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‘Substandard, Unsafe’: WHO Issues Alert on 2 Indian Cough Syrups in Uzbekistan

The two cough syrups in question were linked to the deaths of 19 children in Uzbekistan in December 2022.

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The World Health Organisation (WHO) has advised against using the two cough syrups — e AMBRONOL syrup and DOK-1 Max syrup — that were linked to the deaths of over 18 children in Uzbekistan in December 2022.

In their alert issued on 11 January, WHO called both these made-in-India products 'substandard medical products', that are 'unsafe.'

What makes these products so dangerous?

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The alert issued by WHO said both the products were found to have unsafe levels of DEG contamination, and warned that their use, especially in children, may result in serious injury or death.

"Laboratory analysis of samples of both products, undertaken by national quality control laboratories of the Ministry of Health of the Republic of Uzbekistan found both products contained unacceptable amounts of diethylene glycol and /or ethylene glycol as contaminants."
WHO Statement

The alert also underscores that the manufacturer, Noida-based pharmaceutical company Marion Biotech, has not responded or assured the WHO of the safety and quality of these products.

Why it matters: According to WHO, Diethylene glycol (DEG) and ethylene glycol (EG) are toxic when consumed by humans.

Symptoms of DEG poisoning include, abdominal pain, vomiting, diarrhoea, inability to pass urine, headache, altered mental state and acute kidney injury which can also lead to death.

Moreover, this is not the first time cough syrups made in India have come under fire for having unsafe levels of DEG, having caused fatal consequences. India has had at least five incidents of DEG poisoning in the past, with little consequence.

The action taken: In Uzbekistan, officials had earlier arrested four people in connection to the deaths of the 19 children, including senior employees of the Scientific Center for Standardization of Medicines, who were in charge of testing the products. The state authorities in Uttar Pradesh have suspended the production licence of Marion Biontech, where the company's manufacturing unit is based.

The website of the company has since been taken down.

WHO's Advice: The WHO has advised people to not use these specific products, and to report to the National Regulatory Authority or National Pharmacovigilance Centre, if anyone has used them and experienced any reaction.

The WHO has also urged countries to increase surveillance within the supply chains of countries and regions where these products are sold.

National health authorities of countries have been asked to notify WHO if these products are discovered in their respective countries.

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