致命解药：止咳糖浆是如何导致印度数十名儿童死亡的

Deadly cure The role of cough syrups in the deaths of dozens of children

致命解药：止咳糖浆是如何导致印度数十名儿童死亡的

At least 20 children in India have died after consuming cough syrups contaminated with diethylene glycol, raising safety concerns

印度至少 20 名儿童因服用受二甘醇污染的止咳糖浆而死亡，引发药品安全担忧

Nawab Khan pulls a donkey cart through the narrow lanes in Churu, Rajasthan. On October 2, he took his six-year-old son Anas to the district hospital. The boy had a cough and cold – the kind of illness every parent deals with when the season changes. 

纳瓦布·汗拉着驴车穿过拉贾斯坦邦楚鲁的狭窄巷道。10 月 2 日，他带着六岁的儿子阿纳斯前往地区医院就诊——这个男孩患上了换季时儿童常见的咳嗽感冒症状。

Doctors administered the boy dextromethorphan hydrobromide syrup, a generic cough syrup supplied at government hospitals in Sikar and Bharatpur under Chief Minister’s free medicine scheme.

医生给孩子服用了氢溴酸右美沙芬糖浆，这是锡卡尔和巴拉特普尔政府医院通过首席部长免费药品计划提供的平价止咳糖浆。

Two days later, Anas’s condition had worsened. The doctors referred him to JK Lon Hospital in Jaipur, 200 kilometers away. He reached the state’s largest children’s hospital at 4 am on October 4. At 10 am, Anas was dead.

两天后，阿纳斯的病情恶化。医生将他转诊至 200 公里外的斋浦尔 JK Lon 医院。10 月 4 日凌晨 4 点，他抵达这家拉贾斯坦邦最大的儿童医院。上午 10 点，阿纳斯停止了呼吸。

The family alleges the cough syrup killed their son. It was not the only death in the state that has been reportedly lixed to the medicine. The Rajasthan government has ordered an inquiry and banned dextromethorphan hydrobromide syrup and all 19 of its formulations. Drug Controller Rajaram Sharma has been suspended.

家属指控止咳糖浆导致儿子死亡。据报道，这并非该邦唯一与此药物相关的死亡案例。拉贾斯坦邦政府已下令调查，并禁止氢溴酸右美沙芬糖浆及其全部 19 种配方药物。药品监管官员拉贾拉姆·夏尔马已被停职。

In neighboring Madhya Pradesh, 19 children aged one to six died within weeks of taking a common cough syrup. Health authorities tested water supplies for mosquito-borne diseases, examined food sources. But it was a government laboratory in Chennai, southern state of Tamil Nadu, that provided the answer: the syrup administered to children contained 48.6% diethylene glycol.

在邻近的中央邦，19 名 1 至 6 岁儿童服用常规止咳糖浆后数周内相继死亡。卫生部门曾检测供水系统是否传播蚊媒疾病，检查食物来源。最终是位于泰米尔纳德邦南部的金奈政府实验室揭晓答案：患儿服用的糖浆含有 48.6%的二甘醇。

Following the Madhya Pradesh deaths, the authorities issued alxsfor two additional cough syrup brands: Respifresh (manufactured by Rednex Pharmaceuticals) and RELIFE (manufactured by Shape Pharma). Both contained diethylene glycol several folds above the permissible limit.

在中央邦发生死亡事件后，当局对另外两种止咳糖浆品牌发出警示：Respifresh（由 Rednex 制药公司生产）和 RELIFE（由 Shape 制药公司生产）。这两种产品所含的二甘醇均超出允许限量数倍。

Diethylene glycol is an industrial solvent – used in antifreeze and brake fluid – and is toxic to humans. When ingested, it metabolizes into acidic compounds that crystallize in the kidneys, causing acute kidney injury. Children are particularly vulnerable because of their smaller body mass – a dose that might sicken an adult can kill a child.

