Short analysis of the Vitamin A scandal: 12.03.13

Picture Courtesy: Taskin Al Anas

A nationwide Vitamin A Plus Campaign was held in Bangladesh today. It has been observed that earlier warnings of 'substandard' drug products were disregarded by health authorities, especially the Vitamin A capsules which were supplied from an Indian source, Olive healthcare. Despite concerns raised by the WHO (which funded the campaign project), the Health Ministry decided to continue with its campaign using the same drugs despite rescheduling the campaign twice, citing fact that the drugs had been evaluated successfully by a Singaporean laboratory (approved by the WHO).

At the end of the day, it seemed a bad move. Many children became sick and online reports talked about some patients experiencing a vomiting sensation and feeling unwell. Children were reported sick at Chittagong, Cox's Bazaar and Lakhsmipur among other places. Rumours of death were also reported with one report claiming a child had died from administration of Vitamin A capsule, a claim doctors firmly denied.

Sub standard drugs are those drugs which have lost their potency/activity either due to a defects in their formulation, loss of active ingredients and/or presence of non-compatible excipients (extra ingredients in the product). They are never a safe choice for human beings in general and should have been a no-brainer for rejection in case of children. 

On further research, it is found that in healthy children, Vitamin A supplements actually lead to side effects such as diarrhea and vomiting sensations. Research has found that for children who were not starving, vitamin A supplementation actually increased the risk of diarrhea compared with the placebo group. The vitamin A-supplemented children also had a 67% increased risk of coughing and rapid breathing, signs of further lung infection, although this problem did not appear in children infected with AIDS. Vitamin A provided no benefit to the well-nourished kids. Therefore, it makes sense to not give vitamin A supplements to children unless there is a special reason to do so, such as the presence of a condition causing malabsorption (e.g., celiac disease). 

Whether the nationwide sickness incidents have been caused by substandard drugs or side effects of vitamin A on healthy children is certainly a matter for investigation. The move by the Health Ministry to form a 4 member probe committee in this regard is certainly a move in the right direction. Such campaigns are important in a developing country like Bangladesh, but so is the dissemination of information regarding any side effects of drugs used in such campaigns and/or the presence of any substandard drugs. Its high time our government realized that society and civilization in the information age just don't go anymore with rhetoric and grumpy assurances.