In May 2025, the Union Health Ministry acknowledged in a response to the Lok Sabha that over 7,500 drug samples failed quality tests across India in the previous year, with spurious drugs reported from nearly every major state. The admission, buried in a routine reply, drew sharp criticism from public health experts who warned that the government was normalizing a crisis of mass scale.
This stark admission reveals more than a quality control failure — it points to a chronic, systemic threat that continues to escape urgent national reckoning. Why, then, do deaths of innocent Indians caused by fake or spurious drugs fail to trigger the same outrage, media scrutiny, and policy response as terrorist attacks — such as the one that recently shook the nation?
Terrorism, rightly, provokes collective anger, fear, and decisive action. It disrupts lives, societies, and the national psyche. But when another threat kills even more people every year, acts silently, and feeds off weak institutions — it too warrants being treated as a public emergency.
This comparison is not meant to diminish the horror of terrorism. Rather, it is to confront the staggering neglect of a parallel, preventable crisis. Fake drugs — spurious, substandard, or deliberately mislabeled medicines — kill more Indians annually than terrorism has in decades, yet the political and public response remains muted, fragmented, and disturbingly indifferent.
Fake Drugs: India’s Hidden Epidemic
India is often celebrated as the “pharmacy of the world,” supplying affordable generics globally. But that very scale makes it vulnerable to the systemic menace of fake drugs. According to a 2022 government survey, around 4.5% of drug samples tested in India were substandard, and 0.3% were spurious. While these numbers may seem small, they translate into millions of doses affecting patient outcomes.
Independent estimates, including those from the WHO, suggest that up to 10% of medicines in India’s supply chain may be fake or substandard. That figure increases dramatically in rural areas and among unregulated or informal sellers.
In 2022 and 2023, India-made cough syrups linked to the deaths of over 100 children in Gambia and Uzbekistan exposed the cracks in India’s drug quality surveillance. But such tragedies aren’t just export scandals — similar failures occur domestically, often undocumented and buried in private grief.
Terrorism vs. Fake Drugs: A Deadly Disparity
Let’s look at the numbers:
- Terrorism-related deaths in India (2023): Less than 100, according to the South Asia Terrorism Portal.
- Estimated deaths due to fake drugs (India, annually): 200,000–250,000, based on WHO extrapolations and Indian health sector data.
In other words, fake drugs kill as many Indians in one year as terrorism has in over two decades.
Yet, compare the national response:
- We have a Ministry of Home Affairs-led anti-terror infrastructure, counter-terrorism forces, and international collaborations.
- In contrast, India’s drug regulation is fragmented, underfunded, and chronically understaffed — with one drug inspector for every 200+ pharma units in some states.
Fake Drugs as a Public Health and Security Threat
Fake drugs don’t just cause death. They:
- Undermine treatment of tuberculosis, malaria, HIV, and non-communicable diseases.
- Fuel antibiotic resistance, now one of India’s top health threats.
- Shatter public trust in doctors, hospitals, and medicines.
- Waste public health budgets on ineffective procurement and recalls.
Their proliferation is enabled by:
- Weak state-level enforcement
- Political protection of unscrupulous manufacturers
- Unregulated online drug sales
- A vast informal medical economy, especially in Tier II–IV cities and rural India
Regulatory Paralysis: A Broken System?
Despite repeated alerts from the WHO, Parliamentary Committees, and even the judiciary, India’s drug regulatory ecosystem remains broken.
Key challenges:
- CDSCO has jurisdiction only over a few functions; state drug controllers handle licensing and inspections.
- Punishment for producing fake drugs is weak — most cases drag for years and end with acquittals or token fines.
- A 2021 Parliamentary report found that even quality testing labs were under-equipped, with backlogs of over a year.
What India Must Do — Immediately
This is not an issue of awareness but of political will and systemic reform. India must:
- Strengthen and effectively implement the New Drugs, Medical Devices and Cosmetics Bill with strong enforcement provisions.
- Deploy a national track-and-trace system across the pharma supply chain, from factory to pharmacy.
- Invest in independent drug-testing labs in every state and digitize their data for public transparency.
- Shut down informal and unlicensed drug retailers through coordinated action by health, law enforcement, and revenue departments.
- Launch a public awareness campaign akin to anti-tobacco or anti-dowry campaigns, warning of the risks of fake medicines.
Conclusion:
India has built a global reputation on pharmaceutical strength — but that strength is only as credible as the quality of every tablet sold, domestically and abroad.
Fake drugs may not detonate like a bomb, but their effects are just as lethal. It’s time India recognized this silent terror for what it is: a mass-scale threat to life, public health, and national reputation.
Let’s not wait for more headlines, more funerals, and more international embarrassments. Let’s fight fake drugs with the urgency we reserve for terrorism.
By: Tapan J. Ray
Disclaimer: The views/opinions expressed in this article are entirely my own, written in my individual and personal capacity. I do not represent any other person or organization for this opinion.