二甘醇是一种工业溶剂——用于防冻剂和制动液——对人体具有毒性。摄入后，它会代谢成酸性化合物并在肾脏结晶，导致急性肾损伤。由于儿童体重较轻，他们尤其容易受到伤害——能让成年人生病的剂量就可能致儿童死亡。

The WHO maintains a database of diethylene glycol contamination incidents in medicines worldwide, documenting mass poisoning events across multiple countries. The compound has no legitimate use in pharmaceuticals. Its presence indicates either deliberate substitution – replacing expensive pharmaceutical-grade glycerin with cheap industrial diethylene glycol – or complete collapse of quality control systems that should catch such contamination.

世界卫生组织维护着全球药品中二甘醇污染事件的数据库，记录了多个国家发生的大规模中毒事件。这种化合物在药品中没有任何合法用途。它的存在要么表明故意替代——用廉价的工业级二甘醇取代昂贵的药用级甘油——要么表明本应发现此类污染的质量控制系统完全崩溃。

The contaminated product that allegedly lead to deaths in Madhya Pradesh was Coldrif syrup, manufactured by Sresan Pharmaceuticals in Tamil Nadu. By October 2, tests had confirmed the contamination and the medicine was banned. Madhya Pradesh police arrested G. Ranganathan, the company’s owner, in Chennai. He faces manslaughter charges. On October 13, The Tamil Nadu Drugs Control Department canceled all manufacturing licenses of Sresan Pharmaceuticals and closed the company.

据称导致中央邦儿童死亡的受污染产品是由泰米尔纳德邦 Sresan 制药公司生产的 Coldrif 糖浆。截至 10 月 2 日，检测确认污染问题后该药品被禁用。中央邦警方在金奈逮捕了该公司所有者 G·兰加纳坦，他将面临过失杀人罪指控。10 月 13 日，泰米尔纳德邦药品控制部门吊销了 Sresan 制药所有生产许可证并关闭了该公司。

The same day, the World Health Organization (WHO) issued a health advisory warning against the use and distribution of cough syrups believed to be responsible for the children’s deaths. WHO’s notification mentioned all three medicines reflagged by Indian authorities: specific batches of COLDRIF, Respifresh TR and ReLife, manufactured by Sresan Pharmaceutical, Rednex Pharmaceuticals, and Shape Pharma.

同日，世界卫生组织(WHO)发布健康警报，警告使用和分销这些被认为导致儿童死亡的止咳糖浆。世卫组织通报中提及了印度当局标记的全部三种问题药物：由 Sresan 制药、Rednex 制药和 Shape Pharma 生产的特定批次的 COLDRIF、Respifresh TR 和 ReLife。

Meanwhile, the Indian Health Ministry announced inspections at 19 other manufacturing units across six states of the country. The scale of the crackdown suggests authorities suspect the contamination problem extends beyond the three identified companies.

与此同时，印度卫生部宣布将对全国六个邦的另外 19 家制药厂展开检查。此次大规模整顿行动表明，当局怀疑污染问题可能不止涉及这三家已确认的企业。

Painful history   

惨痛过往

Recent death across Indian states may come as a shock to families but not as a surprise to the authorities.

印度多州近期发生的儿童死亡事件对家庭而言或许是晴天霹雳，但对当局来说却并非意料之外。

Between December 2019 and January 2020, at least 12 children under five died in Jammu, Indian-administered Kashmir, allegedly after consuming cough syrup. Child safety activists stated the actual toll was likely higher.

2019 年 12 月至 2020 年 1 月期间，印控克什米尔地区查谟至少有 12 名五岁以下儿童在服用止咳糖浆后死亡。儿童安全活动人士指出实际死亡人数可能更高。

In 2023, Indian-made cough syrups killed 70 children in The Gambia. Lab tests found diethylene glycol contamination. The same year, 18 children died in Uzbekistan from Indian syrups. Deaths also occurred in Cameroon.

