WHO strategy on antivenoms

Context: The World Health Organization has unveiled a new strategy to dramatically cut deaths and injuries from snakebites, warning a dearth of antivenoms could soon spark a “public health emergency”.

Need for a comprehensive strategy:

• Each year, nearly three million people are bitten by poisonous snakes, with an estimated 81,000-138,000 deaths. Another 400,000 survivors suffer permanent disabilities and other after-effects, according to WHO figures.
• Snake venom can cause paralysis that stops breathing, bleeding disorders that can lead to fatal haemorrhage, irreversible kidney failure and tissue damage that can cause permanent disability and limb loss.
• Most snakebite victims live in the world’s tropical and poorest regions, and children are worse affected due to their smaller body size.
• WHO has already categorised “snakebite envenoming” as a Neglected Tropical Disease.

WHO strategy:

• Aim: to cut snakebite-related deaths and disabilities in half by 2030.
• An important part of the strategy is to significantly boost production of quality antivenoms.
• Reshape the market and employ greater regulatory control.
• Restore a sustainable market for snakebite treatment. There is need for a 25-percent increase in the number of competent manufacturers by 2030.
• Integrate snakebite treatment and response into national health plans in affected countries, including better training of health personnel and educating communities.

Challenges 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.
• 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.
• Poor 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.

Sources: the Hindu.