India has refused drugmakers' requests to extend a year-end deadline for them to upgrade their manufacturing facilities to international standards, four sources said, amid public anger over the recent deaths of at least 24 children who consumed locally-produced cough syrup. New Delhi had in late 2023 ordered pharmaceutical companies to ensure their plants meet World Health Organization-recommended standards, which would require them to invest in protocols to prevent cross-contamination and enable batch-testing of samples, among other measures. The mandate was established after India-made cough syrups were linked to the deaths of over 140 children in Africa and Central Asia, severely denting India's image as a "pharmacy of the world."

While major pharmaceutical companies met a June 2024 de

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