The Indian government has ordered pharmaceutical company Riemann Labs to cease operations after the cough syrup it manufactures allegedly led to the death of at least six children in the western African nation of Cameroon in March.

The move comes amid New Delhi’s crackdown on drug makers whose medicines exported internationally have been linked to dozens of fatalities across several countries in Africa and Central Asia.  

Riemann, which operates out of Indore in the central Indian state of Madhya Pradesh, has been banned from manufacturing medicines following an inspection by both state and federal drug regulators, Deputy Minister for Health & Family Welfare Bharati Pravin Pawar told the parliament, according to a Reuters report. The official did not specify whether the drugmaker’s license was also suspended.  

The government’s action comes close on the heels of the World Health Organization’s (WHO) revelation in June that a batch of cough and cold syrup sold in Cameroon under the brand name Naturcold contained extremely high levels of a toxic ingredient.  

Earlier, the licenses of three cough syrup manufacturers – Maiden Pharmaceuticals Ltd, Marion Biotech and QP Pharmachem – were suspended and their exports were stopped after two of the firms were linked to the deaths of at least 70 children in Gambia and 19 in Uzbekistan last year. The companies have denied the allegations.  

The crackdown on the companies comes amid reputational risks for India’s $41 billion pharmaceutical industry after tests conducted by the WHO and other agencies showed that medicines supplied from India contained toxins. 

Last year’s findings by the WHO suggested that the cough syrups made by Maiden Pharmaceuticals and administered to children in Gambia contained the lethal toxins ethylene glycol and diethylene glycol, which are used in car-brake fluid. These toxins could have been substituted for propylene glycol because they are less than half the price of the key ingredient for cough syrups. The children, who died after being given the cough syrups, were mostly below the age of 5. 

In its probe related to the supply of contaminated cough syrups across the world, the WHO flagged that seven India-made products and another 13 drugs on the list originated in Indonesia, whose consumption led to more than 200 deaths.   

Indian health officials have admitted that the global body’s allegations “adversely impacted the image.” In an attempt at damage control, the government introduced a new rule that took effect on June 1 that requires companies to obtain a certificate of analysis from a government laboratory before exporting medicines. Globally, India ranks third in terms of pharmaceutical production by volume and 14th by value. India’s pharmaceutical industry comprises an estimated 3,000 drug companies and around 10,500 manufacturing units.