By Edward McAllister
Families of 20 Gambian children who died after consuming cough syrups made in India will take their government to court this month for allegedly mishandling drug imports – a rare step in one of Africa's poorest countries, where few have the means to challenge authorities.
The parents' allegations and testimony, detailed in court documents shared exclusively with Reuters, paint the most comprehensive picture yet of the panic, confusion and heartbreak caused by the drugs in an already stretched medical system.
From one mother who unwittingly continued to give her child toxic medicine for two days after he started vomiting, to a family forced to repair a leaking intravenous drip that the hospital had attached to their child, the affidavits show parents in desperation as children with originally minor ailments succumbed.
At least 70 children died from acute kidney injury in Gambia last year, cases the World Health Organization (WHO) linked to medicines made by Indian drugmaker Maiden Pharmaceuticals that were contaminated with diethylene glycol (DEG) and ethyleneglycol (EG), toxins normally used as industrial solvents and antifreeze agents.
Unscrupulous actors sometimes substitute a key ingredient with DEG and EG because they are cheaper, pharmaceutical experts say. Last year, medicines laced with DEG and EG also allegedly killed about 200 children in Indonesia and Uzbekistan.
India's government has said its own tests showed the syrups were safe, and Maiden, which did not respond to requests for comment for this story, has denied wrongdoing.
Now, as Reuters previously reported, parents of 20 of the children are taking legal steps, seeking about $250 000 (about R4.5m) in compensation for each child.
Three Gambian lawyers said this is the highest profile case of its kind against the nation's health ministry and the drug regulator, as well as against Maiden itself.
The case shows the risks of importing drugs into countries which – like Gambia – have no means of testing them before consumption.
It highlights how, in a globalised economy, tainted medicines can poison people across the world with no clear path to redress for victims.
The first hearing is scheduled for July 17. Then the case will be adjourned for 30 days to allow the defendants to file their response, a court spokesperson said.
The lawsuit, prepared by lawyers working for no fees, argues that authorities failed to uphold their own laws requiring they ensure that all drugs imported into Gambia are safe.
The regulator "did not take...any measures to inspect or test the cough syrups for the adulteration and thereby was in breach of statutory obligations," according to the suit.
It adds that the regulator and the health ministry failed to ensure that drugs were prescribed "with the expected standard of care."
Gambia's health ministry did not respond to requests for comment. In a June letter to the parents' lawyers, seen by Reuters, it said it had "initiated a number of steps", including a probe into the incident, which is currently under review.
After the deaths, the World Bank approved funding for Gambia to build a medicines testing lab. An environmental assessment is underway, after which construction will begin, a spokesperson said last month.