Vinay Kumar
If only prescriptions could fix the contaminated medicines problem
Eight months after children died from consuming toxic cough syrups, GOI appears to believe that the recurring problem of contaminated syrups is a matter of classification. It has removed cough syrups from Schedule K, which allowed them to be sold in certain general stores in smaller villages. Now, all cough syrups will require a doctor’s prescription – although many already do in practice. Are prescriptions expected to solve contamination? How? The problem is not how these medicines are sold, but what is being sold.
India keeps experiencing fatal DEG (a regulated chemical used in cough syrups) poisoning outbreaks from contaminated cough syrups – the deaths of at least 22 children in Chhindwara, MP, last Oct being the latest case. Contaminated cough syrups are neither a new, nor a surprising, problem. DEG poisoning has recurred in India since 1972, with similar mass poisonings in 2020, 2022, and 2023. Indian-made cough syrups caused mass child deaths in Gambia, Cameroon and Uzbekistan.
The diagnosis is long established – systemic failure. 1. Manufacturing units operate in unregulated conditions. 2. There’s chronic understaffing and inconsistent inspections, plus there’s corruption. 3. Licences that are cancelled, are quietly reversed once public attention fades. 4. Doctors and pharmacists profit via family-owned pharmacies that skirt conflict-of-interest rules. 5. There’s no system for doctors to flag clusters of poisoning symptoms. 6. There is no effective drug recall mechanism. So, contaminated batches remain in circulation, and cause deaths again. 7. Despite rules that mandate every batch of raw material and final product be tested, and records maintained, there is no documentation of a chain-of-custody of inputs. Poor regulation caters to the resistance to transparency and accountability. It is worth recalling the US example again – tightening drug law in 1937, and strict regulatory enforcement eliminated DEG deaths.
In India, after every mass poisoning, authorities slip into an all-too-familiar cycle of denial, temporary crackdowns, and band-aid. The solution isn’t what has been prescribed – doctors’ prescriptions, which can also be procured falsely, a separate scam. Lastly, how does govt plan to enforce prescription-only sales? Not only has India failed to ensure only-prescription sales of antibiotics, it has also failed to control antibiotic overprescription. There is no reason to expect that the cough syrups’ trajectory will be any different.
https://pmc.ncbi.nlm.nih.gov/articles/PMC12981410/
Disclaimer
Views expressed above are the author’s own.
