When a medicine meant to heal becomes the reason for fear, it shakes the very foundation of trust that patients place in healthcare. That’s what happened recently in Haryana when the state government issued a public health alert after discovering that a batch of cough syrup contained diethylene glycol (DEG) which is a toxic chemical known for claiming lives in the past. The announcement is a serious reminder of how fragile drug safety systems can be in a country where pharmacies are often seen as the first point of care.

The cough syrup in question namely Planokuf D, manufactured by Shreya Lifesciences Private Limited, carried three familiar ingredients found in common cough medicines: cetirizine hydrochloride, phenylephrine hydrochloride, and dextromethorphan hydrobromide. But beneath this ordinary formulation, something dangerous was lurking. Lab tests confirmed that the batch numbered R25053101, made in February 2024 and expiring in January 2027, contained DEG impurities above permissible limits. The drug was immediately classified as adulterated and Not of Standard Quality (NSQ).

For those unfamiliar with the term, diethylene glycol is a sweet-tasting but deadly solvent used in industrial products like antifreeze and brake fluids. It should never find its way into medicine. Even in small amounts, DEG can cause acute kidney failure, metabolic acidosis, neurological damage, and in severe cases, death. Children, especially, are the most vulnerable since their smaller bodies and immature metabolic systems make it difficult to survive DEG poisoning.

This isn’t a new tragedy waiting to happen. India has lived through the horror of DEG contamination several times. From the infamous 1990 mass poisoning in Gurgaon to the heartbreaking incident in Jammu last year that killed several children, each episode carried the same story: negligence, poor testing, and delayed action. Every tragedy has led to new promises of reform. But when a new alert emerges, one can’t help but ask that, have we learned anything?

According to Haryana Health Minister Arti Singh Rao, the state acted immediately after receiving an official communication from the Central Drugs Standard Control Organisation (CDSCO) sub-zonal office in Guwahati. The Food and Drugs Administration (FDA) Haryana was instructed to launch a strict vigilance campaign. All Senior Drugs Control Officers (SDCOs) and Drugs Control Officers (DCOs) across districts were told to scour the markets, collect samples, seize remaining stocks, and ensure the contaminated batch vanished from circulation.

The State Drugs Controller ordered a total ban on the sale, distribution, and prescription of the affected batch. Pharmacies, wholesalers, and hospitals were warned if anyone caught selling or stocking the batch would face strict action. Doctors were advised not to prescribe the product, and the public was urged to stay alert and report any availability of Planokuf D to the nearest FDA office.

At first glance, the response seems swift and firm. But beneath the surface lies an uncomfortable truth; why do these alerts keep coming? Why is DEG, a chemical whose risks are so well known, still making its way into cough syrups decades after being banned in medical formulations?

Experts say the answer lies in the complex supply chain of pharmaceutical manufacturing. Many small and mid-sized companies source raw materials, solvents, and excipients from third-party suppliers sometimes without adequate verification. DEG contamination often occurs when cheaper industrial-grade solvents are used instead of pharmaceutical-grade propylene glycol or glycerin. The substitution cuts costs, but the consequences can be deadly.

Drug regulators are supposed to monitor every stage of this process, from raw material procurement to final product testing. Yet, as history shows, lapses continue. In a country with over 10,000 registered pharmaceutical manufacturers and millions of drug formulations, consistent quality control is a herculean task. Many states face a shortage of qualified inspectors and testing laboratories. The result is an uneven regulatory landscape where some states strictly enforce testing norms, while others rely heavily on post-market surveillance, which only begins after the damage is done.

The Haryana case isn’t just a local concern. It is a national alarm bell that echoes through India’s booming pharmaceutical industry which is the same industry often hailed as the “pharmacy of the world.” When Indian-made cough syrups are found contaminated, it doesn’t merely hurt domestic trust; it damages global credibility. Recent international incidents like the deaths of children in Gambia, Uzbekistan, and Cameroon allegedly linked to DEG-tainted Indian syrups have already cast a shadow over India’s drug export reputation.

For companies like Shreya Lifesciences, which have operated for years with a sizable market presence, such findings raise questions about internal quality checks. The company’s silence on the issue so far has only added to public unease. Transparency in crises like this is not optional; it’s a moral duty. When people take medicine, they are putting their lives into the manufacturer’s hands and that trust cannot be treated lightly.

The human cost of such negligence cannot be overstated. DEG poisoning can be agonizing. It begins with nausea, vomiting, and abdominal pain, progressing quickly to confusion, seizures, and kidney failure. Many victims slip into coma before help arrives. In rural areas, where medical response is often delayed, the outcomes are catastrophic. Even survivors may face lifelong complications, including blindness and neurological damage.

Public health experts are calling this a wake-up call for India’s drug regulation system. They say that while post-market surveillance like catching problems after a drug hits the shelves is important, pre-market testing and real-time raw material monitoring are the real keys to prevention. Every batch of syrup containing solvents like glycerin or propylene glycol should undergo mandatory DEG testing before release. The technology to detect such contamination is not new, it’s the will and accountability that often go missing.

The incident also highlights the need for greater traceability in the pharmaceutical supply chain. Blockchain-based systems, barcoded tracking, and digital documentation can help trace the origin of every ingredient in a medicine. If such systems were in place, the source of contamination could be identified and contained far more quickly. Instead, regulators are often left playing detective long after the drug has reached the public.

The health minister’s proactive stance deserves recognition. But the real test will be in follow-through, ensuring that lessons from this episode lead to lasting reform, not another cycle of outrage and forgetfulness. Drug safety isn’t just a government responsibility; it’s a shared ethical obligation between regulators, manufacturers, pharmacists, and doctors.

At a time when India is racing to become a global leader in pharmaceutical exports, it cannot afford these recurring stains on its credibility. Global health agencies, too, are watching closely. Each contamination case weakens trust, not just in one company, but in the “Made in India” label that powers billions of prescriptions worldwide.

Meanwhile, the public is once again left with fear of whether the medicine on their bedside table is truly safe. In a country where people often buy cough syrup over the counter without a prescription, that fear is not unwarranted. Awareness, therefore, becomes as vital as regulation. Every household should know how to verify drug batch numbers, check official alerts, and report suspicious medicines. The Haryana FDA has urged citizens to immediately report any trace of the affected batch in pharmacies. Such community-level vigilance can make a real difference.

Medicines are not like other consumer goods. A glitch in a phone or a car can be fixed. But when a drug fails, it takes lives. And those lives i.e. often children, the elderly, or the poor cannot be replaced.

As Haryana tightens its surveillance, every other state should be doing the same. Drug inspectors must be empowered, laboratories equipped, and manufacturers audited without bias or political pressure. Transparency should become the norm where every failed batch, every recall, every inspection result should be public information.

Because in the end, drug safety is public trust, and public trust once broken, is nearly impossible to rebuild. If there’s a lesson in the Haryana incident, it’s that safety cannot be reactive. It must be relentless, built into every step of the process. From the moment raw materials are sourced to the time a syrup bottle reaches a patient’s hand, there must be no blind spots. A single oversight can turn medicine into poison.

The story of Planokuf D should not fade into the endless scroll of forgotten headlines. It should become the turning point for a nation that prides itself on its pharmaceutical prowess to finally demand that every medicine made, sold, or exported under its name is safe beyond doubt.

Because in healthcare, trust is not earned by promises, it is earned by proof.