In a significant victory for child health and consumer safety, the Food Safety and Standards Authority of India (FSSAI) has issued a directive banning the use of the term "Oral Rehydration Salts" (ORS) on beverage and food product labels unless they comply exactly with the World Health Organization (WHO) recommended formula. This decision comes after an eight-year-long campaign by Hyderabad-based paediatrician Dr. Sivaranjani Santosh against misleading marketing practices by manufacturers who labeled sugary drinks as ORS.
The Campaign and the Issue
Dr. Sivaranjani Santosh has been at the forefront of this fight, advocating that ORS is a specific drug formulation designed to treat dehydration from diarrhoea with a precise balance of salts and glucose for rapid and effective absorption. For decades, many manufacturers used the term "ORS" on beverages with high sugar content that do not meet WHO standards, misleading consumers and endangering children's health. Such sugary drinks worsen diarrhoea instead of treating it, putting children at risk.
Dr. Sivaranjani personally witnessed many cases where children’s diarrhoea worsened after consuming drinks labeled as ORS but were actually just sweetened beverages. She challenged regulatory bodies, including the Central Drugs Standards Control Organisation (CDSCO), the Union Ministry of Health and Family Welfare (MOHFW), and the FSSAI, raising awareness and pushing for stricter regulations.
Regulatory Evolution and Outcome
Initially, in 2022, the FSSAI allowed some leniency by permitting the ORS tag on some products, provided they carried a disclaimer clarifying that the product was not a WHO-recommended ORS formula. However, Dr. Sivaranjani contested this compromise, emphasizing that such products continued to mislead consumers.
The turning point came following tragic incidents, including deaths linked to contaminated cough syrup in Madhya Pradesh, which underscored the dangers of mislabeling medicinal products. Taking note of these concerns, the FSSAI in October 2025 firmly prohibited all food business operators from using the word "ORS" on their product labels in any form unless they adhere to the WHO-approved formula.
What the FSSAI Order Says
The FSSAI order mandates the removal of the term ORS from all food product labels, whether used alone or in combination with other words or trademarks. It enforces strict compliance with labeling and advertising regulations under the Food Safety and Standards Act, 2006.
Dr. Sivaranjani celebrated this milestone as a major public health victory, stating that misleading products bearing ORS on their labels cannot be sold anymore, ensuring better protection for children facing diarrhoea.
Why WHO-Approved ORS Matters
Oral Rehydration Salts recommended by WHO involve a precise mixture typically made by dissolving six teaspoons of sugar and half a teaspoon of salt in one liter of clean water. This balance is critical for effectively preventing and treating dehydration caused by diarrhoea. The widespread substitution of this life-saving solution with sugary drinks is detrimental to health and counterproductive in managing dehydration.
This regulatory victory highlights the importance of accurate labeling in protecting consumer health, especially children. Dr. Sivaranjani's perseverance over nearly a decade has led to a decisive intervention that benefits public health across India.