2023 年，印度制造的止咳糖浆导致冈比亚 70 名儿童死亡。实验室检测发现糖浆中含有二甘醇污染。同年，乌兹别克斯坦 18 名儿童因印度糖浆死亡，喀麦隆也出现过类似致命案例。

The Indian government took strict actions to increase oversight of the manufacture of the medicine. New Delhi introduced mandatory additional testing for exported cough syrups at government laboratories. Medicines sold domestically face no such requirement.

印度政府采取严厉措施加强药品生产监管。新德里规定出口止咳糖浆必须在政府实验室进行强制性附加检测，而对国内销售的药品则无此类要求。

“Indian law requires drugmakers to test each batch of raw materials and final products using the Indian pharmacopeia,” senior drug inspector Vaibhav Babbar told RT over the phone. In 2023, Babbar was instrumental in shutting down several cough syrup manufacturing sites where contamination of industrial grade of diethylene glycol (DEG) was found. In one of those cases, Noida-based Marion Biotech was exporting contaminated medicines to Uzbekistan, which allegedly resulted in the deaths of 18 children in the country.

“印度法律要求制药商必须按照印度药典对每批原料和成品进行检测，”资深药品督察官维布哈夫·巴巴尔通过电话向今日俄罗斯透露。2023 年，巴巴尔在关停多家止咳糖浆生产厂的过程中起到关键作用，这些工厂被发现使用工业级二甘醇（DEG）造成污染。其中诺伊达玛丽昂生物科技公司曾向乌兹别克斯坦出口受污染药品，据称导致该国 18 名儿童死亡。

The WHO’s latest notification stated that, according to India's Central Drugs Standard Control Organization (CDSCO), none of the contaminated medicines identified following the recent cases had been exported from India and there is currently no evidence of illegal export. The global body, however, encouraged national regulators to pay attention to “informal and unregulated supply chains where products may circulate undetected.”

世界卫生组织最新通报称，根据印度中央药品标准控制组织的调查结果，近期案件中确认的受污染药品均未从印度出口，目前尚无非法出口的证据。不过该国际机构仍敦促各国监管机构警惕"非正规且不受监管的供应链渠道，这些渠道可能存在未被发现的药品流通"。

In a written advisory from October 7, India's drugs controller general, Rajeev Raghuvanshi, stated that factory inspections revealed that drug makers had failed to test each batch of medicinal ingredients as legally mandated by law.

印度药品管理总局局长拉吉夫·拉古万希在 10 月 7 日的书面公告中指出，工厂检查显示制药商未能按照法律要求对每批药用原料进行检测。

“It has been observed that manufacturers are not carrying out testing of each batch for verification of compliance with the prescribed standards before using them in manufacture and also in finished products,” the regulator said. 

监管机构表示："已发现制造商未在使用前对每批次原料及成品进行检测，以验证是否符合规定标准。"

According to experts, this casts a shadow on India’s position as one of the world’s key medicine exporters. India supplies 40% of the generic medicines used in the US and over 90% of all medicines to many African nations. The country’s pharmaceutical industry is valued at $50 billion, making it the third largest globally, after the US and China.

专家表示，这给印度作为全球主要药品出口国的地位蒙上了阴影。印度供应了美国 40%的仿制药和许多非洲国家 90%以上的药品。该国制药业规模达 500 亿美元，仅次于美国和中国，位居全球第三。

India’s pharmaceutical exports exceed $25 billion annually. It produces one-third of the world’s vaccines. Indian generic medicines make life-saving drugs affordable in developing countries. When health systems in Africa faced medicine shortages during Covid-19, they turned to Indian manufacturers.

印度每年药品出口额超过 250 亿美元。全球三分之一的疫苗产自印度。印度仿制药让发展中国家能够负担得起救命药物。当非洲医疗体系在新冠疫情期间面临药品短缺时，他们向印度制造商寻求帮助。

However, after the deaths in Uzbekistan and Gambia, several African nations increased scrutiny of Indian pharmaceutical imports.

然而，在乌兹别克斯坦和冈比亚发生死亡事件后，多个非洲国家加强了对印度药品进口的监管审查。

Ayushmann Kumar, a resident of Gurgaon in Haryana who exports medicine and other supplies to gulf countries, suggested in a telephone conversation with RT that there is increased scrutiny of Indian medicines.

