Indonesia has banned the sale of all syrup medicines as it investigates the deaths this year of nearly 100 children, warning that the liquids may contain ingredients linked to fatal kidney injuries.
The move comes just weeks after the World Health Organization issued an alert over four Indian-made cough syrups that it said were potentially linked with acute kidney injuries and the deaths of 70 children in the Gambia.
Indonesia has said it is investigating 206 cases of acute kidney injury (AKI), mostly in children under the age of five, and 99 deaths, although it has said the real number of cases could be higher.
On Thursday the country’s health minister said two ingredients linked to AKI had been detected in products found in the homes of some of the patients.
“Some syrups that were used by AKI child patients under five [years old] were proven to contain ethylene glycol and diethylene glycol that were not supposed to be there, or of very little amount,” said Budi Gunadi Sadikin, according to Reuters. He did not specify how many.
In the WHO’s laboratory analysis of the contaminated products under investigation in the Gambia, ethylene glycol and diethylene glycol were found in “unacceptable amounts” in the samples.
The WHO said this month that, although the contaminated products had to date only been detected in the Gambia, “they may have been distributed to other countries”. All countries should find and “remove these products from circulation to prevent further harm to patients,” the WHO added.
However, Indonesia’s food and drug agency has said that the four cough and cold syrups in question in the Gambia, believed to have been manufactured by India-based Maiden Pharmaceuticals, were not available locally.
The health ministry has not said which brands of syrups it is investigating, instead imposing a blanket ban “as a precaution” on the sale of all liquid medicines. It has said the ban will continue until authorities have completed their inquiries into unregistered medical syrups suspected of containing ethylene glycol and diethylene glycol.
Indonesia has recorded a rise in the number of AKI cases since January, although a health ministry spokesperson said this week there had been a “sharp jump” since late August.
In the Gambia, where the 70 child deaths have prompted a national debate about drug regulation, the president, Adama Barrow, has ordered the building of “a quality control national laboratory for drugs and food safety” and promised a tightening of laws to ensure regulation is effective.
“I assure you all that the government will leave no stone unturned to get to the bottom of this incident,” he said in a statement earlier this month.
In a preliminary investigation report released on 11 October, Gambian police named four syrups manufactured by Maiden Pharmaceuticals that it said had been imported via a US-based pharmaceutical company.
The report, seen by Reuters, said the US company had ordered 50,000 bottles of the syrups, of which 41,462 bottles had been quarantined or seized, and 8,538 remained unaccounted for. Investigations are ongoing.
The WHO was approached for comment.
Reuters contributed to this report
