Chhindwara’s tragedy exposes a deadly nexus of doctors and pharma firms as toxic cough syrups kill 10 children, shaking trust in India’s drug safety.
BY PC Bureau
New Delhi, October 2025: The tragic deaths of 10 children in Madhya Pradesh’s Chhindwara district, linked to contaminated cough syrup, have ripped open the festering wound of India’s spurious drug trade. The arrest of Dr. Praveen Soni, who prescribed the toxic Coldrif syrup manufactured by Sresun Pharmaceuticals, has spotlighted a chilling reality: a nexus of doctors, pharmaceutical companies, and lax regulators is fueling a deadly parallel economy where profit trumps human lives.
A Nexus of Doctors and Pharma
Go to any small town in India, and you will find numerous doctors prescribing medicines that are available only at select shops. Many of these medicines are produced by companies that exist only on paper—shell firms with no real manufacturing facilities of their own. The so-called “promoters” of these paper companies can hire actual manufacturers in hubs like Hyderabad, Ahmedabad, Vadodara, Baddi, Vapi, Mumbai, Pune, Bangalore, Chennai, or Indore, depending on convenience, and have their branded products made.
Once the medicines are ready, these promoters bribe doctors to prescribe their brands, often offering commissions, perks, or foreign trips. Little or no genuine research or clinical testing is conducted on these products before they reach patients. Some medicines, like the recent Coldrif cough syrup, have been identified because their toxicity caused immediate, lethal effects. But countless others may be silently causing long-term health consequences, eroding public trust in generic medicines.
Yet, despite repeated scandals, no serious effort has been made to dismantle this deeply entrenched nexus of paper companies, rogue manufacturers, and complicit doctors. The consequences are severe: lives are lost, and the reputation of India’s legitimate pharmaceutical industry—long considered the “pharmacy of the world”—is being tarnished.
“It’s a well-oiled racket,” said a senior health official. “Doctors are offered up to 30–40% commission per prescription for certain brands, regardless of their quality or necessity. For many, it’s an offer too lucrative to refuse.”
🚨 How to Spot Fake Drugs in Nigeria.
From malaria meds to multivitamins, fake drugs are everywhere — and they’re killing people silently directly or indirectly.
Here’s how to check if the meds in your hands are safe or deadly:
You will need to save this for later.
Thread 🧵 pic.twitter.com/QdR4iqzoWb
— Pharm. Bola (@DehinsiluBola) July 12, 2025
Poison on Sale
Investigations into the Chhindwara tragedy reveal a deeply entrenched system of incentives driving the prescription of substandard drugs. Doctors like Dr. Soni, who prescribed Coldrif to most of the affected children despite safer alternatives, are often lured by pharmaceutical companies with commissions, foreign junkets, or cash payments.
A 2023 report by the Indian Medical Association (IMA) estimated that 30% of doctors in India have faced pressure from pharma companies to push specific brands, with rural practitioners particularly vulnerable.
Records from Dr. Soni’s clinic showed that 85% of his pediatric patients over six months were prescribed Coldrif, even when generics costing half as much were available. Investigators say this points to a deliberate push by Sresun Pharmaceuticals, a small-scale Indore-based company, to flood the market through incentivized prescriptions.
Laboratory tests of Coldrif syrup revealed a staggering 48.6% Diethylene Glycol (DEG), an industrial solvent known to cause kidney failure and death. DEG, a cheap substitute for pharmaceutical-grade glycerin, has been a recurring menace in India’s drug industry.
India’s history with DEG is grim. In 1998, 33 children died in Gurgaon after consuming DEG-laced cough syrup. In 2006, 21 children in Jammu succumbed to similar poisoning. Globally, DEG contamination has caused over 300 deaths since the 1990s, with Indian-made syrups implicated in nearly half the cases.
Parallel Tragedies: Rajasthan’s Deadly Denial
As Madhya Pradesh reels from Chhindwara’s deaths, Rajasthan has been struck by a parallel tragedy. Four children in Jaipur died in September 2025 after consuming a locally prescribed cough syrup suspected of containing DEG.
The scandal took a surreal twist when Dr. Anil Sharma, a local pediatrician, publicly drank the same syrup to “prove” its safety. Hours later, he collapsed on a busy street with severe renal distress and remains in critical condition at SMS Hospital.
