The tragic deaths of more than 20 children in Madhya Pradesh and Rajasthan from toxic cough syrups mark yet another painful reminder of the country’s unresolved crisis in pharmaceutical regulation. This is not the first time Indian-made medicines have caused such devastation, and unless systemic reform follows, it will not be the last. The recurring presence of diethylene glycol ~ a chemical used in industrial solvents ~ in medicines meant for children is a scandal that should have been impossible in a country that prides itself on being the “pharmacy of the world.”

Instead, the latest tragedy exposes the fragile foundations of India’s drug safety regime. Factories operating under shockingly unhygienic conditions, staffed by poorly qualified personnel and devoid of basic quality assurance systems, have no place in a nation that exports life-saving drugs across continents. The World Health Organisation’s expression of “deep concern” over........

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