Coughing Up All Wrong

If only prescriptions could fix the contaminated medicines problem

Eight months after children died from drinking poisonous cough syrups, the government seems to think the problem can be fixed by changing how these medicines are sold. It has removed cough syrups from a category called Schedule K, which allowed some village stores to sell them. Now, cough syrups will need a doctor’s prescription.

But will prescriptions stop medicines from being contaminated? How? The real problem is not who sells the medicine. The real problem is whether the medicine itself is safe.

India has seen many deadly cases of poisoning from contaminated cough syrups. The latest happened in Chhindwara, Madhya Pradesh, where at least 22 children died last October. This is not a new problem. Poisonings linked to DEG, a chemical used in some cough syrups, have happened again and again since 1972. Indian-made cough syrups have also been linked to the deaths of children in Gambia, Cameroon and Uzbekistan.

Experts already know what is going wrong. Some factories make medicines in dirty or poorly regulated conditions. Drug inspectors are often too few in number and do not inspect factories often enough. Sometimes, factory licences that are cancelled get restored once public attention moves elsewhere. Some doctors and pharmacists also earn money by promoting certain syrups. There is no good system to quickly report poisoning cases. There is also no strong way to recall dangerous medicines from shops, so contaminated batches can remain on sale for months.

Most importantly, rules already require companies to test their medicines and keep records of where ingredients come from. But these rules are often not followed properly, and regulators do not always enforce them. Without transparency and accountability, unsafe medicines can slip through the cracks.

The United States faced a similar tragedy in 1937. After one major poisoning incident caused by contaminated medicine, it tightened its drug laws and enforced them strictly. Such deaths were effectively eliminated.

Yet after every poisoning tragedy, authorities often follow the same pattern: denial, temporary crackdowns and quick fixes. Requiring prescriptions is one such quick fix. Prescriptions can even be obtained dishonestly through separate scams. The real question remains: can we be sure every cough syrup on the shelf is safe?

Right now, the answer is no. And that is the real tragedy.

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