Toxic syrups: WHO probe flags 20 products in India, Indonesia

The WHO has already raised ‘medical product alerts’ on the 15 medicines in Gambia and Uzbekistan, where Indian-made syrups were linked to at least 88 deaths last year, as well as in Micronesia and the Marshall Islands.

Medical product alerts are raised to ensure that more people do not consume the contaminated medicine and the products are removed from the supply chain.

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The World Health Organization’s probe into contaminated cough syrups, which have been linked to nearly 300 worldwide deaths so far, has flagged 20 such toxic medicines originating from two countries — India and Indonesia.

In response to an email by The Indian Express, WHO spokesperson Christian Lindmeier said these 20 products were manufactured by “15 different manufacturers” in the two countries.

All the medicines are syrups — cough medicine, paracetamol or vitamins. These would include the 15 previously identified contaminated syrups, seven of which were manufactured in India by Haryana-based Maiden Pharmaceuticals (4), Noida-based Marion Biotech (2), and Punjab-based QP Pharmachem (1). The rest were made in Indonesia.

The WHO has already raised ‘medical product alerts’ on the 15 medicines in Gambia and Uzbekistan, where Indian-made syrups were linked to at least 88 deaths last year, as well as in Micronesia and the Marshall Islands. It also raised an alert in Indonesia, where the syrups, sold domestically, were linked to the death of more than 200 children.

Earlier this June, the Nigerian drug controller raised an alert after it found a paracetamol syrup sold in Liberia contaminated with diethylene glycol or ethylene glycol. The syrup was manufactured by a Mumbai-based company.

Lindmeier said the WHO is aware of media reporting of “potentially contaminated syrups” in more countries but added that its list of medical product alerts has “not been expanded”.

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“This may change as we receive more information,” he said.

Medical product alerts are raised to ensure that more people do not consume the contaminated medicine and the products are removed from the supply chain. Lindmeier said WHO raises such alerts only when there is sufficient evidence to demonstrate that a product is contaminated.

On being asked whether the instances might be linked, Lindmeier’s reply stated: “Our investigations with the impacted countries are ongoing. To date we cannot confirm a link.”

Following the incidents of Indian syrups being flagged by other countries, the Government has put in place a mechanism for all cough syrups meant for export to be tested before they are shipped out.

In a notification issued in May, the Government said only those cough syrups that receive a ‘certificate of analysis’ from the country’s four central drug testing laboratories, two regional testing laboratories, or any of the NABL-accredited state testing laboratories, will be allowed for export.

The first incident came to light in October last year when the WHO raised its first medical product alert for contaminated syrups manufactured by Maiden Pharmaceuticals. The syrup was linked to the deaths of 70 children in the Gambia.

Uzbekistan reported the deaths of at least 18 children due to acute kidney injury linked to two syrups manufactured by Noida-based Marion Biotech.

In a similar instance in Indonesia, the death of around 200 children due to acute kidney injury were linked to eight contaminated syrups.