In the heart of Madhya Pradesh’s Chhindwara district, tragedy struck as at least 20 children lost their lives after ingesting contaminated cough syrups—a catastrophe that has sent shockwaves across India and reignited global concerns about drug safety. The culprit: diethylene glycol (DEG), an industrial chemical with a deadly history, found in quantities nearly 500 times higher than permissible limits in bottles of Coldrif syrup produced by Sresan Pharmaceuticals. As families mourn and authorities scramble for answers, the story unfolding is not just about a single batch of medicine gone wrong, but about systemic regulatory lapses that have haunted India’s pharmaceutical industry for decades.
According to the BBC, the World Health Organization (WHO) has voiced "deep concern" over gaps in India’s drug safety regulations following these deaths. The contaminated syrups—Coldrif, Respifresh TR, and Relife—were all found to contain DEG, a colorless, odorless liquid commonly used in antifreeze, brake fluids, solvents, paints, and plastics. While DEG is a staple in industrial applications, it is highly toxic to humans. When ingested, it can cause acute kidney injury, anuria, and even death. Symptoms often begin with vomiting, abdominal pain, and lethargy, quickly progressing to renal failure, as tragically observed in the children of Chhindwara.
The Times of India reports that the Coldrif syrup contained 46.28% DEG—staggeringly above the accepted threshold of less than 0.1%. The shock didn’t end with Coldrif. Gujarat state soon recalled two other syrups, Respifresh TR and Relife, after they too tested positive for DEG. Although Indian authorities assured the WHO that none of the contaminated syrups were officially exported, the global health body warned that such medicines could still reach other countries through unregulated distribution channels. This warning carries a chilling resonance: since 2022, cough syrups contaminated with DEG and ethylene glycol have been linked to over 300 child deaths worldwide, including 70 in The Gambia, 57 in Nigeria, and 105 in the United States as far back as 1937.
For many in India, this disaster feels all too familiar. As ABC News notes, the country has a long, grim history of fatal cough syrup poisonings, with hundreds of children’s deaths spanning decades—especially in poor, rural communities. Prashant Reddy, a lawyer and author of The Truth Pill: The Myth of Drug Regulation in India, told ABC, "It was only a matter of time before we saw another tragedy." He points to a pattern of regulatory neglect, where laws mandating testing for raw materials and final products exist but are rarely enforced. "It is a combination of both corruption and incompetence," Reddy said. "The question is, why was this not caught earlier? The law mandates annual inspections of each facility."
The regulatory failings are stark. According to a Tamil Nadu Drug Control department inspection cited by the BBC, Sresan Pharmaceuticals violated an astonishing 364 manufacturing rules—including 39 labeled "very serious" and 325 "major." The inspection report detailed a litany of horrors: poorly qualified staff, substandard water and equipment, lack of pest control, missing production monitoring procedures, and the absence of both a quality assurance and a data collection department. "Manufactured products are stored in a very unhygienic manner...Sewage was discharged without purification. Water for drug production was stored in an unhygienic manner," the report stated. The Indian Express described the site as "stark and unhygienic" with "stained concrete floors" and the "reek of hurried abandonment."
Authorities have moved swiftly in the wake of public outrage. The owner of Sresan Pharmaceuticals, G Ranganathan, a 73-year-old figure well-known in pharmaceutical circles, was arrested and the Chennai manufacturing facility was shut down. Tamil Nadu Health Minister Ma Subramaniam announced that the firm’s manufacturing license would be "permanently cancelled." In addition, a paediatrician who prescribed Coldrif was arrested for negligence. However, Indian medical groups argue that the root of the problem lies with regulators, not individual doctors, and have called for greater accountability from both manufacturers and oversight agencies.
Despite these actions, many experts remain skeptical that meaningful change will follow. Reddy, the legal expert, said, "These days, tragedies like this in India get wiped out of the front page quite quickly, and the government doesn't get to the root of the matter because the government's first instinct generally is to protect itself first, and then the pharmaceutical company. Somewhere in between, the truth disappears." This sentiment is echoed by veteran journalist Barkha Dutt, who bluntly told ABC, "This should not be thought of as an accident. All of these cough syrup bottles contain a toxin that is well beyond ... the permissible level. Heads should roll."
The broader context is sobering. India’s pharmaceutical industry is valued at $76 billion, with exports accounting for more than half its value. Yet, as the BBC and ABC report, regulatory scrutiny tends to focus on products destined for export, often neglecting those sold domestically. The WHO, for its part, has not received official information on the precise source of the DEG contamination or whether contaminated pharmaceutical material has been identified. Still, it has urged all countries to be vigilant for possible imports via informal channels.
The use of DEG in cough syrups is not an accident of chemistry but, in many cases, a result of cost-cutting. Pharmaceutical syrups typically use glycerine or propylene glycol as solvents—both considered safe for human consumption. However, some manufacturers substitute these with DEG to save money, or contamination occurs when industrial-grade solvents are used instead of pharmaceutical-grade ones. Reddy explained, "This is a known issue; they are supposed to be testing propylene glycol before they use it, the law mandates such testing. But it is very evident that a lot of pharmaceutical companies in India, especially smaller ones, aren't conducting this testing."
In the aftermath, Indian states have banned the implicated syrups, and some have prohibited the use of all cough and cold syrups for children under two. But for the families in Chhindwara and beyond, these actions come too late. As images of grieving parents and tiny coffins fill the news, the question remains: will this tragedy finally prompt the systemic reforms India’s drug safety regime so desperately needs?
While the world watches and waits, the deaths in Chhindwara serve as a stark reminder of the human cost of regulatory failures—and the urgent need for accountability in the medicines millions trust every day.
