comment: >
  
  Not cool, India.
context: The countries this happened in are Gambia, Indonesia and Uzbekistan. There are four additional countries where this cough syrup might have been sold: Cambodia, the Philippines, East Timor and Senegal. This has been going on since JULY 2022. >
  
  My personal philosophy is to not base my decisions of couple of incidents that blew up in the media, especially when the country is as large as India and China.  
  People gotta realize, this is a company, it doesn't reflect all Indian products ffs. The company should be sued the fuck out and has to provide relief to all the families, but calling it a nation-wide problem is factually incorrect. >
  
  Medication is not just any peoduct to take quality risks. That’s why most countries have great oversight of its production. This only reflects on the poor job of the government pr India doing that. It’not the only case, another Indian company has been asked to stop production of eye drops related to vision loss issues in the US this month. In 2013 US fined Indian company $500 million for several reasons. Since then , since 2007 they have sampled thousands of drugs made in India and more tahn 7,000 of them were declared “low quality. Ao you see, it’s not a problem of this one company. >
  
  The comment I replied to said anything you eat, not medicine.   
  And even in Medicine, The product should hold more value than the company. Where it is from doesn't matter. Does the medicine do what it's supposed to? What are the side-effects? What is the cost? The nationality of the company producing shouldn't matter at all. If company A has some foreign substances consciously added in it that has severe side effects, then Company A should be punished. Not the whole fucking country. >
  
  Crucial part:
  
  According to the WHO, the cough syrups contained "unacceptable" amounts of diethylene glycol and /or ethylene glycol as contaminants. "Levels varied for specific details of laboratory tests," it added.
  
  Ethylene Glycol.
  Diethylene Glycol.
  Anti-Freeze. They made kids drink anti-freeze. >
  
  I don't get it, if you're making shitty medicine why not just put extra water in it instead of poison. >
  
  Glycerol is a common ingredient in cough syrups because it's syrupy, it's mildly sweet-tasting, lots of things dissolve easily in it, and it will prevent sugar from crystallizing.  Food grade glycerol is pure and safe to consume (it's probably in something you've eaten or put on your skin today), but sometimes glycerol intended for use as an industrial solvent or soap/shampoo additive is contaminated with ethylene glycol, which has similar properties (but is toxic).
  It's likely that somebody at some point in the supply chain thought they could save some money by substituting in a cheaper source of glycerol, or maybe they mixed up the two similar-looking chemicals. >
  
  I guarantee you this person was warned it was highly toxic and did not give a shit, multiple people likely noticed who all decided 'Not my kid who is gonna die, Not my problem'.
  The fact India government is decided there is 'no evidence' tells me everything I need to know about what kind of culture they have. >
  
  I am pretty sure that the manufacturer didn't know. A lot of times (in India) what happens is that someone(can be plural) along the supply chain adulterates some material, which can even be from a trusted brand.
  So you could buy the best material, but it can be adulterated by middlemen and you would not know better.
  Is the manufacturer not at fault then? Nope they are still at fault and should be prosecuted, as it was their job to ensure that the raw materials they used weren't adulterated. Ensuring the quality of raw materials is the bare minimum they should be doing. >
  
  
  I am pretty sure that the manufacturer didn't know. A lot of times (in India) what happens is that someone(can be plural) along the supply chain adulterates some material, which can even be from a trusted brand.
  So you could buy the best material, but it can be adulterated by middlemen and you would not know better.
  
  Bullshit.  Current good manufacturing practices require an ID on all incoming raw materials (Even vendors qualified for reduced testing would still have every lot received subject to at least description and ID tests).  The easiest and most common way to do an ID would be by FTIR spectrum.  Would take all of 10 minutes, and would indicate something wasn't right, which would have led to full testing, where the lot would have obviously failed assay and impurities.
  Or at least this would have happened in a company with a functioning quality unit with a robust culture of quality.  But a huge number of Indian companies don't give a shit about anything but profit.  And it doesn't matter if they are large or small, it's the same story.
  Source: career in pharma.  I've seen it, lived it, and am living it every day at work. >
  
  Suppose you have 100 vats of medical grade glycerol. Somewhere between delivery and actual use it would not be difficult to swap 10 vats and swap the labels.  The problem happens after delivery, so even if your incoming quality team did an FTIR scan, you can't catch it. 
  When someone swaps only 10% of the vats, and your outgoing quality team practices skip lot sampling, it would be statistically probable to miss it. >
  
  How do you propose this occurs in a gmp warehouse? Added bonus, explain how in process, finished product, and stability testing miss this.  Assume assay and impurity testing by HPLC using current USP monographs.  Or EP, or BP depending on the label. >
  
  We don't know what level of sophistication this factory in India has. The article never mentioned the name of the factory, or what type of certifications and accreditations the facility has. We don't even know if the cough syrup is a generic drug or an herbal concoction. Remember that the investigative committee just said that there is no proof the children died because of ingesting the cough syrups. They never reported on the manufacturing process or mentioned any investigation into the operations of the factory. If everyone turned a blind eye, controls and checks wouldn't find anything. >
  
  It happens frequently enough in developing countries to be a wiki article. >
  
  Long story short:
  
  So far it said that across the three countries where this issue has been reported since August 2022
  
