Hyderabad paediatrician launches online petition against ORS misbranding

Hyderabad: A week after resigning from the Indian Academy of Paediatrics (IAP), a city-based paediatrician has launched an online petition raising concerns about how  electrolyte drinks are being marketed in pharmacies and the risk they pose to consumers making critical decisions during dehydration. 

Sharing the link for the online campaign on X, Dr Sivaranjani Santosh urged the public to sign and share it to help protect every family from confusion in critical moments. 

In the post, she said that the issue is not about whether eRZL, an electrolyte drink, is safe in isolation but about how it is presented, perceived, and potentially misunderstood in real-world settings.

She pointed out that the drink is a commercially marketed electrolyte drink, but its branding and communication may create confusion by referencing ORSL. According to her, ORSL itself is not the original medically recommended Oral Rehydration Solutions (ORS) and referencing ORSL in any form creates brand recall in the minds of consumers.  

Instead of reducing confusion, it continues and reinforces it, she said. When the drink is positioned as a continuation or replacement of ORSL, she stated that it keeps that same association alive, especially among parents who may already believe ORSL was equivalent to ORS.

"In pharmacy settings, people often make quick decisions under stress and rely on familiar names and visual cues," she noted, adding that such branding could influence choices and create the impression that the drink is a medical solution for dehydration.

She also raised concerns regarding ingredients like sucralose, particularly in children and with prolonged use, clear communication becomes more important.

The doctor further revealed that after raising these concerns, she received a legal notice from Johnson & Johnson and Kenvue.

Calling it a matter of public health, she has launched an online petition urging authorities, including the Food Safety and Standards Authority of India and the Ministry of Health and Family Welfare, to take action.

Through the petition, she has demanded that authorities ensure that since eRZL closely resembles ORSL, Kenvue is directed to rebrand it in a way that does not create recall or association with ORSL, prevent misleading positioning, strengthen enforcement at the pharmacies, ensure clear differentiation from medically recommended ORS and protect healthcare professionals raising genuine concerns.

"In healthcare, even small confusion can have big consequences. Clear choices save lives. Stand for public health. Sign and share this petition to help protect every family from confusion in critical moments," she said in the post. 

Medical Dialogues had reported that Dr Santosh resigned from the Indian Academy of Paediatrics, alleging that its leadership failed to support her and did not condemn the legal notice issued against her by pharmaceutical companies. She claimed that while several medical associations and doctors came out in her support, the Indian Academy of Paediatrics, being a respected body, failed to act responsibly in this case.

She said that the IAP did not condemn the public statement by Kenvue claiming its products were presented at IAP, nor did it speak against the legal notice sent to her. Instead, the academy issued a position statement highlighting the safety of sucralose without warning parents about its possible long-term risks.

Background

The issue dates back to a long-standing controversy raised by Dr Santosh over the misleading marketing of electrolyte drinks as Oral Rehydration Solutions (ORS).

For several years, the paediatrician has been flagging that many commercially available drinks were being marketed using names similar to ORS, despite not meeting the medically approved formulation. She even documented cases where children with dehydration were given such drinks instead of proper ORS, leading to serious health risks.

As a result, she fought for several years, including multiple Public Interest Litigations and sustained advocacy against the alleged misbranding of electrolyte drinks as ORS.

Following her efforts, the Food Safety and Standards Authority of India (FSSAI) prohibited the use of the term ‘ORS’ on beverage labels unless they strictly meet World Health Organisation (WHO) standards.

However, on March 16, two major pharma companies issued a notice to the doctor accusing her of making slanderous remarks on social media about ORSL (Oral Rehydration Salt and Liquid) and its rebranded variant, ERZL.

The companies said in their legal notice that they are following the rules under the Food Safety and Standards Act, 2006, and that their claims are backed by government approvals and scientific evidence.

They also referred to ongoing legal proceedings in the Delhi High Court, where the judge observed that the products are “not adulterated or unsafe for use” and that the issue is mainly about branding. The companies denied claims that older ORSL products are still being sold or that ERZL is being promoted as a replacement for ORS.

Also read- Hyderabad doctor quits Indian Academy of Paediatrics over ORS controversy, pharma notice