Children poisoned in Uzbekistan: Is corruption to blame?
Published by Radio Azatyk
Children poisoned in Uzbekistan: Is corruption in the health care system to blame?
Saida Mirziyoyeva visits children in a hospital in Chust District
Dozens of children have been admitted to hospitals in Uzbekistan with symptoms of poisoning amid a Government campaign to combat iodine deficiency. This is the second scare in a year to have rocked the country after imported cough syrup killed 65 children last winter. However, this time the Government’s culpability is much clearer.
If Saida Mirziyoyeva, the eldest daughter and chief advisor to Uzbekistan’s President, Shavkat Mirziyoyev, is visiting children in a hospital far away from the capital, it probably means that something serious has happened. When a Minister openly urges journalists “not to investigate the incident” it is a sure sign that someone has something to hide.
For more than a week now, Uzbek media and social networks have been reporting hundreds of sick and dozens of hospitalised children who took medicines approved as part of a national campaign to combine iodine deficiency.
The authorities have so far been unwilling to admit the campaign’s link to the children’s condition – understandably so. Last winter’s death of children who took cough syrup imported from India sparked outrage over the lack of oversight and alleged corruption in the fast-growing pharmaceutical market. And while there have been no fatalities in the latest poisoning incident, it remains a highly sensitive issue for the Government, which purchased seemingly overpriced iodine deficiency prevention drugs intended for 6.5 million children.
As reports began to emerge last week of children being hospitalised in Namangan and Andijan provinces, questions were raised about the responsibility of officials. So far, everything points to “some kind of conflict of interest”, said Alisher Ilhamov, CEO of Central Asia Due Diligence, a UK-based research company. “Was there a kickback for officials? Or did the firm have a relationship with someone influential at the highest level?”, said Ilhamov when speaking to the Azattyk media outlet.
“Social media hype”
On 23 September during a visit to Namangan oblast, Mirziyoyeva stated that the Prosecutor General’s Office had opened a criminal investigation into the hospitalisation of 70 children in the area. Photographs published on Mirziyoyeva’s official Telegram channel show her in a hospital ward where the children are being treated. A statement said that she was in the region on behalf of her father, whose office had earlier expressed concern about the children’s hospitalisation.
“We went to the hospital to see the situation for ourselves and were briefed on the children’s condition. They were in good spirits and everyone is recovering slowly, with most having returned home to their families”, said Mirziyoyeva in a statement on Telegram. No information was provided on the investigation into the poisoning.
The drug “Antistrumin”
On 27 September, Deputy Health Minister Elmira Basitkhanova, stressed that a link between “Antistrumin” potassium iodine tablets produced by the Samo local pharmaceutical company and the children’s illnesses “had not yet been proven”, suggesting that this sudden spike in illness was more likely related to influenza. Despite this, the Ministry of Health suspended the use of Antistrumin on 22 September.
Speaking to the Gazeta.uz news website this week, Orif Inamov, a doctor working at the Republican Scientific Centre for Emergency Medical Care, said that Antistrumin cannot cause intoxication. “If the dosage is high, it is excreted with urine”, said Inamov, who refused to talk to reporters on why the children had to have their stomachs pumped, or provide any information on the results of blood tests carried out on the young patients. Instead, he blamed the increase in the number of patients on “hype” generated on the internet, saying that most children did not require serious treatment.
However, Nodirbek Ishchanov, an independent Uzbek medic and the most popular doctor on Uznet with 3.6 million subscribers on YouTube thinks differently. In a video released earlier this week that attracted more than a million views, Ishchanov said that a document published by the Health Ministry prescribed huge dosages of the drug and that taking such quantities could have damaging effects.
“Provocative” reporting of the tendering exercise
Ishchanov stated that the Ministry’s recommended iodine dosage for older children is 1,000 milligrams and 500 for younger ones. This is several times higher than the doses approved by the World Health Organisation, whose recommendations had earlier been posted on a website dedicated to the iodine deficiency campaign, he said.
So how did all this come about? Was it an overdose or problems relating to the quality of the drug? Was it a simple error or perhaps a misprint that has caused suffering to children across the country? Anything is possible.
However, the situation naturally focused attention on the drug’s manufacturer, Samo, and how it managed to secure a major supply contract.
The President of Uzbekistan, Shavkat Mirziyoyev
The Gazeta.uz investigation has raised new and uncomfortable questions. On 26 September, the website quoted data from the State procurement portal which stated that Uzmedimpex, a department within the Ministry of Health, purchased Antistrumin in two batches comprising more than 3.5 million packs at a price of 5,500 soums per unit in 2022 ($0.45) and 6,600 soums per pack ($0.54) this year.
However, Gazeta.uz has been able to confirm that Antistrumin was available during this period from several online pharmacies in Uzbekistan at a retail price of around 3,000 soums per pack. This could mean that not only did the Government not receive a discount for bulk purchases but actually paid twice the retail price for the drug. Pharmacies are no longer advertising Antistrumin but at least one of them confirmed to the website that the price was the same.
In a press statement issued on 27 September, an Uzbek Health Minister, Amrillo Inoyatov, denied the drug was available at a much lower price, saying such claims were “untrue” and “provocative”. The aide added that his department had tried to offer a lower price, but that this had been rejected by Samo. The company, he admitted, was the only bidder for the supply contract.
“A token of appreciation”
The fact that Gazeta.uz was not invited to the press conference and had to report on what was discussed using information relayed by the journalists who were there is indicative of the grim climate for journalism in Uzbekistan.
The major private media outlet, Daryo, whose correspondents attended the press conference posted but then deleted a report on statements made at the event. The latest version of Daryo’s report did not mention Inoyatov’s appeal to journalists not to cover the story. “There are organisations that are looking into this and they carry out their work quite openly”, said Inoyatov.
On 25 September, the Ministry of Health said that it had launched its own investigation into Samo’s involvement. The simplest of checks before signing the contract with the pharmaceutical company could have raised concerns.
Several Uzbek media outlets and bloggers have published evidence showing that the company is essentially a family business: all four founders have the same surnames and patronymics. One of them is Nodir Yunusov, an Uzbek national pictured in photographs from events promoting the iodine deficiency campaign.
According to the Kun.uz news website, Yunusov looks very similar to a man with the same name who has been pursued by the US Government for more than ten years on “human trafficking, human rights violations and financial extortion” charges. A Samo spokesperson, whom Kun.uz contacted with questions about Yunusov’s identity, blocked the outlet’s telephone number.
Several Uzbek officials have been accused of accepting a bribe of more than $33,000 from an Indian citizen who works for Quaramax Medical. The bribe was allegedly paid to circumvent mandatory drug trials.
Reuters reported on 16 August that Raghvendra Pratar, the Indian facing charges, told the court that he saw the payment to officials as a “token of his appreciation”.