  The poorer nations (Gambia, Uzbekistan and Indonesia) bought the cheaper, unregulated ones from a couple of Indian companies (Marion Biotech and Maiden Pharmaceuticals) and the children died because of it. 
  WHO also issued a warning last year for cough syrups made by four Indonesian manufacturers, PT Yarindo Farmatama, PT Universal Pharmaceutical, PT Konimex and PT AFI Pharma, that were sold domestically. >
  
  Yes I agree that it’s good that the WHO and the UN are looking into this. But what’s the spin? >
  
  You made it sound like it wasn't really India's fault, emphasizing that those other nations just screwed up. >
  
  That was not my intention. My intention was to point out that it was poorer nations (specifically those 3) where this problem was occurring, so most of the reddit users shouldn’t worry about it (happening to them). 
  Edit: added last 3 words >
  
  Yeah and these cough syrup deaths have only been reported in 3 countries I mentioned. >
  
  The spin is that these companies have extremely poor quality control. To save money, especially for large-scale government orders, they switch glycerin with ethylene glycol. This poisons very large batches, but this practice isn’t used for every batch. 
  Your suspicion is unwarranted. Cough syrup mass poisoning have been a frequent problem since the 1990s. There’s even a Wikipedia page for “cough syrup poisonings.” >
  
  Did you reply to the wrong comment? >
  
  the FDA was notified, so it already existed. ketchup I believe was what created the FDA >
  
  Indian lean hits hard >
  
  it's orange drank - mango lassi w cough syrup >
  
  Damn... i hope the right ones will "pay" for this... >
  
  Just lol, in a country ripe with corruption.. yeah, right. >
  
  We are not so ripe with corruption. Also the state has already made investigations and arrests. >
  
  Lmao >
  
  The question is: which Scientist /Chemist/Laboratories manufactured tested/ passed/approved  dispatched the cough syrup to these Countries?
  Ministry of Health, Ministry Trade and Commerce needed to be involved  for this Cough Syrup to be exported. Customs etc.. 
  Plus plus.. Who is liable for the these 'Guinea pig', deaths? 
  WHO is in agreement with the claim. 
  You cannot 'cough' up these 300 children back toife and return them to their grieving families.!! 
  Neither can one brush off the reality of the losses in these Nations. 
  When one refuses to become accountable.. They will continue, money  is more important than life. >
  
  Oh god that website is horrible. Just horrible. >
  
  Wait, wait, let me guess: "propylene" glycol that wasn't.
  *click*
  Yep. :( This happened in the US in the... 1970s, I think?
  Propylene glycol is a sweetener/emulsifier that's mostly harmless in small doses, but if the lab doesn't synthesize it right, it may be contaminated with ethylene glycol, which is horribly toxic. Most of us know the latter chemical as the anti-freeze used in cars.
  Similarly, if a distillery does their fermentation right, their product will contain ethanol (drinking alcohol), but if they mess up, it will also contain methanol (wood alcohol) that is much more toxic. >
  
  I am imagining an Indian minister frantically pacing back and forth in the emergency room as the bodies start to pile up. Not out of concern for the children, but desperately trying to come up with a story to blame Pakistan, before the journalists show up. >
  
  +1 phobia for me. >
  
  Luckily cough syrup regardless of taint level is useless, so there’s not really any need to buy it. >
  
  Damn aside from anti-freeze, I have to be scared of cough syrup contaminated by people’s taints too?! >
  
  Posting this again. Fantastic book about why regulations for drugs are set up, and what happens when generic regulations become lax. Mostly about the Ranbaxy scandal in India. 
  
  Bottle of Lies: The Inside Story of the Generic Drug Boom
  By: Katherine Eban
  Really great book about the generic drug trade that was recommended here on reddit when this first hit the news. Very eye opening about the lax standards in place in certain countries for drug manufacturing and contamination. >
  
  India's pharma export  monitoring org PHARMEXCIL has already revoked their licenses and started legal proceedings against it. >
  
  
  The committee held 6-7 meetings but did not find enough evidence
  
  LMAO. Talking in committees isn't how one uncovers evidence. Sounds like they're keen to not find anything... >
  
  Didn't China do the same thing a few years back?
  Replaced baby formula milk with melamine...
  Fuckers fed kids magic erasers. >
  
  Good, those sick fucks. I grew up in HK, and every week or so I’d hear on the news about some new, fake food: fake beef, fake egg, and guess what? Fake fucking rice! RICE!  
  Those people have no shame, and won’t even spare their own children for a few bucks. I will never trust Chinese food products again, and have literally starved instead of eating at restaurants when visiting relatives in mainland China. In addition, mainland Chinese rushed down to HK to buy milk powder to resell in mainland, resulting in a shortage and prices sky rocketing in HK.  
  Fuck those assholes. They deserve to rot in hell; I have no sympathy and genuinely wish the worst for those who will harm children for their own profit. >
  
  It's actually 2 Indian companies (Maiden Pharmaceuticals and Marion Biotech) and 4 Indonesian ones (PT Yarindo Farmatama, PT Universal Pharmaceutical, PT Konimex and PT AFI Pharma). 
  It's not really OP's fault because they just took over the same title as the website used.