Unlike many other serious health conditions, snakebite envenoming has a highly effective treatment. The majority of deaths and severe complications from snakebites can be prevented through the wider availability and accessibility of safe and effective antivenoms.
These high-quality antivenoms, which are the most reliable treatment for neutralizing venom, are included in the WHO’s List of Essential Medicines and should be integral to primary healthcare in regions where snakebites are prevalent.
Snakebite envenoming is a neglected public health issue, particularly in tropical and subtropical regions. The highest number of incidents occur in Africa, Asia, and Latin America.
In Asia alone, up to 2 million people suffer snakebite envenomations each year, while in Africa, an estimated 435,000 to 580,000 cases require treatment annually. This issue disproportionately affects vulnerable populations, including women, children, and farmers in rural, low- and middle-income communities. Countries with weaker health systems and limited medical resources bear the greatest burden.
Challenges of producing antivenoms
A significant challenge in manufacturing of antivenoms is the preparation of the correct immunogens (snake venoms). At present very few countries have capacity to produce snake venoms of adequate quality for antivenom manufacture, and many manufacturers rely on common commercial sources. These may not properly reflect the geographical variation that occurs in the venoms of some widespread species. In addition, lack of regulatory capacity for the control of antivenoms in countries with significant snake bite problems results in an inability to assess the quality and appropriateness of the antivenoms.
A combination of factors has led to the present crisis. Poor data on the number and type of snake bites have led to difficulty in estimating needs, and deficient distribution policies have further contributed to manufacturers reducing or stopping production or increasing the prices of antivenoms. Weak regulation and the marketing of inappropriate or poor quality antivenoms has also resulted in a loss of confidence in some of the available antivenoms by clinicians, health managers and patients, which has further eroded demand.
Low production of antivenoms
Given low demand, several manufacturers have ceased production, and the price of some antivenom products have dramatically increased in the last 20 years, making treatment unaffordable for the majority of those who need it. Rising prices also further suppress demand, to the extent that antivenom availability has declined significantly or even disappeared in some areas. The entry into some markets of inappropriate, untested, or even fake antivenom products has also undermined confidence in antivenom therapy generally.
Many believe that unless strong and decisive action is taken quickly, antivenom supply failure is imminent in Africa and in some countries in Asia.
