'If I Have To Fight Alone, I Might As Well Do It Independently': Why The Doctor Who Took On India’s ORS Confusion Walked Away From IAP | Exclusive

Last year, Dr Sivaranjani Santosh became a name many parents quietly rooted for. Her 8-year-long fight against ORSL, a product which was often confused with WHO-approved ORS led to action from the Food Safety and Standards Authority of India, which prohibited brands from misusing the term 'ORS' on food products. For most of us watching from the outside, it felt like closure but for her, that moment was just a turning point, not the end.On call with us today, a day after resigning from the Indian Academy of Pediatrics (IAP), there was no sense of triumph in her voice only exhaustion layered with clarity. “If I have to fight my battles alone with no support from my organisation, then I will do it independently,” she said. It wasn’t said in anger

as much as in acceptance. She had already been doing the work on her own where she was reaching out to schools, authorities, raising awareness at the grassroots, even going as far as secretly recording pharmacies that continued to hand out ORSL when parents specifically asked for ORS. What she hadn’t anticipated was resistance from within.Because while the public narrative framed her as someone who had taken on the system and won, her reality was far different and complicated. There was no direct, visible backlash from companies, she told me, but there was a steady stream of threats, allegations, insinuations that she was being funded by competing brands. “That was expected. I knew this wouldn’t be easy,” she admitted. What she didn’t expect was the shift within her own professional ecosystem. Her claims, which she insists were evidence-based, began to be questioned and even dismissed. There were communications circulating among paediatricians supporting the use of sucralose, something she had been openly cautioning against. “That caught me off guard,” she said.Things escalated in March 2026 when she received a legal notice from pharmaceutical firm accusing her of making 'false and defamatory' statements on social media. At the heart of this was the rebranding of ORSL to ERZL, a move she believes continues to create confusion among consumers. She explains, "The argument from the companies is that sugar levels have been reduced and replaced with sucralose, an approved sweetener. But sucralose is not something I would recommend for children, particularly those under two. It has the potential to worsen gut inflammation, disrupt the microbiome and increase long-term health risks." More importantly, she emphasised that such drinks are not meant for regular consumption anyway, something that gets lost in marketing narratives.

What made the situation harder to navigate was the response that followed from within the Indian Academy of Pediatrics. “The IAP said sucralose is safe, and in a way that only strengthens the companies’ case against me,” she said, the fatigue evident now. Instead of questioning the branding or calling for clearer distinctions, she felt the institution had indirectly enabled it. She points to the transition from ORSL to ERZL despite regulatory directions. As per orders from the Food Safety and Standards Authority of India and even observations from the Delhi High Court, such usage should not continue, even in marketing. She raised these concerns internally, expecting leadership to take a stand. Instead she was told she was exaggerating, even accused of misleading. “It became unpleasant. Honestly, I couldn’t take the toxicity anymore. I thought, enough.”Her resignation however is not withdrawal. She is continuing her work, only now without the expectation of institutional backing. Her focus has expanded beyond the ORS versus ORSL debate to larger issues around child safety and public health. She has been actively training people in first aid and CPR, working with medical professionals across Telangana with the goal of making schools safer and better prepared for emergencies. At the same time, she is raising concerns about the way medicines are sold over the counter in India, multiple formulations with the same names, varying compositions that can easily confuse parents and lead to errors. "Paracetamol is a prime example with too many strengths available in the market. Standardisation is long overdue."Listening to her, what stands out is not just the scale of the issues she is taking on, but the clarity with which she sees them. None of this, she knows, is going to resolve quickly. “This is never-ending. It’s something so simple and straightforward, but right now it feels like one small hand fighting a big mountain.” And yet, she isn’t stepping away, just choosing to fight it on her own terms now.