companies, have had their products linked to deaths and have been closed by the authorities. QP Pharmachem, the manufacturer of Indian-made medicines supplied to the Marshall Islands and Micronesia, recalled its products after contamination was detected in Australian laboratory tests prompted a WHO safety alert. Indian company Synercare Mumbai was identified as the manufacturer of contaminated syrups in Liberia. The Nigerian regulator reported that the stock will be incinerated and two other Synercare products will be recalled as a precaution. The WHO has recommended against giving cough syrups to children under the age of 5 since 2001 due to limited evidence of their effectiveness and potential side effects. There have been previous incidents of contamination in paracetamol and cough medicines over the past fifty years, including in India and Panama, but last year’s deaths represent the deadliest recorded. The WHO has called on all countries to increase surveillance and has offered support to countries that lack the necessary resources to test their own medicines. Consequently, while the threat is ongoing, the WHO advises against panicking as many countries are taking proactive measures to address the issue.
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