The public is being shocked by the case of Acute Progressive Atypical Kidney Failure in children or GGAPA which has occurred in more than 260 children. In response to this situation, the Faculty of Public Health (FKM) Universitas Indonesia (UI) as an educational institution in the field of public health held the 23rd series of online seminars on Friday, October 28, 2022. The seminar themed “The Surge in Cases of Acute Kidney Failure in Children: A Public Health Perspective” was well received by the public, academicians, and practitioners.
One of the strong suspicions of the cause of GGAPA is the poisoning of compounds commonly used as solvents in liquid medicines. Therefore, the Head of the Food and Drug Monitoring Agency (BPOM), Dr. Ir. Penny K. Lukito, MCP, was present to discuss the safety assurance system at BPOM. “This drug does have the possibility to be the cause of death or morbidity in GGAPA, but there are many other aspects that we need to investigate,” explained Dr. Penny. Furthermore, Dr. Penny explained the licensing process to drug supervision, the role and institution of BPOM, pre-post market supervision regulations, GGAPA cases, BPOM’s follow-up, and also BPOM’s strategy in preventing adverse events (AEFI) and strengthening quality assurance. In her presentation, Dr. Penny extensively discussed that epidemiological investigations play an important role. 
At this seminar, Dr. Iwan Ariawan, MSPH, Lecturer of the Department of Biostatistics and Population FKM UI who also is a Biostatistics Consultant for GGAPA case control research at RSCM, was present to discuss the epidemiological investigation of GGAPA. In the health sector, determining cause and effect is not as easy as cause precedes effect. This is because the cause of a disease is usually multifactorial. “Currently, a case control study is being conducted so that we can get valid evidence that certain things are actually the cause of GGAPA,” said Dr. Iwan.
Besides Dr. Iwan and Dr. Penny, there was also Dr. Pandu Riono, Ph.D, a lecturer at the Department of Biostatistics and Population FKM UI, commonly known as Juru Wabah. “This case of drug poisoning is not the first time this has happened, therefore, suspicion of this is very reasonable,” said Dr. Pandu. According to Dr. Pandu, there are 5 (five) things that need to be done when a spike in mysterious disease cases occurs: conduct epidemiological investigations, strengthen disease surveillance, conduct literature reviews, conduct rapid analysis and rapid solutions, and conduct transparent communication. 
To discuss Ethylene Glycol and Diethylene Glycol, two compounds suspected of causing GGAPA, were present Professor of FKM UI, Prof. Drs. Bambang Wispriyono, Apt., Ph.D., and Dean of the Faculty of Pharmacy UI, Prof. Dr. apt. Arry Yanuar, M.Si. In his presentation, Prof. Bambang explained how the two compounds cause poisoning in the body. The presentation was then complemented by Prof. Arry regarding the metabolism of Ethylene Glycol in the human body.
According to Prof. Bambang, cases of disease epidemics due to misuse of chemicals in pharmaceutical products will continue to have the potential to emerge. Therefore, periodic evaluation of regulations and implementation of distribution permits and supervision of chemical products in food, beverages, and pharmaceutical preparations are needed. Prof. Arry also provided several recommendations, including withdrawing the sale of drugs outside pharmacies. This is intended so that all drugs in circulation can be stored according to standards considering that each drug has special provisions in terms of storage. (BK)
