A joint report by the World Health Organization (WHO) and the United Nations Office on Drugs and Crime (UNODC) has exposed the deadly impact of contaminated medicines, which continue to kill and harm patients worldwide, particularly children.
The report, “Contaminated Medicines and Integrity of Pharmaceutical Excipients Supply Chain,” reveals that over the past nine decades, at least 25 incidents of toxic excipient contamination have resulted in more than 1,300 deaths globally.
Most victims were children in low- and middle-income countries (LMICs), where weak regulatory systems make populations more vulnerable to substandard medicines.
According to the report, toxic industrial chemicals such as diethylene glycol (DEG) and ethylene glycol (EG) are being illegally used in place of pharmaceutical-grade ingredients like propylene glycol and glycerin. Even small amounts of these substances can cause severe poisoning and death.
The report notes that WHO issued seven global Medical Product Alerts since October 2022 after discovering contaminated liquid medicines—many marketed for children—circulating in LMICs. Two more alerts were raised for falsified bulk chemicals misrepresented as pharmaceutical-grade excipients.
The crisis gained attention after a tragedy in The Gambia, where 66 children died from consuming toxic cough syrups. Similar outbreaks in Indonesia and Uzbekistan claimed at least 268 more lives, prompting further WHO warnings.
The joint investigation uncovered evidence that organized criminal groups are exploiting gaps in the global medicine supply chain. These groups falsify labels, substitute industrial chemicals, and distribute toxic ingredients through online platforms, including e-commerce and social media.
Regulatory oversight of excipient manufacturers remains inadequate in many countries, while post-market surveillance and enforcement mechanisms are described as “seriously lacking,” the report warns.
WHO and UNODC are calling for urgent reforms to tighten regulation and monitoring of pharmaceutical excipients. WHO stresses the need for robust regulatory systems to ensure the safety of all medicines, while UNODC highlights the need for criminal justice measures to dismantle networks trading in falsified and toxic ingredients.
The report calls for closer international collaboration, stronger investigative capacity, and the application of legal frameworks such as the United Nations Convention against Transnational Organised Crime (UNTOC).
Governments, regulators, law enforcement agencies, and pharmaceutical manufacturers have been urged to take immediate steps to prevent further tragedies. “Protecting children from preventable poisoning must be a global priority,” the report concludes.
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