The unimaginable price of poor governance

The biggest mass poisoning by toxic medicine in the world in the last one hundred years perhaps occurred in Bangladesh as more than 2,700 children died in a decade since 1982. 

A report prepared by Scientific Committees of European Commission in 2008 listed nine countries including the US, India, Nigeria, Bangladesh, Haiti and Panama where incidents of mass poisoning by Diethylene Glycol (DEG) took place in the last century. But none of the countries witnessed deaths on as large a scale as Bangladesh. 

The first incident of mass poisoning was uncovered in the US in 1937 in which 105 children and adults died. According to the report, 21 people died in 1986 and 36 in 1998 in India, 88 in 1995 in Haiti, 47 in Nigeria in 1990 and 51 in Panama in 2006 (the death toll in Panama later, however, increased to at least 400.) 

The report indicates that 236 children died in Bangladesh in a short period of time—between 1990 and 1992. But the death toll in Bangladesh was more than 2,700 in one decade (from 1982 to 1992). And at least 28 young children died in 2009 due to poisoning by toxic paracetamol syrup. 

In Bangladesh, their deaths were no way an accident. In legal terms it was manslaughter due to gross negligence. Some pharmaceutical companies used poisonous chemicals in the production of paracetamol syrup for children. Their motive was to make money by using cheaper, but poisonous, Diethylene Glycol chemical which is used in tannery and battery industries. 

The syrup, instead of reducing fever and pain in children, had the opposite effect. Children began to experience acute problems including kidney failure, leading to the death of many. Parents came to know much later, the real reasons behind the deaths. Victims of mass poisoning in Bangladesh still await justice. 

When the first mass poisoning occurred in 1937 in the US, it was not possible for the authorities to take legal action against companies for producing toxic medicine. At the time, the food and drug law did not require that safety studies be done on new drugs. Sale of toxic drugs, although bad for business and a firm's reputation, was not illegal. The tragic incident led to the passage of the 1938 Food, Drug and Cosmetic Act which increased the Food and Drug Administration's power to regulate drugs. The new law gave the US a new system of drug control which provided superior protection while stimulating medical research and progress. It prevented any major drug tragedy in the US. 

There was a law to punish pharmaceutical companies for manufacturing toxic syrup at the time these tragic deaths took place in Bangladesh. The regulatory authority—the drug administration—failed to prevent companies from manufacturing and selling toxic syrup because of its poor governance. Bereaved families sought justice and cases were filed against some pharmaceuticals companies.

But that was the beginning of another tragic chapter due to misgovernance in the drug administration. In December 1992, chemical analysis proved that paracetamol syrups manufactured by five companies—Adflame Pharmaceutical Ltd, Polychem Laboratories Ltd, BCI (Bangladesh) Ltd, Rex Pharmaceutical, and City Chemical and Pharmaceutical Works Ltd—contained the lethal chemical Diethylene Glycol.

Criminal cases were filed against four manufacturing companies except City Chemical and Pharmaceutical Works Ltd which was not prosecuted apparently because the companies had close connections with the then ruling BNP.

Manufacturers of poisonous syrups have been able to escape punishment due to an extraordinary combination of corruption and mismanagement in the Directorate of Drug Administration (DDA) and other government agencies. 

In November 2003, a Mymensingh drug court acquitted the two owners of Rex Pharmaceutical of the charge of manufacturing toxic syrup questioning the integrity of the chemical tests. The court ruling, however, shows that the court was not informed of how the tests had been undertaken and the role of World Health Organization in ensuring their accuracy. Moreover, the court was also not told that the law in fact did not permit it to question the accuracy of the tests. But DDA never appealed the acquittal. 

Last year in March, three officials of Adflame Pharmaceuticals were sentenced to a severe 10-year imprisonment for manufacturing adulterated drug and six owners. And in August of the same year, a Dhaka court jailed six owners and employees of the now-defunct BCI (Bangladesh) for 20 years for producing lethal paracetamol. Most of them punished in the two cases were later released on bail. 

Failure to punish people responsible for manufacturing toxic drugs in the 1990s paved the way for another disaster in 2009 as at least 28 children died due to poisoning by toxic paracetamol syrup manufactured by another pharmaceutical company Rid Pharma. A probe committee formed by the government found poisonous chemical was used to manufacture paracetamol syrup by Rid Pharma. Diethylene glycol is used in the manufacture of unsaturated polyester resins, polyurethanes, and plasticisers.

A criminal case was filed against officials of Rid Pharma. But parents of the victims  could not imagine the shock when a drug court in Dhaka on November 28 acquitted all five officials of Rid Pharma of the charges.

What were the reasons behind the acquittal? According to the judgement released on Tuesday (December 6) two officials of the Drug Administration involved in the case against Rid Pharmaceuticals Ltd knowingly violated due procedure of law, and exhibited sheer negligence, inefficiency and incompetence in dealing with the case which led to the officials' acquittal. 

What can be more glaring examples of poor governance than the above cases? The incidents show how people become easy victims and expose the state's inability to deliver justice to these victims. Poisoning by toxic drugs shows our collective negligence and failure to save the lives of thousands of children. Only time will tell if more tragedy and horror await us in the coming days as a result of poor governance.

The writer is Special Correspondent, The Daily Star.