An American law firm has been hired by Gambian authorities after a government investigation found contaminated medicines from India were linked to the deaths of dozens of children last year, the Justice Minister has announced.
At least 70 children, most under five-years-old, died from acute kidney injury between June and October, reports Reuters.
Local doctors suspected cough syrups imported from India were the likely culprit, and tests by the World Health Organisation (WHO) confirmed the presence of lethal toxins, sparking a global hunt for contaminated medicines.
Gambian Justice Minister Dawda Jallow said legal action was one option under consideration by the government, the first sign of potential international litigation over the deaths. Jallow did not name the target of potential legal proceedings or the law firm hired to help.
The medicines were made by Indian drug maker Maiden Pharmaceuticals, which denied wrongdoing. Tests by the WHO found the Maiden cough syrups contained the lethal toxins diethylene glycol (DEG) and ethylene glycol (EG). India’s Government has said its own tests found no toxins.
Indian officials have said the WHO failed to prove a causal link to the Gambia deaths, accusing the agency of denigrating its $41bn pharmaceutical industry.
However, cough syrups made by a second Indian drugmaker have since been linked to the deaths of another 19 children in Uzbekistan.
India has since made drug testing mandatory for cough syrups before export.
Causality report
Gambia's Justice Ministry commissioned a causality assessment by a panel of international experts, in which experts analysed 56 of the cases of acute kidney injury. Of those, 22 were “very likely” to have died from DEG or EG poisoning after taking Maiden products.
The panel could not confirm the cause of death in another 30 cases but said it was “highly suggestive” they were killed by DEG and EG. There was not enough evidence in four other cases.
Doctors were able to carry out autopsies on just two of the patients, the pathology of both being consistent with DEG and EG poisoning. Of all the medicines tested after the deaths, only Maiden’s were shown to be toxic.
A months-long investigation into the deaths has raised concerns among global health officials about lax regulation in India’s drug sector and oversight of pharmaceutical raw materials worldwide.
Many of the countries India supplies, including Gambia, have no means of testing imported drugs.
The WHO is continuing to investigate the source of contaminated cough syrups in Gambia, Uzbekistan and several other countries, but has been frustrated by a lack of information regarding Maiden's drugs.
Gambia is planning to build a testing facility for imported drugs, with support from the World Bank.
See more from MedicalBrief archives:
Probe into Indian cough syrup link to Gambian children’s deaths
WHO alert after more contaminated Indian cough syrups detected
India cancels licence of company linked to deadly cough syrups