WHO Warns of Toxic Indian Cough Syrups

The World Health Organization (WHO) has issued a global health alert regarding three Indian‑manufactured cough syrups—Coldrif, ReLife, and Respifresh TR—that are contaminated with a toxic industrial chemical. This warning comes in the wake of tragic child fatalities in Madhya Pradesh tied to one of these syrups. The alert underscores serious failures in drug safety regulation and has implications for both domestic and international public health vigilance.

Background: Child Deaths and WHO Intervention

Fatalities in Madhya Pradesh

• In Chhindwara, Madhya Pradesh, 21 children died due to acute kidney failure after consuming Coldrif syrup.
• The alarming number of fatalities prompted immediate state and national investigations, eventually attracting global attention from WHO.

WHO Identifies Contaminated Syrups

WHO confirmed that specific batches of,

1. Coldrif (Sresan Pharmaceuticals)
2. ReLife (Shape Pharma)
3. Respifresh TR (Rednex Pharmaceuticals)

were found to contain dangerously high levels of diethylene glycol, with Coldrif testing at 48.6% DEG, far above acceptable limits. DEG is not approved for human consumption and can lead to fatal poisoning, particularly in children.

WHO described the products as posing serious and potentially life-threatening risks, advising all countries to inspect supply chains and report detection of any affected batches.

Diethylene Glycol: A Deadly Chemical

Diethylene glycol (DEG) is not approved for use in medicines. It is toxic to humans and especially dangerous for children, causing,

• Vomiting and abdominal pain
• Neurological issues
• Acute kidney injury
• Death in severe cases

This is not the first DEG-related tragedy. Similar contamination has caused child deaths in Gambia, Indonesia, and Uzbekistan in recent years.

Regulatory and Legal Fallout

Manufacturing Violations

• The Central Drugs Standard Control Organisation (CDSCO) and state authorities found over 300 serious violations at Sresan Pharmaceuticals.
• These included lack of Good Manufacturing Practices (GMP) and inadequate laboratory controls.
• Similar concerns were raised about the two Gujarat-based firms involved in ReLife and Respifresh TR.
• The CDSCO confirmed that no contaminated syrups were exported, and the US FDA also verified that these batches were not shipped to the United States.

Important Static Takeaways

• WHO: Headquartered in Geneva, Switzerland
• Director-General of WHO: Dr. Tedros Adhanom Ghebreyesus
• CDSCO: Central drug regulatory authority under the Ministry of Health and Family Welfare, India
• DEG (Diethylene Glycol): Industrial solvent; toxic to humans
• Good Manufacturing Practices (GMP): Quality standards to ensure drug safety