Toxic Cough Syrup Deaths Expose Deeper Health Crisis in India
A recent cluster of child deaths in India has once again cast a harsh spotlight on the nation’s struggle with contaminated medicines and a deep-rooted over-reliance on cough syrups. The tragedy brings a grim sense of déjà vu, highlighting systemic failures in both regulation and medical practice.
In early September, at least 19 children, aged one to six, died in a small town in Madhya Pradesh. Weeks of investigation revealed the cause: their kidneys had failed after consuming a common cough syrup tainted with 48.6% diethylene glycol, a toxic industrial solvent. This follows similar incidents in Rajasthan and echoes international scandals in 2023, where Indian-made syrups were linked to the deaths of nearly 90 children in The Gambia and Uzbekistan.
Each new tragedy exposes cracks in India’s drug oversight system. Critics point to a fragmented market with numerous small-scale manufacturers and a weak regulatory framework that fails to prevent contaminated products from reaching consumers. While the health ministry has responded by seizing samples and ordering investigations, experts argue this addresses only part of the problem.
The issue runs deeper than manufacturing errors; it is embedded in India’s cultural and medical “obsession with cough syrups.” The market for these products is projected to soar from $262.5 million in 2024 to $743 million by 2035, despite growing evidence that they offer little therapeutic benefit for most common coughs, which are typically viral and resolve on their own.
Experts explain that the widespread use of these syrups is driven by several factors:
- Weak Primary Healthcare: In rural India, up to 75% of primary care is provided by informal, untrained practitioners who often rely on syrups as a go-to remedy. Patients also frequently seek advice from local chemists who may not be qualified pharmacists.
- Parental Pressure: Anxious parents often seek a quick fix for a child’s cough and may consult multiple doctors until one prescribes a syrup.
- Gaps in Medical Knowledge: Even trained physicians may prescribe syrups inappropriately. Dr. Kafeel Khan, a pediatrician, notes that some doctors prescribe mucus-thinning syrups to toddlers who cannot spit, risking aspiration into the lungs.
- Misdiagnosis of Coughs: With rising air pollution, many persistent childhood coughs are allergic rather than infectious. These coughs respond better to targeted treatments like inhalers, yet syrups remain a common, less effective prescription.
“I don’t usually prescribe cough syrups for ordinary coughs and colds—except occasionally for comfort,” says Dr. Rajaram D Khare, a Mumbai-based pediatrician, emphasizing that the main goal is temporary relief, not treatment.
Ultimately, the recurring deaths highlight a dual crisis: a regulatory system struggling to ensure drug safety and a healthcare culture that promotes the overuse of potentially harmful and ineffective medicines. The challenge is underscored by the Madhya Pradesh doctor who prescribed the fatal syrup, who defended his actions by stating, “I’ve been prescribing this cough syrup for 15 years.”