READ: Indian Student from Hyderabad Shot Dead at Gas Station in Texas
“Dr. Sharma’s stunt was not just irresponsible—it was a symptom of a larger problem where doctors defend substandard drugs to protect their ties with manufacturers,” said public health activist Dr. Meena Rathore. Rajasthan’s Drug Control Department has since seized 5,000 bottles of the suspect syrup and launched a statewide probe.
READ: Doctor Arrested After 10 Children Die from Toxic Cough Syrup in MP
A Grim Continuum of Scandals
These are not isolated tragedies.
- In 2022, WHO issued a global alert after syrups from Haryana’s Maiden Pharmaceuticals killed at least 70 children in The Gambia.
- In 2023, Uzbekistan reported 19 child deaths tied to Marion Biotech’s cough syrup.
- In India itself, a 2024 CDSCO study found that 7% of cough syrup samples failed quality tests, with 2% containing toxins like DEG.
International regulators have repeatedly cracked down. Since 2020, the US FDA has banned imports from 12 Indian syrup makers, citing “gross GMP violations.” The EU has flagged 15 Indian firms. Each incident chips away at India’s standing as the so-called “pharmacy of the world.”
A Multi-Crore Black Market
According to FICCI’s 2024 report, 15–20% of medicines sold in India are counterfeit or substandard, creating an illicit market worth ₹20,000 crore annually. Small-scale manufacturers, especially in poorly regulated hubs like Baddi (Himachal Pradesh) and Vapi (Gujarat), often replace safe compounds with toxins like DEG—cheaper at ₹50 per litre compared to ₹500 for glycerin.
Rural areas bear the brunt. India has only 1,500 drug inspectors for over 10,000 pharma units, and a 2023 CDSCO survey found 40% of rural pharmacies lacked proper licensing, allowing spurious drugs to thrive.
Regulatory Gaps and Government Response
The Madhya Pradesh government banned Coldrif and all Sresun products following the Chhindwara deaths, while Tamil Nadu had already blacklisted the company in September 2025. But experts say India’s fragmented regulatory framework—split between state drug controllers and the central CDSCO—creates gaping loopholes.
A 2024 parliamentary report revealed that only 2% of pharma units are inspected annually, compared to 10% in China. Proposed amendments to the Drugs and Cosmetics Act, which include seven-year jail terms for making substandard drugs, remain stuck in Parliament.
Market Size and Impact:
Market Share: A 2023 joint report by Crisil and the Authentication Solution Providers Association (ASPA) indicates that approximately 20% of India’s pharmaceutical market comprises counterfeit drugs.
Economic Impact: A 2024 analysis by FICCI estimated that counterfeiting across sectors, including pharmaceuticals, costs the Indian economy approximately ₹2.6 lakh crore (about $30 billion) annually.
Global Ranking: India is one of the world’s leading producers of counterfeit pharmaceuticals, contributing significantly to the global counterfeit drug market.
Industry Turnover: The turnover of India’s pharmaceutical industry reached ₹4,17,345 crore (approximately $50 billion) in 2023-24, registering a growth of 10% over the previous year.
Lives for Sale
For families in Chhindwara and Jaipur, the cost is unbearable. Six-year-old Rani from Chhindwara was healthy days before she died. “We trusted the doctor,” her father, a daily-wage labourer, said. “How could we know he was selling us poison?”
Activists warn systemic reform cannot be delayed. “Every tragedy sparks outrage, but the system resets once the headlines fade,” said bioethics expert Dr. Anant Bhan. “Until guilty doctors and manufacturers face lifetime bans and convictions, children will keep paying the price for medical negligence dressed up as treatment.”
The Path Forward
Experts propose a four-pronged strategy:
- Centralised Regulation: Strengthen CDSCO with greater funding and oversight power.
- Mandatory Testing: Enforce batch-wise testing of all liquid formulations before market release.
- Whistleblower Protection: Safeguard insiders exposing spurious drug rackets.
- Public Awareness: Promote consumer use of CDSCO verification tools to check drug authenticity.
As India grapples with these scandals, one question remains: how many more lives must be lost before the system values patients over profit?
