Uzbekistan is moving to tighten rules on how medications and dietary supplements are advertised in the wake of a national scandal over the death of dozens of children administered tainted cough syrup.

Under the decree approved by President Shavkat Mirziyoyev, television and radio advertising for medicinal goods will from July 1 only be permitted with prior express permission from the Health Ministry.

Drug companies will from that date furthermore be required to start developing customs and warehouse facilities designed in conformity with good storage practice, or GSP, requirements. From the start of 2026, it will become illegal to store medicines in warehouses without a GSP certificate.

Drug companies are also being required to create a procedure for providing regulating agencies with evidence that they are complying with the terms of their business operating licenses at least once a year. In instances where members of the public raise the alarm, more stringent quality assurances will be needed, the decree notes.

The way in which drugs are imported and retailed in Uzbekistan has come under heavy scrutiny in Uzbekistan since late 2022, when reports began spreading of children dying in large numbers as a result of taking a widely prescribed cough syrup called DOK-1 Max. At least 65 children are known to have lost their lives. Most of the victims were under three years old.

Marion Biotech, the Indian company that produced the tainted drug, has said that up to 20,000 vials of DOK-1 Max “were delivered throughout Uzbekistan.” There is no information about how many of the doses were sold in pharmacies before the drug was banned.

Fully 21 people, including Sardor Kariyev, who was until the scandal broke the director of the state Pharmaceutical Industry Development Agency, are currently on trial over the DOK-1 Max scandal.

During that trial, the court was told by Raghvendra Pratar Singh, the head of Quramax Medikal, which imported and distributed DOK-1 Max, that his company paid a $33,000 bribe to representatives of the drug regulator to avoid an audit of Marion Biotech products.

The court also heard that Quramax Medikal made regular payments to doctors, nurses and pharmacists to prescribe or promote DOK-1 Max. Overall, the company paid Uzbek healthcare professionals more than $600,000 to fuel the syrup’s prescriptions, it was alleged.