Children’s Deaths From Contaminated Cough Syrups In MP, Rajasthan: WHO-UNODC Report Reveals These Are Not Isolated Cases

The recent deaths of at least 12 children in Madhya Pradesh and Rajasthan — allegedly due to consumption of contaminated cough syrup — may have prompted swift action from state governments, but reports show that such tragedies are part of a wider, systemic crisis.

Madhya Pradesh Chief Minister Mohan Yadav on Saturday banned the sale of Coldrif cough syrup following the deaths of nine children in the state. The sale of other products by the same manufacturer has also been prohibited. In Rajasthan, where three children reportedly died of acute kidney failure after taking the same syrup, the government suspended Drug Controller Rajaram Sharma for allegedly influencing quality assessments and banned all 19 products supplied by Kaysons Pharma, Jaipur.

The Tamil Nadu government on its part has banned sale of ‘Coldif’ and ordered the immediate removal of the product from the market. The syrup, manufactured by a Chennai-based company, was suspected of contamination with diethylene glycol.

Following the development, the Union Health Ministry on Friday had issued an advisory to all States and Union Territories, directing that cough and cold medications should not be prescribed to children under the age of 2 years.

The Directorate General of Health Services released an advisory for all to aware people about the medicines to be administered to the children. But it seems to be a formality given that these recent heart-breaking incidents are not isolated one.

A joint report by the World Health Organization (WHO) and the United Nations Office on Drugs and Crime (UNODC) released in July 2025 has identified a recurring pattern of contaminated medicines — particularly paediatric syrups laced with toxic chemicals — contributing to public health crises across multiple countries, including India.

The report, titled “Contaminated Medicines and Integrity of the Pharmaceutical Excipients Supply Chain,” examined eight major incidents of mass poisoning involving tainted cough syrups in India, The Gambia, and Indonesia. It attributes the deaths of hundreds of children to the presence of hazardous substances such as diethylene glycol (DEG) and ethylene glycol (EG) — industrial-grade chemicals never meant for medicinal use.

In one of the cases cited from India, the report refers to a 2019 tragedy in Ramnagar, Jammu & Kashmir, where 12 children died from acute kidney injury after consuming a locally manufactured cough syrup. Lab tests revealed the product contained 34–36% DEG — a lethal concentration. The manufacturer had received 16 warnings for substandard production prior to the incident, yet failed to test raw materials, a clear violation of pharmaceutical safety norms.

Alarmingly, the report notes that following the incident, the same company rebranded the product under a different label and resumed sales through a sister firm in a neighbouring state. Though temporary regulatory action was taken, the plant was later allowed to operate for non-PG-based products.

A similar but more high-profile incident occurred in The Gambia between July and September 2022. At least 66 children, mostly under the age of two, died after consuming contaminated paediatric syrups imported from an Indian pharmaceutical manufacturer. The syrups, manufactured in December 2021, were not licensed for sale in India, where domestic regulatory oversight is comparatively stricter.

Independent tests confirmed the presence of DEG and EG in the formulations, leading the WHO to issue a global alert. The Gambian government launched a nationwide recall and the Indian authorities suspended the manufacturer’s operations after uncovering serious violations of Good Manufacturing Practices (GMP). The report revealed that the pharmaceutical-grade solvent was, in fact, industrial-grade PG falsely labelled by a local supplier.

Indonesia witnessed a similar crisis in 2022, when over 300 children fell ill and many died after consuming DEG/EG-contaminated medicines. A network distributing falsified excipients with fake certificates was identified, prompting Indonesian authorities to revoke over 100 product licences and initiate criminal proceedings.

Earlier incidents in Panama (2006), Haiti (1996), and China (2008) were also tied to DEG-laced medicines. All these cases, the report notes, share common causes: poor regulatory oversight, falsified documentation, and failure to test raw materials.

The WHO-UNODC report, spanning 120 pages, documents at least 21 mass poisoning incidents linked to DEG and EG contamination since 1937, resulting in over 1,000 recorded deaths. These have not been limited to medicines; contaminated toothpaste and alcoholic beverages were also involved in earlier episodes.

Calling for global regulatory reforms, the report recommends mandatory DEG/EG testing for all excipients, especially in liquid formulations; stricter oversight of export-only medicines; and severe penalties for violations of GMP and falsification of pharmaceutical documentation.

The authors also highlighted the need for better traceability in supply chains and criminal accountability for those involved in deliberate falsification.

Following these incidents, India has mandated DEG/EG testing for all syrups intended for export and issues public recall notices. The Gambia now conducts third-party testing of all imported medicines and is working to establish a national quality control laboratory. Indonesia has revised permissible limits for DEG/EG and tightened regulatory procedures.

The WHO-UNDOC report cautions that these are not isolated incidents. These “represent a deeper, systemic issue affecting the integrity of medicine supply chains." It adds that criminal actions, such as falsification of pharmaceutical excipients and labels, continue to pose a persistent threat to global public health — particularly to children, who remain the most vulnerable.