This "mixture" (not sure where this term came from...) contains paracetamol and Diphenhydramine Hydrochloride - an antihistamine. NAFDAC (sorry website is "down" (12/12/08)) is said to have revealed that the a batch of the teething mixture included lethal doses of a toxic chemical; Diethylene glycol. This is an organic solvent, also used as an engine coolant which upon metabolic conversion is toxic to the kidney. The Vanguard reports that ...the contaminated ingredient used in the formulation of the killer paracetamol drug, "My Pikin" was obtained in the open market at Ojota, Lagos. Dora Akunyili, director-general, National Agency for Food, Drugs Administration and Control, NAFDAC, confirmed that 15 children died at the Lagos University Teaching Hospital, LUTH, eight died at the Ahmadu Bello University Teaching Hospital, ABUTH, Zaria, and two deaths were recorded at the University College Hospital, UCH, Ibadan.
We had the "normal" responses from the concerned parties in our beloved country as we have come to expect....
- NAFDAC bans "My Pikin" Teething Mixture !!!!
- NAFDAC announced said it had arrested the chemical dealer who sold the chemical to Barewa Pharmaceuticals, makers of "My Pikin" (and I not even know that NAFDAC had powers to arrest!).
- Managing Director of Barewa Pharmaceuticals Limited, Mr. Kola Okunola, the manufacturer of the alleged contaminated teething mixture, My Pikin was himself arrested!
- An "antidote" has been ordered according to the BBC.
- There were calls for Professor Dora Akunyili, Director General of NAFDAC perceived by many (and some say by herself) as a superhero to resign, siting the recent resignation of the Indian Security Chief in Mumbai the aftermath of the bombings there...now really that would be totally un-Nigerian!
- Akunyili claimed that NAFDAC was not notified of the wave of kidney-failure related deaths in children early enough by LUTH...
- Chairman of MDCAN, a Consultant Pediatrician Dr. Edasanmi Temiye, MDCAN described Akunyili’s response as “highly provocative, abusive and distractive to the course of finding a lasting solution to this current problem.”
....and while the arguing has continued..there are to many questions here that no one is really asking...
- Simple question? What is a "teething mixture"? Is "teething" a medical condition that requires treatment? What are the symtoms of "teething" that requires treatment? I have been asking around if any of my colleagues in Nigeria or anywhere else in the world has been taught this as a medical condition in medical school...have not found any yet! I am priviledged to have been taught pharmacology by the present DG of NAFDAC in medical school...I have gone back to my notes and found nothing! Finally the Medical and Dental Consultants Association of Nigeria.....is asking the same questions.
- What are the procedures by which NAFDAC actually registers new medicines. Clinical trials are how new medicines as tested and approved around the world. Does NAFDAC carry out independent clinical trials or do they rely on trials carried out in other settings with more resources. If this is the case where and when were the trials for My Pikin conducted. The name "My Pikin"...literally means "my child". The bottle is a picture of a happy mother with her smiling baby. What regulatory agency will allow a medicine, any medicine be named "my child" ???
- When a child has fevers associated with teething, a most common condition in childhood he/she should be seen by at the very best a primary care physician and would not require anything more than paracetamol. What are our "best" tertiary institutions doing managing fevers during teething???
- Outbreaks are a fact of life...even in the most advanced countries. Often they result from infectious diseases but could be as a result of chemicals as in this case. Does the MoH have an emergency response plan, infrastructire and outbreak response capacity to investigate and respond to outbreaks beyond asking NEMA do deliver blankets.
- Finally....why is it that after the celebrated successes of NAFDAC are medicines still being openly sold in every open market in Nigeria.
I bet ...it is only a matter of time before we find the next 25 children that have died in another cluster! ...unless someone sits down to think of answers to the questions above.....
...do you want to bet?