#StopFakeMeds #ThinkSmart
For 90 years, more than 27 deadly incidents linked to contaminated syrups have been recorded, causing hundreds of child deaths in the United States, Bangladesh, Haiti, Panama, Nigeria… Since 2022, a new wave has struck: The Gambia 66 deaths, Indonesia 200, Uzbekistan 68, Cameroon 12.
The warning often comes too late, when children are admitted to hospital with acute kidney failure. Death can occur in less than a week.
Manufacturers replace the excipients in syrups with ethylene glycol or diethylene glycol – toxic industrial solvents – to cut costs. These odorless and colorless substances easily slip through weak quality control systems.
The operating methods are well known:
- Purchasing excipients through opaque brokers, often impossible to trace;
- Absence or insufficiency of systematic batch testing, both at export and import;
- Outsourcing the production of excipients or syrups intended exclusively for export (“export only”), which are cheaper, not meant for domestic markets, and subject to far laxer oversight;
- Moving products across borders with weak or corrupt controls;
- Repackaging or relabeling without inspection, obscuring traceability.
Following the recent scandals in The Gambia and Uzbekistan, some producing countries have strengthened controls on export batches – a welcome step – but without applying equivalent requirements to domestic markets. This imbalance has led to new cases within their own borders, showing that targeted export controls alone are not enough to protect local populations.
The regulatory double standard between products for domestic markets – subject to stricter norms – and those exported to countries with weaker oversight capacities has become a real system: tolerated, and even tacitly encouraged, for commercial reasons.
Many importing countries lack the laboratories, human resources, or logistics to verify product quality upon arrival.
More importantly, they are heavily dependent on a small number of major exporters to supply their health systems. This economic and political dependency fuels reluctance to confront these partners and intermediaries: banning, sanctioning, or demanding stronger guarantees could disrupt supply chains or strain strategic alliances.
On the exporters’ side, between the defensive strategies of some – often combined with limited resources and weak sanctions – and the low level of public scrutiny in others, thousands of children remain exposed to fatal risks.
Mechanisms for shared responsibility and international cooperation already exist. The question is no longer how to act, but when.
See this recent case from India, which shows how the same tragic patterns continue today : lnkd.in/dENEPUFW
See the full, recent, exhaustive report issued by the UNODC and WHO on contaminated syrups unodc.org/pdf/publications/WHO-UNODC_landmark-report-on-c…
