BENGALURU: The World Health Organisation (WHO) has raised an alert over three contaminated cough syrups — Coldrif, Respifresh TR, and ReLife — after multiple child deaths were reported in Madhya Pradesh and Rajasthan. The global agency warned that these products pose a potential risk of international spread through unregulated export channels.
Responding to a WHO letter dated October 1, India’s Central Drugs Standard Control Organisation (CDSCO) confirmed that the syrups contained diethylene glycol (DEG), a toxic substance commonly used in industrial solvents and antifreeze agents. The regulator clarified, however, that “none of the products were exported from India.”
DEG and ethylene glycol (EG) are highly poisonous even in small doses, particularly for children. Their ingestion can cause severe kidney damage, metabolic failure, and death.
The WHO’s main concern lies in the possibility of contaminated medicines slipping into international markets through informal or unregulated trade. “While there is currently no evidence of export through such channels, the risk cannot be ruled out,” a WHO spokesperson told TOI. “National Regulatory Authorities are encouraged to conduct targeted market surveillance, particularly in informal markets.”
When asked if such incidents had occurred previously, the spokesperson said there were no confirmed precedents but noted that “illicit exports typically leave no formal trace,” making the potential threat “particularly concerning.”
Meanwhile, Karnataka’s health department conducted preventive random testing of cough syrups following reports of the deaths in other states. Health Minister Dinesh Gundu Rao said that “300–400 samples” were collected and tested across the state, with no samples found to be not of standard quality (NSQ).
The state government has banned the sale and prescription of all three products — ReLife, Respifresh TR, and Coldrif — as a precautionary measure. “Even suspected syrups have been withdrawn,” Rao said. The Food Safety and Drug Administration Department has issued circulars to pharmacies and hospitals to stop stocking or prescribing the products.
Rao added that Karnataka will soon launch a statewide digital drug recall system via its new flagship app, designed to enable rapid withdrawal of contaminated medicines up to the distributor level.
The latest episode has once again highlighted gaps in drug quality surveillance and export monitoring, following similar tragedies in Gambia, Uzbekistan, and Cameroon in recent years, where contaminated syrups manufactured in India were linked to child deaths.
While the CDSCO insists that none of the implicated syrups were exported, the WHO’s warning underscores the need for stronger pharmacovigilance, tighter control over informal drug markets, and robust traceability mechanisms to prevent repeat tragedies.
