NEW DELHI: An unnamed middleman in Mumbai provided a crucial raw material used in Indian-made cough syrups that have been linked to the deaths of more than 70 children in Gambia, a chemicals trader involved in the supply chain said.

The World Health Organisation said last year the syrups, made by Indian manufacturer Maiden Pharmaceuticals Ltd, contained lethal toxins ethylene glycol (EG) and diethylene glycol (DEG) used in car brake fluid. These ingredients can be used by unscrupulous actors as a substitute for propylene glycol (PG), which is a key base of syrupy medicines because they can cost less than half the price. The children who died were mostly under age 5 and died of acute kidney injury, some within days of taking the syrups.

India’s drugs regulator told the WHO in December that the propylene glycol used in the syrups came from Goel Pharma Chem, a Delhi-based pharma-supplies company, and was “recorded to have been imported” from South Korean manufacturer SKC Co Ltd.

Sharad Goel, whose eponymously named company is based in north Delhi, said he had bought the ingredient in sealed barrels but not directly from SKC. “We bought the propylene glycol from an importer in Mumbai who bought it from SKC,” Goel said in February, speaking out for the first time.

“I can’t name the supplier — we have business links that we need to keep,” said Goel, adding his company had “not done anything wrong.” He said his business was “just a trader and we pass on sealed barrels that we get. We can do nothing with them.”

He said that after the Gambia poisonings, his company had stopped selling PG but continued to supply other products such as starch, and that he generally buys most of his products from 8-10 importers.

Goel subsequently stopped answering calls and when a reporter called at his business twice in April, it was locked. Workers at a neighbouring factory said they had not seen it opening in the past few months. SKC said it had never supplied any PG either to Goel or to Maiden.

If true, Goel’s claim would point to a missing link in investigations by Gambia, India and the WHO into the contaminated products. The clue comes as the WHO and Gambia’s government say the search for a culprit has been stymied by a lack of information from India.

India’s drugs regulator said in December its own tests found no toxins in the syrups, but its factory inspectors did earlier find that batches of medicine may have been incorrectly labeled, according to a notice it sent to Maiden.

It has not made clear how, in light of that, it can be sure it tested the correct batch.

India’s health ministry did not respond to questions about the alleged intermediary or about any of the other issues raised in this story.

Asked to comment on the claim there was a middleman in the supply chain, the WHO’s lead investigator said inquiries have reached a “dead end” due to a lack of information from the Indian authorities and the drugmaker.

“If you ask and you don’t get informed, it’s a dead end,” Rutendo Kuwana, the WHO’s team lead for incidents with substandard and falsified medicines, said in an interview on March 31.

Published in Dawn, April 30th, 2023