THE COUGH SYRUP CATASTROPHE

THE recent spate of child deaths in India from contaminated cough syrups starkly exposes a grave systemic failure in the nation’s pharmaceutical regulation.

- AMAL CHANDRA Author, policy analystand columnist. yy. AYEMEN FATIMA Clinical pharmacist

In early October 2025, at least twenty-four children in Madhya Pradesh’s Chhindwara district died of acute kidney failure after consuming Coldrif syrup—a medicine prescribed for the common cold. Three more fatalities in Rajasthan’s Sikar and Bharatpur districts, linked to another dextromethorphan-based syrup from Kaysons Pharma, brought the toll to twenty-seven.

Most victims, all under five, showed symptoms of diethylene glycol (DEG) poisoning—vomiting, abdominal pain and inability to urinate. On October 13, the World Health Organization (WHO) confirmed DEG levels as high as 48.6 percent in Coldrif batches, exposing a criminal disregard for human life.

In legitimate formulations, safe solvents such as propylene glycol or glycerin dissolve active ingredients. Unscrupulous manufacturers, however, replace these with cheaper, toxic DEG or ethylene glycol to cut costs. Once ingested, these chemicals destroy the kidneys and nervous system, and are often fatal to children.

This tragedy repeats a grim pattern, mocking India’s image as the ‘pharmacy of the world’. In 2022, Indian-made syrups contaminated with DEG killed 66 children in The Gambia and eighteen in Uzbekistan. Similar poisonings in Indonesia and Cameroon, linked to firms such as Maiden Pharmaceuticals and Marion Biotech, claimed hundreds of lives. Under global pressure, India tightened export scrutiny. Yet, its domestic market remains a regulatory Wild West where untested potions circulate freely. The double standard is unconscionable. Exports are policed, while poor Indians relying on cheap generics remain unprotected.