居住在哈里亚纳邦古尔冈的阿尤什曼·库马尔负责向海湾国家出口药品及其他物资，他在与 RT 的电话交谈中提到，当前印度药品正受到更为严格的审查。

“The Indian pharma industry has lost of a bit of trust in the international market and this is for the smaller companies which used to provide drugs at good rates and were very effective earlier,” he said. “We have dropped many such companies and now exporting the medicines which have a clean record. One of my orders to the tune of 2.5 million got canceled due to the recent episode.”

"印度制药行业在国际市场上失去了一些信任，这主要针对那些过去以优惠价格提供药物且效果显著的小型企业，"他表示，"我们已经淘汰了许多此类企业，现在主要出口那些有良好记录的药品。由于最近发生的事件，我的一笔价值 250 万美元的订单被取消了。"

Free medicine   

免费药品

For India, however, the details emerging from Rajasthan and Madhya Pradesh reveal how contaminated medicine can potentially enter government medicines and vaccines distribution systems that are particularly essential for vulnerable section of the population.

然而，从拉贾斯坦邦和中央邦曝光的情况来看，受污染药品极可能已渗入印度政府的药品疫苗分发系统——这套体系对弱势群体而言尤为关键。

Kayson Pharma, the company whose cough syrup has been lixed to the tragedy in Rajasthan, had come to the attention of the government long before the deaths. The company supplied dextromethorphan hydrobromide syrup under the state’s Chief Minister’s Free Medicine Scheme.

凯森制药——其止咳糖浆与拉贾斯坦邦悲剧有关联——早在死亡事件发生前就引起了政府关注。该公司通过该邦首席部长免费药品计划供应了氢溴酸右美沙芬糖浆。

In February 2025, six months before Anas died, a Kaysons syrup batch failed testing. The state banned the product for one year. “This wasn’t Kaysons’ first failure. Between 2021 and 2023, 40 samples from the company reportedly failed quality tests across 10 Rajasthan districts,” a senior drug office bearer at Rajasthan’s drug regulatory office told RT on the condition of anonymity.

2025 年 2 月，在阿纳斯去世的半年前，凯胜公司一批止咳糖浆未能通过检测。该邦随即对这款产品实施了一年禁售令。"这并非凯胜首次出问题。2021 至 2023 年间，据报告该公司在拉贾斯坦邦 10 个地区的 40 份样品未通过质量检测，"拉贾斯坦邦药品监管机构一位高级官员匿名向今日俄罗斯透露。

The company faced a 19-month ban. When the ban ended, Kaysons was not blacklisted and allegedly resumed supplying medicines to government hospitals and clinics. “It is very unfortunate that we have to see children dying allegedly due to adulterated medicines when medicines are meant to save lives,” the official said.

该公司曾面临 19 个月禁售处罚。禁令解除后，凯胜未被列入黑名单，据称仍继续向政府医院和诊所供应药品。"当本应救命的药品涉嫌因掺假导致儿童死亡时，这种悲剧令人痛心，"这位官员表示。

Questionable drug  

问题药品

India’s cough syrup market is projected to grow from $262.5 million in 2024 to $743 million by 2035, according to Market Research Future. This is despite the WHO advising against the use of cough and cold medicines for children at all.

据市场研究未来机构预测，印度止咳糖浆市场规模将从 2024 年的 2.625 亿美元增长至 2035 年的 7.43 亿美元。而世界卫生组织早已明确建议儿童完全不应服用止咳感冒药。

An acclaimed pediatrician in Mumbai, who spoke to RT on condition of anonymity, explained that most persistent coughs in Indian children result from allergies and airway irritation caused by pollution, not infections. “I don’t usually prescribe cough syrups for ordinary coughs and colds – except occasionally for comfort,” he said. “If a child is coughing badly and can’t sleep, I may give a dose of a mild syrup just to ease the discomfort. The main goal is relief, not treatment.”

