Why did Indian drugs kill 9 Belarusians? Officials may be saving money, and doctors fear punishment

The publication "Zerkalo" and the organization Belpol found out that from January to May 2026, at least nine patients died in Belarus after being administered the same Indian adenosine — the drug "Cardiurex" (Cardiurex) from Welcure Remedies — during heart surgeries. Bacteria residues were later found in it. Stanislau Salavei, deputy representative of the United Transitional Cabinet for Social Policy on Healthcare Issues and a medical professional, explained in the "Studio" program on "Belsat" how a defective drug ended up in operating rooms.

The interlocutor emphasized that without all the documents, it is difficult to say whether this was a random coincidence or a закономерный result of the system's operation. A full investigation is needed.

"In any case, such situations, unfortunately, do happen. They even happen in countries with very strict regulation, like the USA," he stressed.

The company that produced the drug does not have certificates in the USA and most European countries, Salavei noted. It only has local certificates. These should supposedly be sufficient, and they are supposedly compliant with World Health Organization (WHO) standards.

However, Salavei continued, it is known that obtaining a local certificate is simpler: experts from the States do not come to Belarus to conduct a strict inspection of the entire supply chain. And it is necessary to understand exactly how the drug entered Belarus:

"Belarus has quite strict pharmaceutical control, however strange that may sound, and theoretically, all batches are examined. And here a logical question arises: was the entire batch defective — or was there some 1% [defective], and selective control simply missed it due to statistics? Or did it go through an accelerated procedure that allows avoiding [control], based on papers submitted by the manufacturer?"

One of the most important differences in drug control in the European Union and the United States is the impossibility of falsifying documentation and the results of already taken tests, Salavei observed. Indian legislation, however, is not as strict, judging by the frequency of drug recalls. Something might have been overlooked in India at the manufacturer's factory, as recalling a batch is expensive. A defect might have been accidentally missed during batch control. But the problem was discovered at the stage when the drug had already killed patients.

The problem is not only in human deaths, but also in the system's reaction

On the one hand, the drug was used during heart surgeries, when patients are most vulnerable. In the Brest Regional Hospital, the drug was administered to 13 patients — 8 died. Patients, according to leaked documents, developed sternomediastinitis — an infectious process where the sternum and tissues inside the chest cavity become inflamed and suppurative. Three developed sepsis, two had generalized infection. In the Minsk RSPC "Cardiology", 9 patients received the drug — eight were saved, one died. All showed highly resistant bacteria and were diagnosed with sepsis.

"Inflammation after surgery can happen! But if it's sudden and widespread, something is wrong," Salavei emphasized.

On the other hand, he noted, this drug has a relatively narrow range of use, which minimized the consequences: hospitals performing such operations can be counted on one hand. If it had been a more widely used drug, there could have been more victims.

The trouble is that the Brest Hospital did not report the detection of bacteria in patients' blood to either the city or regional center for hygiene and epidemiology, Salavei stressed. Minsk "Cardiology" did report it — perhaps, Salavei assumes, because this RSPC is "on a special account", it is more forgiven because it works with the most severe patients and has closer ties with the Ministry of Health.

According to Salavei, the reason could be a "peculiarity" of Belarus: doctors' mistakes are criminalized here, even patient complications. Accordingly, even if the doctor is not at fault, but an independent set of circumstances, the doctor will be punished. Senior officials are usually not punished for this, because the investigation is conducted by those same officials.

"Accordingly, the first natural reaction of a clinic is to try to resolve this on its own, without airing dirty laundry," Salavei believes.

He recalled a story where a doctor-intern experienced a standard complication, which occurs in 1-2 patients out of a thousand anyway, and "was dragged through prosecutors' offices." Even if this doesn't end in prison, but only with the threat of a criminal case, it's enormous stress that doctors try to avoid.

Salavei suggests that in Brest, doctors did everything correctly on the operating table but decided not to risk court cases and therefore did not stop operations with the dangerous drug. And as a result, the worst happened: not only did people die, but trust in the system, already damaged during the COVID era, was undermined. The deaths were not reported immediately — and rumors spread. Salavei thanks Belpol and "Zerkalo" for uncovering this, but asks:

"How many patients will now be afraid to go for a planned operation, which is vital for them, and in six months their lives will be cut short because they did not have the planned operation?"

Why was this particular Indian drug chosen?

Belarus has lost a lot due to sanctions and political repression. But, Salavei stressed, sanctions do not apply to medicines, although propaganda loves to manipulate this.

"In a global sense, price is the deciding factor here," Salavei explained.

There are original drugs, and there are so-called generics — drugs with the same main active pharmaceutical ingredient, but certain other ingredients. Generics begin to be produced when the patent on the original drug expires. For example, there is Hungarian "No-Shpa," and there are analogous "Drotaverine" of various variations and manufacturers (including Belarusian ones), "Notasmazm," "Spasmol," and others, in which the main active substance is the same — drotaverine. Generics, Salavei explained, are usually cheaper. But even when they are produced by European companies, they are viewed with slightly more suspicion than original drugs.

There is also a difference in regulation, the interlocutor continued. A local license costs several tens of thousands of dollars and can be obtained in months. European or American certification is a matter of millions and years. The same "No-Shpa" and its generics are not approved in either the States or the European Union, but are legally used in fifty countries worldwide, including Belarus.

"That is, it's not like some underground Indian office bought some fake drugs," Salavei emphasized. "This is a company that supplies many of these drugs across Asia, across Africa... But the risks associated with these products are higher due to less strict control."

Any medication carries risks, the interlocutor added. Both European and American drugs can cause side effects, allergies, or have defective tablets or ampoules in a batch. No healthcare system is immune to what happened with "Cardiurex." Absolutely safe drugs do not exist, but that does not mean one should abandon medicine. And Indian drugs do not mean "bad drugs."

What is important, Salavei argued, is the speed of reaction from medical personnel when something goes wrong. In the case of "Cardiurex," it was necessary to stop planned operations as quickly as possible, conduct infection control, and warn other hospitals: "We know this is happening; act in such and such a way." This could have saved lives. But the fear of legal problems led to the Minsk RSPC having to repeat the path of the Brest hospital and search for the causes of the tragedy. And the fear of publicity led to a loss of trust.

"If the Ministry of Health had immediately said, 'We have a disaster, we will investigate, don't panic,' it would have led to far fewer long-term problems," Salavei reiterated.

It will take more than five or ten years to deal with this. Especially since patients in Belarus are often deprived of a choice between European, American, and cheaper drugs. Salavei hopes that it will be clarified why the problem bypassed Belarusian control, and that the tragedy will serve as a lesson.

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