New Delhi: The Indian Medical Association (IMA) has urged Union health minister J.P. Nadda to intervene and demanded withdrawal of the case against the paediatrician arrested in connection with the deaths of children who consumed contaminated cough syrup in Madhya Pradesh. The IMA underlined that the manufacturer and regulatory bodies are primarily responsible for the tragedy, not the medical practitioner.

“The primary legal liability and culpability for introducing an adulterated drug into the market, which violates the Drugs and Cosmetics Act, rests squarely with the manufacturer and the enforcement agencies,” the IMA mentioned in its letter to the health minister on Wednesday (October 8), The Hindu reported.

Further, Dr Dilip Bhanushali, national president of IMA wrote: "We call upon the ministry to recognise the doctor as a secondary victim of a systemic collapse and to direct the immediate closure of all legal proceedings against them, ensuring justice for their professional defamation and trauma."

According to the IMA, the doctor's arrest is a classic case of "legal illiteracy" and sends a wrong message to healthcare providers nationwide. The association argues that doctors prescribe medications in good faith, relying on approvals from regulatory bodies and certified supply chains, and cannot be held accountable for manufacturing lapses.

The IMA has proposed five systemic reforms to ensure the quality of medicines in India, including strengthening regulatory manpower and infrastructure, mandatory testing for contaminants, establishing a robust drug recall policy, strengthening pharmacovigilance and reporting and risk-based inspections and license audits, The Hindu report added.

Also read: PIL Seeks CBI Probe into Toxic Cough Syrup Deaths

Sresan Pharmaceuticals, which made Coldrif cough syrup has shut permanently after its owner Ranganathan was arrested in connection with the deaths of at least 21 children in Madhya Pradesh and Rajasthan, as per India Today.

Last week, the Union health ministry has confirmed that the Coldrif cough syrup contains diethylene glycol (DEG), a toxic chemical linked to the deaths of children in Madhya Pradesh and Rajasthan. The ministry had initially denied allegations of DEG contamination, citing a report from the Madhya Pradesh Food and Drug Administration (FDA) that found no DEG in the syrup. However, after receiving a report from the Tamil Nadu Food and Drug Administration department, the ministry confirmed the presence of DEG in the syrup.

Meanwhile, the Madhya Pradesh government has suspended two drug inspectors and a deputy director of the Food and Drug Administration, and transferred the state's drug controller, following the deaths of several children due to suspected kidney failure linked to the consumption of a contaminated cough syrup.

In July 2025, a joint report by United Nations Office on Drugs and Crime (UNODC) and World Health Organisation (WHO) on "Contaminated Medicines and Integrity of the Pharmaceutical Excipients Supply Chain" underlined the "persistent nature of this preventable harm, revealing that what were once considered isolated incidents are, in fact, symptoms of systemic vulnerabilities within the global pharmaceutical supply chain, mostly facilitated by criminal actors".

The report also makes recommendations such as greater focus during regulatory inspections on the procurement and testing of high risk excipients, streamlining the process for reporting cases of contaminated medicines locally, educating the public and encouraging reporting of suspicious products, MOU’s or agreements with the e-commerce and social media platforms in order to request the take down of postings advertising falsified high risk excipients that represent a serious threat to public health and ensuring regulation and legislation provides adequate powers for law enforcement, customs and regulatory authorities to investigate, detain, examine, sample, test, and where necessary quarantine, seize and destroy medical products and high-risk excipients suspected or established to be substandard of falsified.

Notably, the UNODC and WHO report underlined several instances where medicines manufactured in India resulted in deaths globally. Four national regulatory authorities prepared the report, including Medicine Control Agency (MCA), The Gambia; Indonesian Food and Drug Authority (BPOM); Drug Regulatory Authority of Pakistan (DRAP); United States Food and Drug Agency (USFDA).

In October 2022, the WHO had issued a global alert for four cough syrups manufactured by Haryana-based Maiden Pharmaceuticals, linking them to 66 deaths in The Gambia, primarily due to acute kidney failure. In December 2022, 18 children died in Uzbekistan after consuming cough syrups made by Noida-based Marion Biotech. In August 2023, the WHO issued another alert about a batch of India-made common cold syrup contaminated with DEG and EG, which was detected in Iraq.

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