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Police in the Gambia named a US company in its first report investigating dozens of child deaths linked to paracetamol cough syrups in the country. This comes after the World Heath Organization (WHO) issued a global alert over four brands of cough syrups last week.

Based in Georgia, Atlantic Pharmaceuticals imported 50,000 bottles of cough syrups into the Gambia from India-based Maiden Pharmaceuticals, but the Gambian police said those bottles were contaminated, per Reuters. While about 41,000 bottles have been quarantined or seized, over 8,000 are unaccounted for.

The Gambia suspended paracetamol syrup sales last month and opened an investigation after many children developed acute kidney problems from taking cough syrups sold in the country. The government says the death toll stands at 69 since cases were first identified in July.

What cough syrups caused deaths in the Gambia?

At issue are four Maiden products imported into the Gambia by Atlantic: Promethazine Oral Solution, Kofexmalin Baby Cough Syrup, Makoff Baby Cough Syrup, and Magrip N Cold Syrup.

The WHO said the four were substandard pediatric medicines because they contained “unacceptable amounts” of potentially fatal chemicals typically used to make paints and cosmetics.

“To date, these four products have been identified in The Gambia, but may have been distributed, through informal markets, to other countries or regions,” the WHO said, on Oct. 5. Counterfeit and contaminated drugs tend to travel rapidly through borders in west Africa, a problem compounded by underdeveloped national and subnational healthcare infrastructure with weak drug verification systems.

Some health authorities in west Africa are taking notice. In Nigeria, the food and drug regulator said the four products were not registered in the country and should not be used. Gambia is surrounded by Senegal; it is not immediately clear how the latter has responded to the situation.

Indian syrup maker is temporarily shut down

As the only company named in the Gambia police’s report, Atlantic Pharmaceuticals is a key company of interest in a case evolving into a scandal, though little is known publicly of the company’s activities. A request for comment sent to an email listed on its website failed to deliver.

But Maiden, the drugmaker, is under scrutiny too.

The company said it was “shocked” by news of the deaths in the Gambia, explaining that it did not sell the drugs in question in India. That said, Maiden is not new to controversy, having been blacklisted or failed multiple quality control tests in India alone in the past decade. The WHO said the company had not provided guarantees as to the safety and quality of the four products, as at last week.

Yesterday (Oct. 12), Indian health officials and drug regulators in Haryana, the northern state near New Delhi where Maiden’s factory is, suspended the company’s activities. Four site inspections this month showed the company had violated manufacturing and testing codes.

With follow-up investigations expected, parents of the syrups’ victims and rights activists in the Gambia are beginning to demand justice, criticizing president Adama Barrow’s government for being slow to detect the problems early and having no drug testing systems.

“This is a lesson for parents, but the greater responsibility is with the government,” said Mariam Sisawo, mother of a five-month-old girl who died from one of the syrups. “Before any drugs get into the country, they should be properly checked if they are fit for human consumption or not.”

This content was originally published here.

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