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Tainted syrup medicine imported from India was the cause of an outbreak of kidney failure that killed more than 60 children in the West African nation of Gambia last year, according to a report by a team of international experts.

The report, submitted to the Gambian health ministry earlier this year and not yet made public, is the most definitive statement yet on the cause of the episode. It contradicts the official position of Indian authorities, who insist that the country’s products weren’t to blame. A director for the Gambian ministry of health didn’t respond to calls and an emailed request for comment.

Although the committee was able to establish that a child drank the contaminated medicine from an Indian drugmaker, Maiden Pharmaceuticals Ltd., in only 22 deaths from so-called acute kidney injury, or AKI, it said that symptoms in 30 others were consistent with the poison’s effects and no other cause could be found. It lacked enough information on 13 more cases. 

“The outbreak of AKI in children in the Gambia is attributable to medicines contaminated with DEG/EG,” the committee concluded, referring to the two contaminants, diethylene glycol and ethylene glycol.

Last year’s outbreak sparked concerns about the quality of generic medicine from India, an export powerhouse that calls itself the “pharmacy of the world.” Those concerns intensified this year when exported syrups from two other Indian manufacturers were found to be tainted in the same way, leading in one case to about 20 deaths in Uzbekistan.

“We have made our stand clear that as per our testing, the product had no issue,” said Rajeev Raghuvanshi, the Indian drug controller general, in a text message to Bloomberg. He referred further questions to the health ministry, which didn’t respond to requests for comment. A representative of Maiden also didn’t respond to inquiries.

India’s central government this week imposed a new regulation requiring cough syrup to be tested by a government lab before it can be exported.

Products from Maiden, a small New Delhi firm, fell under suspicion in Gambia last September, when health officials investigating the outbreak arranged tests of several drugs given to children prior to their deaths. Three labs in three different countries would eventually confirm the presence of the contaminants in Maiden products, the committee said in its report. 

The World Health Organization issued a public alert in October and Gambia recalled the drugs.

“After the poisonous medicines were withdrawn, there were no further cases,” said Kalle Hoppu, one of the committee members, in an email to Bloomberg. He called that “a very definitive sign that this outbreak was caused by these medicines.” Hoppu is a former director of the Poison Information Center at Helsinki University Hospital in Finland.

Indian authorities have defended the drugs. In December, the Indian drug controller general at the time, V.G. Somani, told the WHO that his organization’s own tests of Maiden drugs found no contamination. He went on to accuse the agency of acting on flimsy evidence and having “adversely impacted the image of Indian pharmaceutical products across the globe.” As recently as March, the Indian government said in a statement that the drugs weren’t tainted and didn’t kill anyone. 

Earlier reports by a Gambian parliamentary committee and by the U.S. Centers for Disease Control and Prevention both pointed to the Maiden drugs as the most plausible explanation for the outbreak. But the report by the 11-member expert committee was the first charged specifically with establishing the cause. 

The panel was set up by Gambia’s health ministry and consisted of five clinicians from local hospitals, two WHO officials, and four consultants from Senegal, Finland, and the UK. It was chaired by Abdou Niang, a nephrologist and professor at Cheikh Anta Diop University in Senegal. Members met for a week in December, and Hoppu said the report was submitted to the health ministry sometime around February. It’s unclear why the report has not been made public.

At the time the committee convened in December, Gambian authorities had logged 70 deaths of children suffering from AKI. Of those, the committee couldn’t get detailed information on 13, and it concluded that one death wasn’t consistent with AKI. That left 56 deaths that it examined in detail. The children in this group were about two years old on average, the committee report said.

In only four of the 56 cases did the committee find a possible alternative or contributing cause, such as Covid-19 or severe malaria. That left the 22 it tied to consumption of Maiden drugs, and 30 others where consumption of the drugs wasn’t established but the symptoms were consistent with exposure to the contaminants and no alternative cause was found. The report noted that parents can’t always recall the brand of medications they give their children. 

Bengaluru, May 19: Congress has not invited AAP chief Arvind Kejriwal, BSP’s Mayawati, BRS’ K Chandrasekhar Rao, BJD’s Naveen Patnaik and YSR Congress’ Jaganmohan Reddy for Siddaramaiah’s swearing in on Saturday in Bengaluru where the party intends to display a show of strength of the Opposition.

West Bengal Chief Minister and Trinamool Congress supremo Mamata Banerjee will not attend the ceremony despite being invited to the ceremony in Kanteerava stadium but deputed Lok Sabha Deputy Leader Kakoli Ghosh Dastidar for the event. 

Mamata, who “conveyed her best wishes” after Siddaramaiah and other leaders personally invited her, not sending Sudip Bandhyopadhyay or Derek O’Brien is seen as a signal by the Trinamool Congress that it is not so much thrilled by the Congress victory and it does not want to give much lee-way in Opposition politics.

Congress’ decision not to invite at least five parties to the function, sources said, is part of positioning in respective states. The Congress is at loggerheads with AAP in Punjab and Delhi where state leaders are up in arms against any sort of link with the Kejriwal-led party and had vehemently opposed when central leadership leaned towards it.

Though BRS was its comrade-in-arms in Parliament, the upcoming Telangana elections and Rao’s allegiance to the regional party bloc has generated suspicion in Congress circles. The state unit is also against any signal to BRS. 

BSP’s Mayawati is another leader the Congress has not invited. BSP has so far kept itself away from any Opposition grouping in the recent past and the Congress does not consider that Mayawati is in any way inclined to join the Opposition.

YSR Congress and BJD have also scrupulously kept themselves away from the Opposition and though there are demands from a section of the Opposition, they have not given any signal.

Leaders from parties like DMK, NCP, RJD, CPI(M), CPI, Shiv Sena (UBT), JMM, National Conference and Samajwadi Party have been invited to the function. Some more parties are also on the list.

With the Congress inviting Chief Ministers like MK Stalin, Nitish Kumar, Mamata and Hemant Soren, the omission of Kerala Chief Minister Pinarayi Vijayan has raised eye-brows. Congress sources said nothing much should be read into it, as only party leaders are invited and an invite has gone to CPI(M) General Secretary Sitaram Yechury.

However, there are indications that the Congress kept the political situation in Kerala in mind during discussions while preparing the invitee list. 

Mangaluru: The Puttur town police have detained nine Hindutva activists and are on the lookout for another accused in connection with the case of an alleged derogatory banner. 

Those detained Hindu activists have been identified as Abhi alias Avinash, Shivaram, Chaithresh, Eshwar, Nishanth, Deekshith, Guruprasad, Madhav and Vishwanath.

A black condolence banner with the pictures of former chief minister D V Sadananda Gowda and BJP state president Nalin Kumar Kateel had sprung up near the KSRTC bus stand in Puttur after the May 13 assembly poll results. 

The black banner, decked with a garland of footwear, offered “condolences” to Gowda and Kateel for ensuring a humiliating defeat to the BJP candidate in the Puttur Assembly segment. Due to a triangular contest, BJP candidate Asha Thimmappa Gowda, who polled 37,558 votes, was pushed to third position.

MLA Ashok Kumar Rai Kodambady had polled 66,607 votes and defeated BJP rebel independent candidate Arun Kumar Puthila by a margin of 4,149 votes. The BJP supporters, who have been trolling Kateel on social media, installed the banner taking potshots at the caste miscalculations of both Kateel and Gowda. Later, the Puttur police intervened and had the banner removed.