“I never imagined doing anything other than becoming a doctor. My father and grandfather are doctors, but it wasn’t their influence that inspired me—I just always knew I wanted to be a doctor. I was born in Tanuku, West Godavari, my mother’s native place, and my father is from Uyyuru, Krishna district. We are a middle-class family, happy and supportive. My parents encouraged us to follow our choices, but my decision to pursue medicine came from within; I wanted to help people, especially children, and make healthcare accessible to those who needed it most. I had many idealistic dreams, and I know I haven’t achieved all of them yet, but I am trying.

I did my schooling in Vijayawada, then pursued MBBS and MD at Jawahar Lal Institute of Postgraduate Medical Education & Research, Pondicherry. JIPMER taught more than medicine; ethics, empathy, and patient care were drilled into us. We were trained to be healers, not just prescribers. Paediatrics was an easy choice; I love being with children. Caring for them felt natural and fulfilling.

After graduation, I worked at Apollo, The Birthplace, and MaxCure hospitals. At Apollo, the first two years were mostly administrative, but I built goodwill through my work. At The Birthplace, I was asked to head the Pediatrics department. Eventually, I chose to work independently, which allowed me to care for children without compromise.

The real challenge began when children with diarrhoea weren’t improving with what parents thought was ORS. They were actually being given sugar-rich beverages falsely marketed as ORS. Seeing children worsen, some ending up hospitalized, was heartbreaking. I started raising awareness and documenting these cases. In 2021, I wrote to the drug controller and the Health Ministry. They replied no permission had been granted and advised me to approach FSSAI. I did, and finally, on April 8, 2022, an order was issued, very similar to the present one. Unfortunately, it was quietly changed, allowing products like ORSL with the disclaimer: “This is not ORS.”

I couldn’t take it. It would have been enough guiding the parents of the children I see, but my conscience didn’t allow me to stop with that seeing parents trusting these products and children’s health getting worse. I knew I had to act. So I filed a Public Interest Litigation where the respondents were the Union Government and companies who were making these drinks.

WHO-approved ORS has a precise formula: 2.6 grams sodium chloride, 1.5 grams potassium chloride, 2.9 grams sodium citrate, and 13.5 grams dextrose per litre. Many marketed products contained nearly 120 grams of sugar per litre and electrolytes far from WHO norms. Parents thought they were saving lives, but these products could make children sicker. I fought this for eight years — writing letters, recording videos with proofs, filing PILs, and following up persistently.

Finally, on October 14, 2025, FSSAI issued a directive banning the term ‘ORS’ for any beverage not meeting WHO standards. All previous permissions were withdrawn, including orders from 2022 and 2024.

The next day, FSSAI reaffirmed that labeling beverages as ORS misleads consumers and violates the Food Safety and Standards Act, 2006.

The fight isn’t over. Some companies still have stockpiles of these sugar-heavy products. I’m actively working to prevent the clearance or sale of 180 crore rupees worth of these beverages. We are submitting objections and following up to ensure these products don’t endanger children or mislead parents.

Many doctors supported me, including the Endocrine Society of India and the Women Pediatricians Forum. The Indian Academy of Pediatrics didn’t support me, and my family experienced stress watching me challenge big corporations. Companies even tried to distract me with ‘Speaker’ opportunities, which I refused. But I couldn’t let children’s lives be at risk.

I’ve also raised concerns about several other issues including cough syrups and other medicines. People need to understand labels, handle emergencies, and know basic first aid. Schools could teach first aid and CPR from 7th or 8th grade. Medicines should be safe, clear and accessible, and healthcare should reach everyone, especially the poor.

This fight wasn’t about one person. It was about people’s power — doctors, advocates, parents, and communities. Eight years of persistence, three years of PILs, and countless efforts finally led to a positive outcome. It feels like a victory, but my work isn’t over. I will continue to speak out, raise awareness, and protect children wherever I can. Because when a child’s life is at stake, staying silent is not an option.”

• Dr. Sivaranjani Santhosh, Pediatrician