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By Conor Gaffey
Staff Writer
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Tens of thousands of lives could be put at risk from snakebites unless immediate action is taken to replenish dwindling antivenom stocks, according to a leading medical charity.
Global stockpiles of Fav-Afrique, the only antivenom which has been proven both safe and effective in treating a variety of bites from snakes native to Sub-Saharan Africa are due to expire in June 2016, according to international aid agency, Medecins Sans Frontieres (MSF). Sanofi Pasteur, the French pharmaceutical company that manufactured the drug, stopped production in 2014 and there will now be a two-year gap before a replacement product becomes available in 2018.
MSF estimates that five million people worldwide suffer snakebites each year, with 100,000 dying from their injuries and 400,000 suffering permanent disability or disfigurement as a result. The problem is most acute in south and southeast Asia and Sub-Saharan Africa, where farming activities expose people to snakes and a scarcity of antivenom leads to higher mortality rates, according to the World Health Organization (WHO).
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Sanofi Pasteur announced in 2010 that it would stop producing the antivenom. A Sanofi Pasteur spokesman told AP that the company stopped producing the drug due to competitors selling cheaper alternatives and that it has offered to transfer their antivenom technology to other companies but "nothing has materialized yet."
Manica Balasegaram, the executive director of MSF's Access Campaign, told Newsweek that the shortage would leave doctors with few alternative ways to treat snakebite victims in Sub-Saharan Africa. "This is potentially quite a serious issue and I think we may well see an increase in morbidity and mortality as a result of that," says Balasegaram. "At the moment there are virtually no alternatives to use in this part of the world in terms of an antivenom."
Rob Harrison, head of the Venom Research Unit at the Liverpool School of Tropical Medicine, says that snakebite has been "one of the most neglected of tropical diseases that I can think of in terms of its effect on snakebite victims."
He adds that the problem is exacerbated by the proliferation of cheap but ineffective antivenom treatments which are not bite-specific. Sub-Saharan Africa, in particular, is "awash" with antivenoms that come from other continents "that are marketed aggressively and very cheaply but are ineffective," says Harrison.
"Very few purchasing agents understand that snakebite antivenoms are very different from paracetamol [i.e. acetaminophen]. Paracetamol is effective whether you get a headache in East Africa or Papau New Guinea...but antivenoms have to be specifically manufactured for the bite you're trying to treat," he adds.
According to the WHO, the major groups of snakes which cause envenoming are elapids (which includes cobras and mambas), vipers and sea snakes. Symptoms depend on the type of venom, but often include the death of muscle tissue, abnormal blood clotting and, in serious cases, paralysis of respiratory muscles. Harrison says victims envenomed by black mambas, which are endemic to Sub-Saharan Africa, can die within an hour if not treated with an effective antivenom.
MSF also said subsidies for antivenom were required to make treatment viable and criticized WHO for neglecting to deal with the issue. Antivenom can cost up to $500 per victim in the most expensive cases—the equivalent of four years' pay in Sub-Saharan Africa. The WHO has no formal programs to address snakebite, according to MSF.
WHO spokesperson Gregory Hartl says the organization does have a dedicated medical professional working on the issue of snakebite but that more funding was required. Hartl told Newsweek, "The WHO works as much as we can in the absence of the funding we would really need in order to do more on [snakebite]. It's great that MSF brings this to the public attention again because, maybe with more public attention to this issue, we might get more funding and that's what's needed to take this work further."
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