A devastating wave of child deaths in India due to toxic cough syrups has reignited concerns over the nation’s fragile pharmaceutical oversight. In October 2025, at least 24 children in Madhya Pradesh’s Chhindwara district died after consuming Coldrif syrup, followed by three more deaths in Rajasthan’s Sikar and Bharatpur districts linked to another dextromethorphan-based syrup from Kaysons Pharma. All victims, aged below five, exhibited signs of acute kidney failure caused by diethylene glycol (DEG) poisoning.
The World Health Organization (WHO) later confirmed DEG levels as high as 48.6 percent in Coldrif batches a staggering violation of safety norms. In standard formulations, safe solvents like propylene glycol are used, but unscrupulous manufacturers often substitute them with cheaper, toxic DEG or ethylene glycol to reduce costs. Once ingested, these chemicals can cause irreversible kidney and nervous system damage, often proving fatal for young children.
Repeat of a Global Pattern
This tragedy mirrors past incidents that have tarnished India’s pharmaceutical image. In 2022, DEG-contaminated syrups made in India killed 66 children in The Gambia and 18 in Uzbekistan. Similar deaths were reported in Indonesia and Cameroon, tied to firms like Maiden Pharmaceuticals and Marion Biotech. Despite international backlash prompting tighter export checks, India’s domestic market remains largely unregulated a double standard that protects foreign consumers but leaves poor Indian families vulnerable.
Regulatory Collapse and Corruption
The Central Drugs Standard Control Organisation (CDSCO), India’s top drug regulator, has again come under fire. Tasked with overseeing a $50 billion industry, the agency is chronically understaffed and underfunded. Inspections began only after the recent deaths. At Tamil Nadu’s Sresan Pharmaceuticals the manufacturer of Coldrif authorities found abandoned premises, fake records, and no batch testing. Two inspectors were suspended, but these actions highlight systemic rot rather than accountability. WHO and UN officials have labelled the contamination “criminal negligence.”
Doctors and Commissions Under Scrutiny
The scandal also exposed unethical medical practices. In Madhya Pradesh, Dr. Praveen Soni was arrested for prescribing Coldrif and accepting commissions from the manufacturer. Similar complicity was seen in Rajasthan, where a drug controller and pharmacist were suspended. Despite long-standing health ministry advisories against cough syrups for children under two, enforcement remains absent.
Fragmented Oversight Across States
India’s fragmented regulatory setup worsens the problem. State drug controllers issue licences and conduct inspections, often leading to inconsistent enforcement. Tamil Nadu swiftly cancelled Sresan’s licences, while Gujarat merely recalled contaminated products without arrests. Such disparities allow rogue companies to exploit loopholes in the 1940 Drugs and Cosmetics Act, which imposes meagre penalties often as low as ₹1 lakh for adulteration.
Government Slow Response
Madhya Pradesh banned Coldrif on October 2, with a nationwide ban following nine days later, after the death toll rose. The CDSCO call for “strict compliance” has done little to rebuild public trust. While the Indian Council of Medical Research and Rajasthan expert panel have joined probes, critics say these are routine post-crisis rituals. WHO offer to assist in investigations was reportedly met with bureaucratic resistance.
A Policy Crisis Rooted in Deregulation
Analysts argue that India pharmaceutical boom has been fuelled by neoliberal deregulation prioritising industry growth over safety. Over 1,300 deaths worldwide in the last nine decades have been traced to DEG-laced syrups. Whistleblower Dinesh Thakur has long warned that weak laws and poor accountability enable such tragedies to recur.
The Way Forward
Experts say preventing future disasters requires deep structural reform. CDSCO needs independent funding, stronger inspectorates, and transparency. Each batch of medicine should carry a verifiable quality certificate from accredited labs. Adulteration must invite severe criminal penalties, including blacklisting and prosecution of negligent firms. Medical commissions should be publicly disclosed, and paediatric drug-use guidelines strictly enforced.
The deaths of 27 children are not isolated accidents they are the result of decades of institutional neglect. Accountability must extend from corrupt manufacturers to complacent regulators and policymakers. As public outrage grows, India faces a defining moral test: whether its pharmaceutical might will serve humanity or profit at any cost.