Blood on the Label: India's ORS Betrayal

They sold sugar water to dying children and called it medicine.

For years, pharmaceutical giants in India peddled beverages containing 120 grams of sugar per liter, nearly nine times the WHO-mandated 13.5 grams and stamped them with "ORS." They placed them in medical stores.

They watched parents buy them for children with diarrhea. They knew these products would make those children sicker. They did it anyway.

This isn't corporate negligence. This is corporate murder with panache.

The Body Count We Ignored

Diarrhea kills. In India, it's the third leading cause of death among children under five, claiming 13 percent of all deaths in that age group. Only 60 percent of affected children receive proper ORS treatment. Into this crisis walked companies selling poison in medicine bottles.

The science is brutal in its simplicity: excess sugar pulls water into the gut through osmotic imbalance. A child already losing fluids to diarrhea now loses more. The "treatment" accelerates the dying.

Parents did everything right. They recognized symptoms early. They rushed to pharmacies. They bought products labeled ORS from medical stores, not corner shops, I repeat medical stores. They measured doses carefully. Their children ended up in emergency rooms. Some didn't make it out.

One Doctor Against an Industry

Dr. Sivaranjani Santosh, a Hyderabad pediatrician, noticed in 2017 that children were returning sicker after taking store-bought "ORS." She investigated. She found the sugar levels. She understood the betrayal.

Then she did something remarkable: she refused to stay silent.

Nine years. Nine years of research, advocacy, and resistance. In 2022, she filed a Public Interest Litigation in the Telangana High Court. She forced the system to see what it had chosen to ignore.

Nine years. How many children died waiting for bureaucracy to care? Irony right?

The Verdict

On October 14, 2024, FSSAI finally acted. The directive was unambiguous: these products "mislead consumers through false, deceptive, and ambiguous claims." All permissions previously granted to use "ORS" with disclaimers were revoked. The regulator admitted what should have been obvious from day one, no disclaimer undoes the lie of labeling sugar water as life-saving medicine.

Companies were ordered to immediately halt production, remove "ORS" from all labels and advertisements, and stop selling these products.

Dr. Reddy's Laboratories and JNTL Consumer Health India (Johnson & Johnson's subsidiary) ran to the Delhi High Court.

The Audacity of Profit

Here's where the story turns from tragic to obscene and notorious.

These companies didn't just challenge the ban. They asked the court for permission to sell their existing stock. Read that again. After being told their products were harmful, misleading, and potentially deadly, their first concern was clearing inventory. Not recalling products. Not compensating victims. Selling more.

Justice Sachin Datta refused. He made the court's position explicit: the interim order was never meant to enable continued production or sale of misleading products. "Public health considerations are paramount," he ruled, upholding FSSAI's ban entirely.

The companies lost. The embargo on manufacture and sale continues. But the request itself reveals everything about corporate priorities. Children's lives versus warehouse inventory and they chose inventory. They prioritised their balance sheet. Profit mattered more.

The System That Enabled This

FSSAI itself bears blame. The regulator had previously granted permissions allowing "ORS" labeling with disclaimers. This bureaucratic compromise acknowledging deception while permitting it gave corporate fraud official cover.

It took a lone pediatrician's nine-year war to force a reversal. Not internal audits. Not consumer complaints. Not the deaths of children. One doctor who wouldn't stop fighting.

What does it say about our regulatory system that corporate fraud thrives until individual citizens sacrifice years of their lives to expose it?

Where Are the Consequences?

The ban is welcome. It's also insufficient.

These companies violated the Food Safety and Standards Act, 2006. Where are the prosecutions? They sold products they knew were harmful. Where are the criminal charges? Children died because of their decisions. Where is the accountability for executives who signed off on this fraud?

 Rebranding isn't punishment. It's a business expense.

The families who lost children, who spent savings on emergency care, who blamed themselves for their child's deterioration they deserve compensation. They deserve to see executives in courtrooms, not boardrooms. They deserve justice that matches the crime.

The Question That Remains

Somewhere in India today, a child has diarrhea. A parent is walking into a medical store, trusting that products on those shelves won't harm their child.

The October 2024 ban has removed one category of fraud. But the system that enabled it remains intact. The executives who profited remain unpunished. The regulators who permitted it face no consequences.

Dr. Sivaranjani Santosh finally stopped one crime. We haven't fixed the system that made it possible.

Until we do, every label is suspect. Every medical store is a gamble. Every sick child is a test of whether we've learned anything at all.

The pharmaceutical companies asked to sell their remaining stock of harmful products. That request alone should tell you everything about what children's lives are worth to corporate India.

Remember that the next time someone tells you the market regulates itself.

(Anshuman Dutta is a digital transformation professional and a published columnist.) 

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