Devouring books from a young age, Sheena Almaera Maryam had been excited about her first day of kindergarten near Jakarta.

But when she developed a fever in September 2022, the syrup she was prescribed turned out to be toxic. It ravaged her internal organs. Now the five-year-old spends her days lying in a room lined with Hello Kitty wallpaper, staring blankly up at a baby mobile, her mother Desi Permatasari says.

Sheena is one of hundreds of children from Gambia to Uzbekistan found by national authorities and the World Health Organization (WHO) to have been poisoned by contaminated medicinal syrups in the past two years, in one of the largest episodes of such contamination on record. The rash of poisonings led to criminal probes and lawsuits in at least four countries, a surge in regulatory scrutiny, and families with children dead or disabled.