UHC-Partnership: A bright future for safe medicines in The Gambia

Binta, a mother of two from Banjul, recalls the harrowing months of the acute kidney injury crisis in 2022 with a mix of relief and sorrow. Her children were spared, but her friend lost a child to the tainted cough syrup during the crisis that had gripped the country.

"It was terrifying time," Binta says. "We didn't know which medicines were safe."

In July 2022, The Gambia's Ministry of Health alerted the public and WHO to a surge in acute kidney injury cases amongst children. Acute kidney injury, characterized by a sudden and rapid decline in kidney function, can be fatal if not promptly treated.

From July to September 2022, 78 cases were reported, with 66 confirmed deaths, a staggering 85% mortality rate.

WHO stepped in to provide support, issued a medical product alert, and started investigations into four potentially contaminated cough syrups. It collaborated closely with the Gambian Medicines Control Agency, a bastion of public health protection which plays a pivotal role in ensuring the safety, efficacy, and quality of medical products in The Gambia.

As a quick response, the Government recalled the syrups from all pharmacies and homes by implementing an urgent door-to-door campaign. It prohibited the consumption of all paracetamol or promethazine syrups and advised people to take pills instead, which limited further deaths.

It also directed importers and retailers to stop selling all varieties of paracetamol syrups. Since The Gambia has no laboratory for testing, it shipped the medicines abroad for testing and the results revealed contamination.

The experience underscored the huge significance of a robust regulatory system to ensure that medicines and medical products are safe for the population to use. This is a crucial element of a strong health system, which is fundamental for achieving universal health coverage.

Robust regulation is essential for health

The crisis became a turning point for the Medicines Control Agency to implement meticulous scrutiny of every medical product entering The Gambia, replacing the previous practice of random sampling.

Over some years, WHO, through the UHC Partnership, has provided technical support to the Medicines Control Agency and Ministry of Health, facilitated partnerships, and invested in capacity building and training initiatives to support a stronger regulatory system for medical products.

WHO accelerated actions and support during the acute kidney injury crisis to avert even greater loss of life across the nation and followed it up with increased technical support. Today the Medicines Control Agency is stronger than ever, backed up with amended legislation for a more efficient and safe system.

"The partnership between the Medicines Control Agency and WHO has been instrumental in transforming our regulatory capabilities. Through WHO's expertise and support, we've enhanced our framework, ensuring the safety, efficacy, and quality of medical products in The Gambia. This collaboration has not only strengthened our operations but also empowered us to uphold the highest standards of public health protection. Together, we are paving the way for a safer and healthier future for our nations," says Tijan Jallow, Director of Operations, Medicines Control Agency.

Safe medicines for all

^{WHO's Risk Communication Expert, Aziza Amina Sahid engages Chief Ebrima, his three wives, and children during the house-to-house recall of Paracetamol syrup and other drugs amidst the acute kidney injury (AKI) outbreak response, fostering community awareness and safety.
Photo credit: WHO Gambia/Mr Monik Bhatta}

Looking to the future, WHO remains a steadfast ally in the Medicines Control Agency's quest for regulatory excellence. Together, they envision a healthcare landscape where every stakeholder is mobilized to uphold the highest standards of medical regulation. From community engagement initiatives to promoting international best practices, the collaborative efforts between WHO and the Medicines Control Agency serve as a beacon of hope for a safer, healthier future for The Gambia and beyond.

"Universal health coverage can only be achieved when there is affordable access to safe, effective, and quality medicines and health products. Ensuring that all medicines are safe, effective, and available to the entire population is foundational to ensure strong primary health care and health for all" said Dr Jane Maina, WHO Interim Country Representative to The Gambia.

As The Gambia continues to navigate the complexities of healthcare regulation in the 21st century, it is making solid steps towards achieving these health ambitions. A robust approach to health security is an essential part of ensuring a healthy future for all.

The UHC Partnership operates in over 125 countries, representing over 3 billion people. It is supported and funded by Belgium, Canada, the European Union, France, Germany, Ireland, Luxembourg, Japan, the United Kingdom of Great Britain and Northern Ireland, and WHO.

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