DAKAR (Reuters) – Families of 20 Gambian children who tragically lost their lives after consuming cough syrups produced in India are preparing to take legal action against their government. This unprecedented move comes in one of Africa’s poorest nations, where challenging authorities is often out of reach for most due to limited resources. The parents’ heart-wrenching accounts, outlined in court documents exclusively shared with Reuters, provide a detailed and comprehensive picture of the panic, confusion, and devastation caused by these contaminated drugs, exacerbating an already strained healthcare system.
The affidavits reveal accounts from desperate parents who unknowingly continued administering toxic medicine to their children for days despite vomiting, and others who had to fix leaking intravenous drips that hospitals had connected to their children. These heartbroken parents originally sought treatment for minor ailments that tragically proved fatal.
Last year, the World Health Organization (WHO) identified at least 70 cases of acute kidney injury in Gambia, linking them to contaminated Indian-made medicines manufactured by Maiden Pharmaceuticals. The drugs were found to be tainted with diethylene glycol (DEG) and ethylene glycol (EG), toxic substances typically used in industrial solvents and antifreeze agents. Unscrupulous actors often replace a crucial ingredient with DEG and EG due to their lower cost. Tragically, the use of DEG and EG-laced medications was also implicated in the deaths of approximately 200 children in Indonesia and Uzbekistan last year.
Indian authorities maintain that their tests confirmed the safety of the cough syrups. Maiden Pharmaceuticals, the Indian drugmaker responsible, declined to comment on these allegations.
As previously reported by Reuters, the parents of these 20 deceased Gambian children are currently pursuing legal action, seeking compensation of approximately $250,000 for each child. This case marks the most high-profile challenge ever faced by Gambia’s healthcare ministry, drug regulator, and Maiden Pharmaceuticals.
This case underscores the dangers associated with importing drugs into countries like Gambia that lack the means to independently test them before distribution. It demonstrates how tainted medicines can harm individuals across the globe, leaving victims with limited avenues for justice within the globalized economy.
The first court hearing is scheduled for July 17, followed by a 30-day adjournment period for the defendants to file their response, according to a court spokesperson.
In a lawsuit prepared pro bono by lawyers, the plaintiffs argue that authorities failed to uphold their own laws concerning the safety of imported drugs in Gambia. The suit alleges that the regulators neglected to inspect or test the cough syrups for adulteration, thereby breaching their statutory obligations. Furthermore, it claims that both the regulatory body and the health ministry failed to ensure medications were prescribed with the expected standard of care.
Gambia’s health ministry did not provide a comment. However, a letter from the ministry sent in June to the parents’ legal representatives, seen by Reuters, indicates that an inquiry is underway to investigate the incident.
In response to the deaths, the World Bank has approved funding for the construction of a medicines testing lab in Gambia. Environmental assessments are currently taking place, and construction will begin once these assessments are complete.
FEW OPTIONS
Gambia ranked third from the bottom in terms of health spending, with the World Bank reporting a spending of $18.58 per person in 2020.
The parents’ testimonies depict a healthcare system unable to provide effective assistance once the contaminated syrups were available in Gambian pharmacies. Reuters was unable to independently verify all the details outlined in the affidavits.
According to a Reuters analysis of the testimony, nearly half of the 20 affidavits reported delays in receiving urgent medical attention or a proper diagnosis as their children experienced symptoms such as vomiting, decreased urine output, and loss of appetite after taking the medicines.
Families recounted instances where their children’s treatment was delayed due to a lack of portable oxygen, leaks in intravenous drips that required repairs, or premature discharge from hospitals despite inadequate urine output for several days.
Desperate for better care, five families even took their children to neighboring Senegal. Tragically, all 20 children succumbed to the medicine’s effects within days of consumption.
One grieving parent, named Amie Jammeh, recounted taking her 2-year-old son Mafugi Jassey to a pharmacy in mid-August after he developed a fever. The pharmacist prescribed medications.
During this time, the Gambian health ministry had sent samples of the Maiden syrups abroad for testing. However, confirmation of the presence of deadly toxins did not arrive until September.
Two hours after the first dose, Mafugi began vomiting. Despite this, his mother continued administering the medicines for another two days.
When Mafugi’s condition failed to improve, Jammeh rushed him to the hospital, where she noticed he had stopped urinating. She waited three days for a doctor to visit, but by then, Mafugi was breathing rapidly and experiencing swelling in his stomach and limbs. The doctor indicated that Mafugi required surgery but needed a blood test to determine his blood type.
Tragically, as they awaited the test results, Mafugi passed away while strapped to his mother’s back.
CONFLICTS OF INTEREST
“Gambians, especially the poor, do not believe they can challenge the government and emerge victorious. Additionally, malpractice claims are often disregarded since most incidents occur in government-run hospitals and clinics,” said Loubna Farage, the lead counsel for the parents.
However, this case is different due to the tragedy’s scale, the pro bono legal representation, and the families’ frustration with the lack of accountability. One year later, neither Gambia nor India has penalized anyone for these deaths.
“Many African countries lack a robust regulatory authority,” stated Jude Nwokike, vice president of the Promoting the Quality of Medicines Program at U.S. Pharmacopeia (USP). “These countries struggle to adequately assess and approve medicines or monitor the quality of medications available on the market.”
The lawsuit also accuses Maiden Pharmaceuticals of falsely claiming their products were certified by the WHO. Maiden Pharmaceuticals did not respond to Reuters’ request for comment on this matter.
The legal action highlights potential conflicts of interest within Gambia’s pharmaceutical trade, as some regulators simultaneously hold supervisory positions in the very pharmacies they oversee.
Markieu Janneh Kaira, the executive director of the Medicines Control Agency, Gambia’s drug regulator under the health ministry, previously told Reuters in March that any potential conflicts of interest would not compromise the Agency’s oversight of the industry. He cited proper declarations and management to ensure that conflicted staff do not participate in the regulatory process.
Reporting by Edward McAllister; Editing by Michele Gershberg and Sara Ledwith
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