Lessons from Chhindwara: Health governance needs accountability
By Raju Kumar
BHOPAL: The Chhindwara cough syrup tragedy has once again exposed the deep cracks in Madhya Pradesh’s health system—especially in the quality control and supply chain of medicines. Dozens of children lost their lives, and the investigation revealed that the cough syrup administered to them contained toxic diethylene glycol. The same chemical has been responsible for several international disasters in the past. The deaths of these children have raised serious questions about the accountability of not only local authorities but the state’s entire health department. The arrest of the manufacturer and the notice issued by the National Human Rights Commission are enough to show how fragile and ineffective the state’s drug-regulation mechanism has become. This tragedy is not an isolated accident but a symbol of a system that has been decaying for over a decade.
This is where one must look back. Around 2013–14, Dr Ajay Khare, then president of the Madhya Pradesh Medical Officers’ Association, had demanded an investigation into the substandard medicines being supplied to government hospitals. Along with Arun Dwivedi, president of the Madhya Pradesh Class III Government Employees’ Association, he filed a public-interest litigation in the Jabalpur High Court. The petition came at a time when the health department was facing serious allegations of large-scale irregularities in drug procurement. Dr Khare had openly stated that medicines reaching public hospitals were often substandard and that departmental lobbies were protecting suppliers. He demanded an independent probe to identify who was profiting from the medicines bought in the name of public welfare.
He was committed to restoring ethics and public interest in the health system. His belief was clear: unless transparency and accountability become integral to healthcare delivery, any reform will remain cosmetic. His uncompromising stance made him a target of the entrenched medical-supply mafia. When he spoke out against substandard drugs, he received threats and institutional pressure. In 2015, he died in a road accident, taking with him one of the few remaining voices that had dared to challenge the decay within the system.
The Chhindwara tragedy is the result of the same systemic rot he had identified a decade ago. The questions remain unchanged: Where is the transparency in government procurement? How active and independent are the state laboratories that test drug quality? And who will protect those inside the system who expose corruption? When the deaths of children have shaken the conscience of the nation, it is worth recalling that the very flaws listed in that 2014 PIL persist unchanged. The High Court had sought a response from the state government, which promised an “internal inquiry,” yet a decade later the same failures have resurfaced. This is not mere administrative negligence; it is institutional collapse—where regulators remain buried in paperwork and the pharmaceutical lobby enjoys unchecked freedom.
Madhya Pradesh’s health crisis shows that corruption is no longer just an economic offense—it has become a form of mass killing. Behind every contaminated bottle lies an entire chain of culpability: procurement officers, laboratory certifiers, transport contractors, and political patrons. Corruption in this ecosystem is multilayered, and accountability has no anchor. Earlier warnings had made it clear that lack of transparency in public health would not only cause financial loss but cost human lives. The Chhindwara tragedy now reads like the grim fulfilment of those warnings.
Meanwhile, the lack of coordination among the Drug Control Office, the State Medical Corporation, and the Health Department has come to the fore once again. Often, drug samples are never sent to labs, or reports are delayed for months. Manufacturers rarely face punishment because of political protection. When doctors and health-workers raise their voices, they are branded “troublemakers” and sidelined. After the Chhindwara episode, the same familiar cycle is repeating—committees will be formed, a few officials will be transferred, licenses will be cancelled, and the case will fade from headlines. True reform will come only when we accept that the very foundation of the health-governance system is rotten and must be rebuilt from within.
The grim irony is that in a vast state like Madhya Pradesh, where access to healthcare is already limited, such episodes devastate the poor and marginalized the most. Those dependent on public hospitals face the gravest risk. We must recognize that healthcare is not a charity—it is a constitutional right. The Chhindwara tragedy can be forgotten as “just another accident,” but if society and the state fail to learn from it, the next disaster will claim even more lives.
Seen in totality, the problems identified a decade ago remain unaddressed. This is not merely the failure of individuals but of policy-making itself. What is needed now is not another round of blame but the reconstruction of an integrated system where drug manufacturing, procurement, testing, and grievance redressal are all linked through a transparent digital framework. This is the time to strengthen accountability in health governance—both legally and technologically—so that no future tragedy repeats at the cost of policy negligence. The dream of an honest, ethical healthcare system remains unfulfilled, and the innocent lives lost in Chhindwara stand as its most painful reminder. (IPA Service)
