Moajungshi Menon
The Madhya Pradesh tragedy exposes the cracks in India’s pharmaceutical system and the danger of blind trust.
India, often celebrated as the pharmacy of the world, is today grappling with a painful contradiction. In Madhya Pradesh, 22 children have lost their lives after consuming what was supposed to be a simple cough syrup. The medicine, meant to comfort sick children became the very thing that killed them. This horrifying incident, which has shaken families and ignited national outrage, is more than an isolated accident, it is a mirror reflecting the deeper cracks within India’s pharmaceutical and regulatory systems.
The cough syrup, branded Coldrif and manufactured by Sresan Pharmaceuticals in Tamil Nadu, was found to contain dangerously high levels of diethylene glycol (DEG), a toxic chemical used in paints and industrial products. Laboratory results showed the syrup contained nearly 48.6% DEG, an astonishingly lethal amount. The parents gave their children the syrup, trusting their doctors, their pharmacists and above all, the safety of medicines approved for sale. Within days, the children developed kidney failure, a cruel fate caused by what should have been a cure.
But this tragedy did not come out of nowhere. It was a disaster long foretold. Years of warnings, ignored audits and neglected responsibilities paved the way for this catastrophe. The Comptroller and Auditor General of India (CAG) had previously highlighted glaring gaps in Tamil Nadu’s drug safety system, noting that inspections were irregular and testing of medicine samples fell far below required standards. Despite these official warnings, little changed. When deaths began to occur in Madhya Pradesh, it became painfully clear that the warnings had been wasted.
Investigations have since revealed that the manufacturer failed to conduct the mandatory testing of raw materials and final batches, a direct violation of the Drugs and Cosmetics Act. Every batch of medicine is legally required to be tested in a licensed laboratory before release to the market, but in this case, that crucial safeguard was ignored. The company also neglected to print the required warning label stating that the syrup should not be used for children below four years of age. Furthermore, drug inspectors in Tamil Nadu, the very officials responsible for oversight had not inspected the plant for months. After the deaths, they were swiftly suspended but the loss of innocent lives cannot be undone by such late gestures.
What makes this tragedy especially haunting is that it is not the first of its kind. In the past few years, Indian-made cough syrups have been linked to child deaths in The Gambia, Uzbekistan and Cameroon all due to similar contamination with diethylene glycol or ethylene glycol. Each time, the pattern repeats: international outrage, domestic promises and temporary crackdowns. And yet, the root causes which is weak enforcement, corruption and indifference remain untouched.
This raises a fundamental question: can the public, most of whom have no medical or scientific knowledge, really trust the companies that manufacture their medicines? Ordinary citizens do not have laboratories in their homes. They cannot test what they buy from the pharmacy. They rely completely on the honesty of manufacturers and the vigilance of regulators. When that trust is betrayed, the result is devastating.
The poor, the rural families and the uneducated, those least equipped to question or verify become the easy victims of a careless system. For them, a doctor’s prescription and a sealed bottle from a chemist represent safety. But when that system fails, it exposes the helplessness of ordinary people who depend entirely on others for their health and safety.
This is not just a matter of regulation; it is a matter of moral duty. Pharmaceutical companies are not selling biscuits or cosmetics, they are dealing with human lives. The slightest negligence can mean the difference between life and death. When profit becomes more important than ethics, when testing is skipped to save money and when accountability is absent, the consequences are catastrophic.
The government, too, cannot wash its hands of responsibility. It is the duty of the Central and State Drug Control Authorities to ensure that every medicine reaching the market is safe. India has the laws and infrastructure in place but they are often undermined by inefficiency and lack of transparency. Reports suggest that inspections are often done on paper, samples are rarely verified independently and violators get away with small fines or brief suspensions. Such leniency has made negligence a habit rather than an exception.
India’s pharmaceutical industry is one of the largest in the world, supplying affordable generic medicines to over 150 countries. This should be a source of national pride. Yet, it becomes a source of shame when Indian-made medicines are linked to deaths both at home and abroad. The world cannot trust India’s medicines if India itself cannot guarantee their safety. Being the “pharmacy of the world” should not just mean being the cheapest but it must also mean being the safest and most ethical.
Reform is not optional; it is urgent. Every batch of medicine must be tested, verified and documented. Inspection reports should be made public to ensure transparency. Regulatory agencies must be strengthened with independent oversight. Manufacturers found guilty of negligence should face criminal prosecution, not symbolic punishment. Doctors and pharmacists must also act responsibly, ensuring that medicines prescribed especially to children come from verified and compliant manufacturers.
The tragedy in Madhya Pradesh is a national wake-up call. Behind every dead children are real faces, grieving parents and shattered communities. Their only mistake was trusting a system that failed them. If India wishes to uphold its global reputation, it must begin by protecting its own citizens first. Medicines must heal not harm and trust, once broken, must be rebuilt through truth, accountability and reform.
In the end, the question remains painfully clear, in a nation that dreams of curing the world, can its own people trust the medicines they buy? Until the answer is a confident yes, every cough syrup bottle on a pharmacy shelf will carry not comfort, but a shadow of fear and one cannot help but wonder, are the people of this country merely guinea pigs, experimented on with untested and unsafe medicines outside the laboratories meant to protect them?