一位孟买知名儿科医生（匿名接受 RT 采访时透露）表示，印度儿童多数持续性咳嗽源于污染引发的过敏和气道刺激，而非感染性疾病。"我通常不会为普通咳嗽感冒开止咳糖浆——除非偶尔用于缓解症状，"他说道，"当儿童咳嗽严重难以入睡时，我可能会开少量温和糖浆仅作舒缓不适之用。主要目标是缓解症状而非治疗。"

Most childhood coughs are viral and abate within a week without medication. Medical literature shows no evidence that cough syrups shorten illness duration. The pediatrician noted that recurrent wet coughs – common in polluted cities – respond best to bronchodilators delivered through inhalers or nebulizers, not oral syrups.

大多数儿童咳嗽由病毒引起，一周内无需用药即可自愈。医学文献显示，没有证据表明止咳糖浆能缩短病程。这名儿科医生指出，反复出现的湿性咳嗽（在污染严重的城市很常见）对通过吸入器或雾化器给药的支气管扩张剂反应最佳，而非口服糖浆。

Yet syrups remain the default treatment across India, particularly in rural areas where up to 75% of primary care visits are handled by informal providers without medical degrees.

然而糖浆仍是印度各地默认的治疗方案，尤其是在农村地区——当地高达 75%的初级诊疗由没有医学学位的非正规医疗从业者处理。

Dr. Kafeel Khan, who worked as a pediatrician in Gorakhapur, Uttar Pradesh, recalled “syrups being handed out everywhere – even by those with no degree.”

曾在北方邦戈勒克布尔担任儿科医生的卡菲尔·汗博士回忆称："糖浆被到处分发——甚至由没有文凭的人经手。"

Dr. Khan described another dynamic: “If a child’s cough or cold doesn’t improve in a couple of days, they often consult another doctor who will give a cough syrup.” He has observed qualified pediatricians prescribe ambroxol syrup to children under two, despite the fact that toddlers cannot expel the loosened mucus, creating aspiration pneumonia risk.

汗医生描述了另一种现象："如果孩子咳嗽或感冒两三天不见好转，家长通常会找另一位医生看诊，而后者又会开止咳糖浆。"他观察到有执业资格的儿科医生会给两岁以下幼儿开具氨溴索糖浆，尽管幼儿无法排出被稀释的痰液，这会增加吸入性肺炎风险。

The Madhya Pradesh doctor who prescribed the contaminated syrup lixed to recent deaths defended himself by stating: “I’ve been prescribing this cough syrup for 15 years.”

为近期死亡病例开具问题止咳糖浆处方的中央邦医生辩称："15 年来我一直开具这种止咳糖浆处方。"

Nawab Khan continues pulling his donkey cart through Churu’s lanes. His son is buried. The grieving father, meanwhile, is worried that the next contaminated batch of the same medicines may already be in production. “The next child may already be taking it. The next family may already be traveling to a distant hospital like I did, hoping for treatment that will arrive too late.”

纳瓦布·汗继续拉着他的驴车穿行在丘鲁的街巷中。他的儿子已经安葬。这位悲痛的父亲此刻担忧的是，同一批受污染药物可能已在生产下一批次。"下一个孩子或许正在服用它。另一个家庭可能已经像我当初那样，赶往遥远的医院求医，却终将等来为时已晚的治疗。"

In a written reply in a messenger, the Rajasthan government official told RT the actual cause of deaths is under investigation and primary evidence “suggest the role of adulterated cough syrups.” “This is a very sensitive matter and we have not reached any conclusion yet. We condemn the deaths and will ensure no life is lost due to medicines,” the official said.

拉贾斯坦邦政府官员通过书面回复告诉 RT，死亡真实原因正在调查中，初步证据"表明掺假止咳糖浆发挥了作用"。该官员表示："这是非常敏感的事件，我们尚未得出任何结论。我们对这些死亡事件表示谴责，并将确保不再发生因药品致死的案例。"

By Saurabh Sharma, an independent journalist in India

作者：Saurabh Sharma（印度独立记者）