Inside India’s cough syrup obsession

It happens again.

In early September, a group of unjustified child mortality in a small town in the state of Maadi Pradesh pushed local health workers to scramble.

At least 11 victims – aged one to six years – died within days of the common cough syrup. The officials tested everything, from drinking water to mosquitoes, before the truth appeared: their kidneys failed.

Weeks later, a government laboratory in the southern city of Chenyy confirmed the worst. The drink in question contains 48.6% of the ethylene glycol, a toxic artificial solvent that should never be found in medicine. Renal failure is common after eating this toxic alcohol.

Horror was not limited to the state of materialism Pradesh. In the neighboring state of Rajasthan, the death of two young children, after taking a local dickomethorphran drink – an inhibitory cough medicine for young children, caused great anger and opened a government investigation.

As for India, this brought a dark feeling that she had lived before.

Over the years, the ethylene glycol di -ethylene in the Indian cough syrup has been able to live in dozens of young people. In 2023, an Indian contaminated drink was linked to the ethylene glycol bipolar with the death of 70 children in 2023. Gambia And 18 inches Uzbekistan.

Between December 2019 and Janier 2020 at least 12 children have died under the age of five In the state of Jammu in Kashmir, which is subject to the Indian administration, it was claimed to be caused by cough syrup, where activists indicated that the number of victims was perhaps higher. In the past, there was also Codion -containing cough syrupIt is a light phonomic substance that can cause ecstasy in high doses and lead to dependence on it, and it is not recommended for young children.

Each time the organizers promised to reform, polluted juices return to appearing – which reflects the fragmented drug market, and critics claim that the regulatory system is weak and fights to supervise hundreds of low -cost juices, often approved, which are produced by smaller manufacturers and sold without a prescription.

Days after the death of the last children, the Indian Ministry of Health urged “sane” Using such medications – which is actually warning doctors of the need to be more careful when prescribed for young children – and confiscated samples of the drink, stopped sales and ban, and ordered an investigation.

But the problem, as critics say, is deeper than excessive prescriptions. Each new tragedy reveals the corruption suffered by the drug control system in India – the maze of poor implementation and organization. The Indian coughing market is expected to increase from $ 262.5 million in 2024 to $ 743 million by 2035, at a growth rate An annual rate of 9.9%According to market research.

But any of this will not happen if India and the Indians can west themselves from obsession with cough medicines. For decades, doctors described it, and the patients eaten, although most of them only use little and can cause severe damage.

These sweet drinks are marketed as a quick remedy for sore throat and stubborn cough, and they mix sugar, color and flavors with a mixture of antihistamines, congestion and phlegm.

In theory, each component plays a role: one dries secretions, the other relieves phlegm, and the third relieves coughing reflex. In practice, the evidence that these drugs is very useful, as most cough cases improve on their own within a few days.

Coughing can be caused by infection or an allergic reaction. Coughing medications are generally divided into two types – sedatives that help the child rest, and the bronchial enlargement that facilitate breathing – usually prescribe doctors one or the other, and not a mixture.

Most cases of continuous coughing in children in Indian cities that are increasingly produced from infection, but rather allergies and irritation of the lower airways, according to Dr. Rajaram de Curry, a pediatrician residing in Mumbai. Allergy occurs when the immune system exaggerates its reaction to causes such as dust and pollution.

These children often have a cold or a runny in the nose and a cough that is exacerbated at night or early in the morning, and it is repeated every few weeks. He says that in major cities, such a frequent wet cough usually occurs due to dust and smoky fog, and is sometimes accompanied by a light bronchite.

Dr. Khair said that such a cough responds better to the bronchial expansion – medicines that open the airways – preferably through inhalation or sprays, although many doctors still depend on the drink that only provides limited comfort.

Most of the cases of childhood cough are viral, ending on its own, and disappear on its own within a week. Doctors say there is no drink that limits their path. At best, it provides passing comfort. In the worst case, it carries the risks of addiction, toxicity and excess dose.

Dr. Khair says: “I do not usually describe cough syrup for regular cough and colds – except for rest. If the child is strongly and unable to sleep, he may be given a dose of a light drink only to relieve discomfort. The main goal is comfort, not treatment, especially when the cough is dry and part of a viral infection.”

Why is cough syrup widely described in India?

One of the reasons is the weak primary health care system in India, especially in small cities and rural areas. Since the high air pollution leads to a continuous cough, it is increasingly misused to treat routine respiratory infections.

The problem is deeper in the countryside. In the countryside of India, it reaches 75% of the initial care visits are dealt with by non -official service providers Often, self -made “RMPS” or rural medical practitioners without official medical training.

In places where the local public health clinic is far, or suffers from employee deficiency, or closed, they are doctors by virtue of the fait accompli – and juices are their most trusted tools. When it was published in Gourakhapur, a town in Uttar Pradesh, Dr. Cavail Khan, the pediatrician, remembers, “The juices are distributed everywhere – even by those who do not hold any university degree.”

In many of these towns, patients depend on anyone who seems medical knowledge – from informal practitioners to store owners – to deal even with routine cough.

“Many poor patients resort to local chemists to obtain advice, assuming that the person behind the counter is a pharmacist; and at 10 of every 10 times in rural areas in India, this is a wrong assumption,” says Denish Thakur, the former Indian drug director who has turned into a public health expert.

“While this problem appears to be largely limited to small cities and rural areas in India, there are some data that indicates that it is not.

Another factor leads this trend, which is the common pressure of anxious fathers and gaps in medical knowledge.

“Parents are not always well aware, and their patience can be exhausted. If the child’s coughing or cold does not improve within two days, they often consult another doctor to give him a cough drink,” says Dr. Khan.

Low knowledge between doctors adds to the problem. Dr. Khan says, “He watched even pediatricians describing the children’s cough syrup.”

“It aims to break up phlegm, but children under a second cannot spit, so mucus can be inhaled into the lungs, causing pneumonia – however it is still prescribed.”

India needs a clear policy on coughing medications and national awareness between doctors and parents to reduce reckless use. The risks are real: the physician of the state of Maadi Pradesh, who described the drink associated with the last children’s deaths He defended his practice, He said, “I was describing this cough syrup for 15 years.”