Hyderabad doctor quits Instagram after long fight over ORS-like drink brand: 'Tired of fighting alone'

Pediatrician Dr. Hyderabad-based Sivaranjani Santosh, who grabbed social media attention for her campaign against drinks she says could be mistaken for oral rehydration solution (ORS), has announced she is leaving Instagram after years of championing the issue.

Dr. Santosh said Indian Express that she felt exhausted by the long-running battle and disappointed by the response of professional bodies to the concerns she raised.

“I am tired of fighting alone. I am hurt by the way the Indian Academy of Paediatrics (IAP) has treated me and more importantly, the way they have handled my concerns,” Dr Santosh told the publication.

Her decision comes after she resigned from the Indian Academy of Paediatrics, the country’s premier paediatrics body. According to Dr Santosh, she felt the organization did not adequately address her concerns about the drinks brand setting up kiosks at its annual conference. The brand has previously used the term ORS in its name.

A campaign that garnered national attention

Dr Santosh came into the limelight after an eight-year campaign targeting products she said could be confused with oral rehydration solution, a medically recognized formulation used to treat dehydration caused by diarrhoea.

ORS is considered a life-saving procedure because its formulation is carefully designed to replace fluids and electrolytes lost during illness. According to medical experts, changes in composition can change the balance of salts and sugars, which can affect how fluids are absorbed in the body.

Over the years, Dr. Santosh has repeatedly raised concerns about fruit-based soft drinks, which she believes could be mistaken for ORS despite having different formulations.

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Resignation from IAP and criticism of management

After the IAP accepted her resignation, Dr Santosh publicly criticized the organization’s leadership.

“Finally, my resignation from the IAP has been accepted, thankfully! Until now, I’ve had to show some restraint before calling out management for their miserable servitude to pharma! Now I have no obligation to show that restraint!”

Her criticism stems from what she called the organization’s lack of support in its campaign for products that use ORS-like branding.

Concerns about a rebranded Kenvue product

The main focus of the campaign Dr. Santosh was Kenvue, formerly the consumer health division of Johnson & Johnson.

The Food Safety and Standards Authority of India (FSSAI) has banned the use of the term “ORS” for electrolyte drinks that do not meet World Health Organization recommendations. Subsequently, Kenvue rebranded its hydration product as EZRL, retaining the ORSL for its diarrhea-specific formulation.

Dr Santosh argued that the new brand continued to resemble the earlier product, which could confuse consumers. She said similarities in the name, font style, colors, packaging layout and depiction of the fruit could lead people to associate the two products.

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Based on those concerns, she filed a trademark opposition in February.

Kenvue’s answer

In response to the opposition, Kenvue denied the allegations.

“(The objection)… has been filed with the intention of delaying the applicant’s application and is wrong in law. This opposition proceeding is without merit as the applicant’s trade mark ERZL… is in compliance with all the provisions and in compliance with the orders passed by the Food Safety and Standards Authority of India (FSSAI) which has restricted the use of their portfolio of hydrated ORS for the food products herein.”

The company further stated:

“Since the subject mark does not contain the expression ORS and the subject mark is not similar to ORS, the adoption and use of the subject mark is not illegal or misleading or in contravention of any orders of FSSAI or Hon’ble Courts.”

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Why IAP became part of the debate

Dr. Santosh also questioned why the company was allowed to be present at the IAP Pedicon conference.

While she acknowledged that the company had not made a scientific presentation, she argued that allowing promotional booths for products she said created confusion raised important questions.

After the challenges of Dr. Santosh et al., the IAP issued an opinion that highlights the differences between ORS and electrolyte drinks. The statement urged clinicians to ensure that patients with diarrhea receive properly formulated ORS products.

The organization also raised concerns about products that may look or sound similar to ORS, noting that such similarities could lead to consumer confusion.

However, Dr Santosh remained unhappy with parts of the statement, particularly the reference to non-nutritive sweeteners such as sucralose, which he said were regulated and considered safe within accepted intake limits.

She has previously expressed concern about the regular consumption of hydration drinks containing sucralose, citing debate within the global scientific community regarding the use of these sweeteners.