GAMBIA— The highly anticipated Presidential Task Force Report on the Acute Kidney Injury (AKI) Outbreak, has finally revealed that the 70 deaths of Gambian Children from AKI could be conclusively linked to the four cough syrups imported by Atlantic Pharmaceuticals from Maiden Pharmaceuticals in India.

The press briefing, which was moderated by the government spokesperson and presidential adviser on Diaspora, Ebrima G. Sankare, also witnessed the launch of two other reports: Acute Kidney Injury Outbreak and Causality Assessment Report.

The Minister of Health, Dr Ahmad Lamin Samateh led the press briefing & confirmed that AKI was brought on by the consumption of toxic levels of Ethylene Glycol (EG) and Diethylene Glycol (DEG) found in four syrups.

The tainted cough syrups are namely, promethazine oral solution BP, Kofexmaline baby cough syrup, MakoFF baby cough syrup, and MaGrip cold syrup.

Breaking down the task force’s report

Minister Samateh elaborated that AKI is a sudden onset of deteriorating function of the kidneys which manifests as Oliguria (diminished urination) or anuria (absent urination) and other symptoms such as oedema, confusion, nausea, vomiting, diarrhea, shortness of breath, and coma.

According to Dr. Samateh, the Ministry of Health was alerted on the 26th of July 2022, on the increasing number of children presenting at the Edward Francis Small Teaching Hospital with signs of AKI, with many of them succumbing to the disease.

Dr. Samatech added that the Epidemiology and Disease Control Unit of the Ministry was instructed to swing into action to get to the root of the problem.

Additionally, World Health Organization (WHO) was contacted for support in handling the outbreak, and an Incident Management System was set up and Co-chaired by the Ministry of Health and WHO, to manage the situation.

“Since this phenomenon was unprecedented in this country, it was very difficult to ascertain at first, what was causing the Acute Kidney Injury (AKI),” Dr. Samatech said.

The Committee suspected that AKI could be caused by drug toxicity since paracetamol toxicity was identified as the cause of AKI in some countries in the past.

The WHO Country Office helped to send patient samples and samples of the drugs used by the patients to laboratories in Senegal, Ghana, France, and Switzerland.

The Minister of Health said laboratory analysis confirmed that toxic levels of Ethylene Glycol (EG) and Diethylene Glycol (DEG) were found in the above-mentioned four syrups.

“The illegal use of DEG to replace glycerine or propylene glycol as a solvent in medication had been reported in some countries in the past,” the health minister added.

Dr. Samatech also noted that the Medicines Control Agency then sprang into action with a series of steps to remove the drugs from circulation, which steps included a ban on the sale and consumption of all Maiden Pharmaceutical products in The Gambia.

Moreover, this was followed by a recall of all products from the drug outlets and households, and the outbreak was controlled by November 2022, after the products were removed from circulation.

“We have never lost sight of the fact that sadly, 70 children died as a result of the outbreak. The AKI outbreak was a national tragedy…However, it was very important to establish the cause of the Acute Kidney Injury in a scientific way,” the Minister said.

The task force’s make stern recommendations.

The presidential task force recommended that the Government permanently revoke the importation license of Atlantic Pharmaceutical Company Limited and its directors.

The task force also recommended that the Government refer the matter of Sait Kebbeh, the Supervising Pharmacist for Atlantic Pharmaceuticals to the Pharmacy Council for appropriate disciplinary action.

Moreover, the Government through the Pharmacy Council, Ministry of Higher Education Research Science and Technology, and the University of The Gambia, to prioritize the establishment of a School of Pharmacy at the University of The Gambia to meet the growing demand of Pharmacists in the country.

Reacting to these recommendations from the Presidential Task Force on AKI, Dr. Samateh said the matter of Sait Kebbeh will be immediately referred to the Pharmacy Council for appropriate disciplinary action.

The task force also recommended for the Government of the Gambia through the MOH, review the laws and regulations surrounding the granting of importation licenses.

Moreso, to instill stringent conditions to ensure that importers are approved based on their qualification of operating with a sense of accountability and responsibility, rather than being principally driven by profit.

Reacting to the above recommendation, Minister Samateh said the Ministry of Health has retained an experienced firm that is currently carrying out a review of all health-related Legislation in the country and said this will be carried out as part of the ongoing review of the acts under the MOH.

“The Government of The Gambia through the Ministry of Justice and Ministry of Foreign Affairs should forthwith explore the possibility of instituting further legal action against Atlantic Pharmaceuticals and Maiden Pharmaceuticals, and should engage with the Government of India, to seek criminal and civil redress on behalf of families of victims of the AKI outbreak,” the report stated.

Minister Samateh said the Government is far advanced in exploring avenues for potential legal action against Atlantic Pharmaceuticals and Maiden Pharmaceuticals, as well as potential redress through engagement with the Government of India, and said Government is currently benefiting from legal advice from a top-tier international law firm.

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