It is now reported that 70 children have died from AKI while the number of children suffering from the condition has not been announced by the government until now. Not only is The Gambia government lackadaisical in responding to this crisis but it has also neither been transparent nor demonstrated any commitment in ensuring justice and accountability. Thus, it is necessary that citizens, CSOs, political parties and other stakeholders stand up more vigorously to demand that The Gambia government demonstrate greater leadership and responsibility in tackling this deadly crisis.
The evidence of the government’s lack of interest in justice and accountability can be found in their own words and actions since WHO issued a global medical product alert on October 5th. The alert identified four syrups which the WHO said failed to meet quality standards and are unsafe. AKI surfaced in The Gambia in June, but The Gambia government did not inform the WHO until September. It was WHO that disclosed that 66 children had already died.
Two days after the WHO issued its alert, President Barrow made an insensitive six-minute national address on October 7th because of public outcry and pressure. In his address, the president did not only spread blatantly false information but in doing so he was also making a calculated attempt to cover up and deny responsibility, as evidenced in this statement: “I must state that the child mortality figure of 66 is not at much variance with the recorded data for similar periods in the past.” Clearly this is an attempt to downplay, mislead and avoid responsibility
As if the attempt by the president to mislead and refuse to take responsibility was not enough, the following day the minister of health, Dr Ahmadou Samateh, staged a press conference to further mislead the public. In his October 8th press conference, Dr Samateh went into unnecessary sentimental rantings only to downplay the gravity of the crisis and run away from responsibility. To further distort issues, he viciously went after the WHO condemning them for announcing to the world about these drugs.
Dr Samateh knows that the WHO has a duty to inform the world of any major health issue that has international ramifications. The WHO was not informing Gambians. That was the responsibility of the Ministry of Health which failed to do as it should. For example, until now both the State House and health ministry have refused to disclose the names of the suspended importer and pharmacy. Why didn’t the minister inform Gambians that 66 children had died well before WHO did when it was the ministry that gave WHO those figures?
Further to the attempts by the president and the minister to mislead the public and refuse to ensure justice, next to play games was the IGP. On October 11th, the IGP issued what he called “a preliminary investigation” into the crisis. In his report, the IGP reported: “The deaths of these children are associated with four contaminated Indian-made baby syrups bearing the names MaKOFF Baby Cough Syrup, MaGrip n Cold Syrup, Promethazine Oral Solution BP, and Kofexmalin Baby Cough Syrup imported in The Gambia by Atlantic Pharmaceuticals Company Limited. It is established that from the aforesaid sum of 50,000 bottles of contaminated baby syrups, 41,462 bottles have been quarantined or seized by the Medicines Control Agency, and 8,538 bottles remained unaccounted for.”
If the IGP has reached the suspicion that the drugs which killed the children were imported by Atlantic Pharmaceuticals Company, one wonders why then has the IGP refused to raid the company’s offices and warehouses, confiscate suspected materials, arrest the owner and lockdown the premises? It is standard practice in law enforcement that those who engage in illicit business of such seriousness are raided, arrested, and locked up. But the IGP did not do that. Rather the police even left the syrup bottles in the custody of MCA which is also a subject of investigation. Therefore, the IGP’s preliminary report is another game intended to hoodwink the public that the government is investigating this matter when in fact they are not doing so.
Next is the State House press release of October 14th which also confirms that The Gambia government is not investigating these dangerous syrups. In that press statement the most telling portion is this paragraph: “The probe established that the Medicines Control Agency, MCA, was established by the Medicines and Related Products Act of 2014. At the time it started product registration in 2017, there were thousands of unregistered products in the country. This was due to a lack of testing facilities in The Gambia and the exorbitant costs involved in outsourcing the testing.”
What is the State House really trying to say here? Clearly it is obvious that the State House is trying to create an excuse for the MCA when it should be holding them accountable for failing in their functions. The Act was enacted in 2014 hence from that same year MCA should start to carry out its functions. It should not wait until 2017 to begin medicines registration and now said to have no testing facilities. Why? If The Gambia government is serious about the health and lives of citizens, why should MCA start work three years after its law was created and then to stay on for almost 10 years without a testing facility?
The Medicines and Related Products Act 2014 is a law that should be enforced by the MCA. There is no excuse whatsoever for failing to do so because if MCA fails to enforce the Act, it means people die as just happened with these deadly syrups. The Act empowers the MCA to license all importers and exporters of medicines and register all medicines. But MCA did not even develop its guidelines for licensing and registration until 2020, six good years after the Act came into force. So, what was MCA doing from 2014 to 2020 to control the entry of medicines into The Gambia?
In addition to the MCA, there is also the Pharmacy Council of Gambia (PCG) which was created under the Pharmacy Council Act 2014. The purpose of the Pharmacy Council is for the “promotion and protection of health and safety of the general public through safeguarding, maintaining and enforcing the highest standards in the practice of pharmacy and for connected matters.” Since 2014, what has the PCG also been doing until such a deadly crisis could erupt?
Both the MCA and the Pharmacy Council have a legal obligation as regulators to ensure that the health system is kept safe. The government – the president and the minister of health – have both policy and legal obligations to provide these institutions with the necessary resources, tools, and staff to do their work effectively and efficiently. Thus, the entry of these fake and deadly syrups is the failure of both the policy makers (the president and minister) and the regulators (MCA and PCG). For that matter, they must be seen taking responsibility and not diverting, distorting, and misleading issues just to cover up negligence and corruption.
Madi Jobarteh is a leading social activist.