Indian authorities have begun a criminal investigation into the contaminated cough syrups made by Maiden Pharmaceuticals. This move comes after the World Health Organization’s (WHO) warning of a possible connection between such syrups and deaths of kids in The Gambia. In a tragic and preventable turn of events, at least 69 of those children have died from acute kidney failure. Surveillance information on these cases indicates they are associated with syrups ingested within the last three months.
The WHO’s shocking warning flagged the concerns about the overall quality and safety of pharmaceutical products emerging from India. Syrups under investigation included concentrations of diethylene glycol up to a shocking 48.6%. This toxic industrial solvent is a known danger to human health and should never be included in any form of medicine. This incident isn’t just an outlier, but indicative of a deeply corrupt trend. Earlier in 2023, Indian-made cough syrups laced with diethylene glycol killed 70 children in The Gambia and 18 in Uzbekistan.
Cough syrups generally fall into two categories: sedatives that help children rest and bronchodilators that promote easier breathing. Today, physicians usually prescribe one class or the other—but not both together. With the increasing concern about dangerous cough syrup adulterations, scrutiny on prescribing practices and patient welfare is crucially needed.
“In recent years, diethylene glycol has claimed dozens of young lives,” an industry expert noted. “This situation exposes the rotting core of India’s drug oversight system, characterized by weak enforcement and regulation.”
The Indian health ministry is responding. They welcome their advice to healthcare professionals to be cautious when prescribing cough syrups for under-6s. In recent years, alarm has been growing over the reckless misuse of these drugs, especially among unregulated private practitioners. In rural areas, informal providers of care such as self-taught rural medical practitioners (RMPs) account for 75% or more of primary care visits. These practitioners often work outside of official parameters of medical education.
Dr. Kafeel Khan emphasized the role of parents in this crisis, stating, “Parents aren’t always well-informed, and they can become impatient. If a child’s cough or cold doesn’t improve in a couple of days, they often consult another doctor who will give a cough syrup.” This chain reaction can lead to the cycle of inappropriate medication use to continue.
Dr. Rajaram D Khare remarked on his cautious approach: “I don’t usually prescribe cough syrups for ordinary coughs and colds – except occasionally for comfort. If a child is coughing badly and can’t sleep, I may give a dose of a mild syrup just to ease the discomfort.”
Finally, the Indian cough syrup market is outpacing all other developing countries. It will fly up from $262.5 million in 2024 to $743 million by 2035, with an amazing annual compound growth rate of 9.9%. This forecast raises concerns among health experts about the potential for further mishaps if regulations do not improve alongside market growth.
Dinesh Thakur highlighted a major issue, noting that many patients rely on local chemists for medical advice, often mistaking them for qualified pharmacists. “In 10 out of 10 times in rural India, that is a wrong assumption,” he stated.
Yet cough syrup prescriptions are fraught. In India’s steadily worsening polluted cities, daily coughs in children are typically due to allergic conditions and irritation with little to no infections involved. This often misdiagnosis can result in cough syrups that offer no therapeutic benefit but can cause injury being prescribed.
According to anecdotal evidence, this issue seems to disproportionately harm smaller towns and rural areas across India. Yet, recent data shows that its tradition reaches further. An unnamed source commented. And we see this same attitude among high density urban residents as well. Even by the standards of the drug supply in small towns and rural India, it’s much worse. It instead lands far short of the quality seen in bigger cities.
Recent deaths associated with Maiden Pharmaceuticals’ cough syrups have renewed calls for a systematic policy approach. This framework must underlie the production and distribution of cough syrups across India. Public health advocates stress the need for nationwide awareness campaigns aimed at educating both medical practitioners and parents about the dangers associated with improper cough syrup use.