DRUG FROM HELL! Top Indian Firm Troikaa, Distributor Abacus in Hot Soup as Fake Anaesthetic Drug Paralyzes Uganda’s Surgery Wards

KAMPALA — A storm has engulfed Uganda’s pharmaceutical sector following the revelation that the deadly anaesthetic drug Bupitroy Heavy (Bupivacaine 0.5%), recently recalled by the National Drug Authority (NDA), was manufactured in India and distributed locally by one of East Africa’s largest pharmaceutical giants — Abacus Pharma (A) Limited.

The NDA’s “Class A” recall, the highest possible level signaling life-threatening risk, was triggered after reports from hospitals and clinics indicated that the drug was failing to deliver the expected anaesthetic effect during surgical and labour procedures.

According to NDA spokesperson Abiaz Rwamwiri, preliminary investigations discovered that the recalled batch of Bupitroy Heavy did not contain key active components as indicated in its registration profile — a finding that suggests either gross manufacturing negligence or deliberate product adulteration.

“This drug poses an immediate and serious danger to patients. Continued use during surgery could lead to fatal outcomes,” warned Rwamwiri in a Tuesday briefing.

The Drug at the Heart of the Scandal

Bupitroy Heavy, a spinal anaesthetic agent, is designed to block pain during major medical procedures — from C-sections and dental surgeries to orthopaedic operations.

It contains Bupivacaine Hydrochloride, a potent local anaesthetic that numbs the nerves and suppresses pain transmission.

But instead of easing suffering, the substandard version that found its way into Ugandan hospitals may have exposed patients to excruciating pain during operations, and potentially fatal complications.

Though NDA says no deaths have yet been confirmed, sources within several health facilities in Kampala and Gulu told this publication that multiple patients complained of feeling pain during procedures, prompting medical teams to switch to alternative anaesthetics.

Abacus Pharma — The Local Distributor in the Spotlight

At the centre of the recall is Abacus Pharma (A) Limited, one of Uganda’s most dominant pharmaceutical players.

Documents obtained by this news outlet show that NDA has ordered Abacus to file a detailed report by Thursday, listing all clients supplied with the defective drug — including hospitals, pharmacies, and clinics — and indicating which of them have responded to the recall notice.

Established in 1995, Abacus is Uganda’s largest drug distributor by market share, boasting 41 branches and 7 warehouses across the country.

The company employs over 1,200 staff and maintains distribution partnerships with over 30 multinational pharmaceutical companies, importing and distributing over 600 products ranging from prescription drugs to surgical equipment.

Abacus also operates manufacturing facilities producing large volume parenteral (LVP) and small volume parenteral (SVP) injectables — including sterile water for injection, eye and ear drops, and nasal solutions — under popular brands such as XSONE, CIPROCIN, and ABNAL.

The company’s headquarters are located along Coronation Avenue, within the UMA Show Grounds in Kampala, and its reach extends across Kenya, Tanzania, Rwanda, and Burundi.

The company’s founder and CEO, Ramesh Kumar, an Indian national, has so far not issued any public statement regarding the recall. Repeated attempts by this publication to reach Abacus’s senior management by phone and email were unsuccessful by press time.

The Indian Connection: Troikaa Pharmaceuticals

The manufacturer of the defective drug, Troikaa Pharmaceuticals Ltd, is a research-driven Indian firm headquartered in Ahmedabad, Gujarat, and founded in 1983.

Troikaa is well known for innovations in pain management and critical care, and boasts operations in over 120 countries.

The company claims to uphold strict quality control standards and is celebrated for inventing the world’s first painless diclofenac injection, a milestone in modern drug delivery.

However, the NDA’s laboratory tests found that the Bupitroy Heavy batch imported into Uganda lacked key elements present in the approved formula, suggesting possible manufacturing lapses or product tampering along the supply chain.

This discovery prompted the NDA to deregister the drug entirely, with Rwamwiri confirming that no re-importation will be permitted without exhaustive re-evaluation of both the manufacturer and product composition.

Public Health Implications and Regulatory Questions

The recall raises troubling questions about the effectiveness of Uganda’s drug monitoring systems and the degree of oversight exercised over foreign-manufactured pharmaceuticals.

While NDA maintains that every imported drug undergoes batch verification before market release, this incident suggests that defective drugs can still slip through regulatory filters — sometimes with catastrophic potential.

Health experts warn that anaesthetics fall within a category of high-risk medications, meaning even small deviations in formulation can have life-threatening consequences.

Dr. Lydia Nansubuga, a medical anaesthetist at Mulago National Referral Hospital, told this publication that any compromise in the potency of such drugs could “render surgeries unbearable and endanger patients’ lives.”

“When spinal anaesthesia fails during surgery, patients may experience pain mid-procedure, forcing doctors to either administer risky emergency alternatives or halt the operation. That’s how dangerous this situation is,” she said.

Accountability and Fallout

The NDA has since dispatched inspectors to verify the recall compliance among hospitals, pharmacies, and distributors.

Meanwhile, sources at the Ministry of Health confirmed that an inter-agency team has been formed to audit the procurement and importation records of all anaesthetic drugs distributed in the country over the past two years.

The Class A recall means all stocks of Bupitroy Heavy must be immediately withdrawn, quarantined, and returned to the NDA for destruction.

Hospitals and pharmacies that fail to comply risk license suspension or prosecution under the National Drug Policy and Authority Act.

A Pattern of Weak Oversight

This is not the first time Uganda has faced challenges with substandard or counterfeit imported pharmaceuticals.

In 2022, the NDA recalled an Indian-made Paracetamol suspension after it was found to contain unsafe impurity levels, and in 2023, fake anti-malarial drugs infiltrated private clinics in western Uganda.

The repeated incidents raise alarms over the reliability of import verification systems, particularly for products sourced from high-volume manufacturing hubs like India and China, which supply over 70% of Uganda’s pharmaceutical imports.

What Lies Ahead

As investigators dig deeper, the scandal threatens to expose deeper cracks in Uganda’s medical supply chain governance and pharmaceutical accountability framework.

For now, the NDA has urged the public and health professionals to remain vigilant, and report any side effects or suspected cases of the recalled drug via its toll-free hotline.

But for many patients who unknowingly received the compromised anaesthetic, the recall has come too late.

The big question remains: How did a defective, potentially deadly drug pass multiple layers of inspection — from India’s export controls to Uganda’s regulatory gates — and end up in patients’ veins?

Until that question is answered, the recall of Bupitroy Heavy stands as a chilling r

eminder that in the business of medicine, negligence kills just as surely as disease.