Photos: Fighting Mislabelled ORS Drinks – How Hyderabad’s Dr Sivaranjani Santosh Ended the Misuse of Sugar-Laden Drinks and Changed India’s Health Rules

After an eight-year relentless campaign, Hyderabad-based paediatrician Dr. Sivaranjani Santosh has finally achieved a historic breakthrough. The Food Safety and Standards Authority of India (FSSAI) has issued a directive banning the use of the term “ORS” in any food or beverage product name, label, or trademark, whether used alone or as a prefix/suffix. This decision marks a significant step toward protecting children and adults from misleading products falsely marketed as oral rehydration solutions, ensuring that ORS retains its life-saving purpose.

Flavoured “hydration” drinks and energy beverages often marketed as ORS contain dangerously high levels of sugar—up to ten times more than what the World Health Organization recommends. Instead of rehydrating children suffering from diarrhoea, these sugary drinks worsen dehydration, cause electrolyte imbalances, and can lead to severe complications. Children under five are particularly vulnerable, making the distinction between true ORS and these fake alternatives a matter of life and death.

Hospitals across India have reported numerous cases where children became critically ill after being given sweetened drinks labeled as ORS. One case involved a four-year-old child who became severely dehydrated despite being given “ORS water” for two days. Blood tests revealed dangerously high sugar and low sodium levels. Doctors warn that improper substitutes for ORS can trigger brain swelling, seizures, kidney failure, and other life-threatening complications, demonstrating the urgent need for public awareness and correct use of WHO-approved ORS.

Medical experts emphasize that proper awareness and education are key to preventing dehydration-related fatalities. WHO-recommended ORS, when prepared correctly, restores lost salts and glucose during diarrhoea, helping children recover safely. In contrast, sweetened beverages, energy drinks, or sports drinks marketed as “hydration solutions” cannot replace true ORS and may worsen symptoms. Parents are urged to strictly follow instructions on WHO-ORS sachets and avoid misleading packaged drinks, which can endanger children’s lives.

Dr. Santosh spent eight years fighting against unethical marketing practices by beverage companies that falsely used the term ORS. Despite facing threats on social media, backlash from the industry, and pressure from authorities and even family, she remained steadfast in her mission to protect public health. By documenting cases, raising awareness online, and filing complaints and public interest litigation, she ensured that the dangers of sugar-laden drinks posing as ORS could no longer be ignored. Her perseverance has resulted in a landmark victory for child health in India.

In a decisive move, the FSSAI clarified that the use of the term “ORS” in any form—standalone, as a prefix, suffix, or part of a trademark—is strictly prohibited on food and beverage products. Authorities across India are instructed to enforce compliance under the Food Safety and Standards Act, 2006. This directive ensures that misleading labelling is removed from shelves, protects children from dangerously sugary drinks, and reinforces that only properly prepared WHO-ORS can be used to treat diarrhoeal dehydration safely.

With the ban in effect, Dr. Santosh expressed immense relief, emphasizing that no child should die or suffer worsening diarrhoea due to sugar-laden drinks falsely marketed as ORS. Her tireless efforts have ensured that ORS continues to save lives as a proven, life-saving solution for dehydration. This victory is not only a win for Dr. Santosh but also a milestone for public health in India, highlighting the importance of vigilance, awareness, and strict regulation in protecting children from preventable health risks.