The recent deaths of children linked to the Coldrif cough syrup have once again exposed one of the darkest corners of the pharmaceutical industry the recurring presence of Diethylene Glycol (DEG), a highly toxic industrial chemical that has killed thousands across the world for nearly a century. Despite repeated warnings and multiple mass poisoning episodes, this colorless and sweet-tasting liquid continues to find its way into medicinal syrups, transforming cures into killers.
What is Diethylene Glycol (DEG)?
Diethylene Glycol (C₄H₁₀O₃) is a clear, odorless, and viscous liquid belonging to the glycol family. It is widely used as an industrial solvent in the production of resins, paints, antifreeze, brake fluids, lubricants, and adhesives. It has no approved medical use and is never intended for human consumption. However, its sweet taste and low cost have made it a dangerous substitute for glycerin or propylene glycol, which are commonly used as solvents in pharmaceutical syrups and oral solutions.
Because DEG closely resembles pharmaceutical-grade solvents in appearance and consistency, unscrupulous or negligent manufacturers sometimes use it to cut costs. The consequences, however, are deadly. Once inside the body, DEG breaks down into toxic metabolites that attack the kidneys, liver, and nervous system, leading to irreversible organ failure and death especially in children.
Why is DEG So Lethal?
Even in minute quantities, DEG is a potent poison. The compound is absorbed quickly by the body and metabolized into 2-hydroxyethoxyacetic acid and diglycolic acid, substances that destroy kidney tubules and interfere with the body’s ability to filter toxins.
The initial symptoms of DEG poisoning may appear mild vomiting, abdominal pain, headache, and decreased urination. However, within 24 to 48 hours, the damage becomes catastrophic, leading to acute renal failure, seizures, paralysis, and coma. In many cases, death occurs within a few days. Survivors often suffer from lifelong kidney damage and neurological complications.
DEG poisoning is especially deadly for children because their organs are smaller, their metabolic rates are higher, and their systems cannot detoxify chemicals efficiently. A dose as small as 1 ml per kilogram of body weight can prove fatal.
How Does DEG Enter Medicines?
The contamination of medicines with DEG is not an accident of nature it is a product of human negligence and weak regulatory control. In India and several developing countries, pharmaceutical excipients like glycerin are often sourced from unregulated or unverified suppliers. Some manufacturers purchase cheaper, industrial-grade chemicals that are mislabeled or diluted with DEG.
In the Coldrif cough syrup case, investigators found unbilled containers of DEG at Sresan Pharmaceuticals’ factory in Kancheepuram, Tamil Nadu. Authorities discovered that the company had been adding 46–48% of DEG to its cough syrup a shocking violation of safety standards, given that the permissible limit is only 0.1%. The contaminated syrup caused the deaths of at least 20 children in Madhya Pradesh and Rajasthan.
This tragedy reveals a glaring failure of compliance with Good Manufacturing Practices (GMP). Experts say the absence of batch testing for raw materials, poor documentation, and lack of government supervision have created fertile ground for such disasters.
A Chemical With a History of Mass Deaths
The Coldrif incident is not isolated. Diethylene Glycol has been responsible for some of the deadliest pharmaceutical disasters in history.
In 1937, the United States witnessed the Elixir Sulfanilamide tragedy, where a company used DEG as a solvent for a new antibiotic formulation. The result was catastrophic 107 people, including dozens of children, died. This led to the enactment of the U.S. Food, Drug, and Cosmetic Act (1938), which for the first time required manufacturers to prove drug safety before marketing.
Decades later, in 1995–96, Haiti reported the deaths of 88 children from DEG-contaminated paracetamol syrup. Similar incidents followed in Panama (2006), where 365 people died from medicines made with DEG-laced glycerin imported from China.
In The Gambia (2022), at least 70 children lost their lives after consuming contaminated cough syrups traced to an Indian manufacturer. The World Health Organization (WHO) issued a global alert, warning all countries to strengthen testing of liquid medicines, particularly for children.
India itself has faced repeated tragedies from Kota (1972) to Mumbai (1986), and Jammu (2020) all caused by DEG-contaminated syrups. Each disaster has sparked outrage but little lasting reform.
Global Warnings and Regulatory Failures
After multiple incidents, the World Health Organization and national regulators, including India’s Central Drugs Standard Control Organization (CDSCO), issued strict guidelines to prevent DEG contamination. Manufacturers are required to:
• Test every batch of raw materials and solvents before use.
• Maintain traceability of all chemical suppliers.
• Obtain WHO-GMP certification to ensure adherence to international quality standards.
However, implementation has been weak. Many small and medium pharmaceutical firms operate without GMP certification, and routine audits are either delayed or incomplete. As per government data, nearly 1,470 pharmaceutical MSMEs in India still lack quality certification, creating serious risks in the drug supply chain.
The Pattern of Preventable Poisoning
Every DEG-related tragedy has followed the same pattern negligent manufacturing, inadequate oversight, and delayed accountability. Investigations are launched after deaths occur, but systemic reforms fade once public attention shifts. The pharmaceutical industry’s dependence on unregulated intermediaries for raw materials continues, while penalties remain minimal.
The Coldrif case underscores that India’s pharmaceutical boom must not come at the cost of human safety. As one of the world’s leading exporters of generic medicines, India bears a global responsibility to uphold the highest standards of production and testing.
A Poison That Should Never Be in Medicine
Diethylene Glycol is an industrial chemical not a medicine, not a solvent, and certainly not a safe substitute for glycerin. Every time it finds its way into a syrup bottle, it exposes a fatal weakness in the health system meant to protect the innocent.
The deaths of children from Coldrif syrup are not just statistics; they are a tragic reminder that when oversight fails, even a spoonful of medicine can turn into a death sentence. The world has learned this lesson repeatedly from Tennessee to Gambia, from Panama to India but has yet to act decisively.
Until manufacturers, regulators, and governments treat DEG contamination as a crime, not an accident, the haunting question remains unanswered:
How many more children must die before we ensure that what is meant to heal no longer kills?