Chennai: A growing public health crisis has cast a harsh spotlight on India’s state-level response to pharmaceutical safety. While Tamil Nadu acted with remarkable speed to stop the sale of contaminated cough syrup, Madhya Pradesh remains mired in bureaucratic caution even as nine children have died, their families pointing to the same medications.
The controversy revolves around cough syrups Coldrif and Nextros DS, widely prescribed for fever and cough. In Madhya Pradesh, children who were given these syrups first developed fever, followed by vomiting, diarrhea, and abrupt cessation of urination a pattern consistent with Diethylene Glycol (DEG) poisoning. This deadly industrial solvent, previously responsible for mass child fatalities in Gambia in 2022, attacks the kidneys and can lead to rapid organ failure.
In Tamil Nadu, the response was swift and uncompromising. On October 1, after receiving a letter from Madhya Pradesh about batch SR-13 of Coldrif syrup, inspectors visited the Sresan Pharmaceuticals plant in Kanchipuram, despite a government holiday. They discovered 39 critical and 325 major violations of drug manufacturing norms, immediately drew samples, froze remaining stocks, and sent them for DEG and ethylene glycol testing.
Within 24 hours, laboratory analysis confirmed contamination: batch SR-13 contained 48.6% Diethylene Glycol and failed ethylene glycol tests. The Tamil Nadu government immediately banned the batch statewide, issued alerts to prevent further sale, circulated the distribution list to inspectors, notified neighboring states including Odisha and Puducherry, and ordered the manufacturer to halt production. Deputy Director of Drugs Control, S Gurubharathi, noted this as India’s first instance where inspection, sampling, testing, and a stop-production order were executed within two days, including holidays.
Madhya Pradesh, in stark contrast, has moved cautiously, leaving families frustrated and fearful. State Health Minister Rajendra Shukla maintains that tests so far have shown no substances linked to the deaths, while Sub-Divisional Magistrate Shubham Yadav points to kidney infections from common environmental causes like water contamination, rats, and mosquitoes. Sales of the syrups have been paused, but authorities insist on waiting for complete lab reports before taking decisive action.
Behind the official narrative, senior health officials quietly acknowledge the probable truth. Dr Prabhakar Tiwari, Senior Joint Director of the National Health Mission, admitted that renal biopsies point to kidney failure caused by a toxic substance, likely the contaminated syrups. The children Shivam, Vidhi, Adnan, Usaid, Rishika, Hetansh, Vikas, Chanchalesh, and Sandhya have left grieving families bewildered at the delay in action.
The situation in Rajasthan further complicates the national picture. Following three child deaths, State Health Minister Gajendra Singh Khimsar blamed the parents, claiming the medications were self-administered and not prescribed by government doctors, dismissing any fault on the part of the health department.
The stark contrast raises pressing questions for India’s public health system: If Tamil Nadu can test, confirm, and ban a toxic batch in under 24 hours, even during a holiday, why does another state stall while children die? The slow pace in Madhya Pradesh highlights the dangers of bureaucratic inertia in matters of life and death. Families are left asking why denial seems stronger than action even when confronted with irrefutable evidence of a public health emergency.
The tragedy underscores a critical need for a uniform, rapid-response protocol across states, ensuring that industrial negligence or regulatory gaps do not continue to cost young lives.