Facing an anti-venom shortage, WHO tries to mobilise new suppliers

By Phil Taylor

- Last updated on GMT

Photo -reptiles4all/iStock
Photo -reptiles4all/iStock
Sanofi's recent decision to stop making anti-venom could lead to shortages from next year and place the lives of thousands of people in jeopardy, says the World Health Organisation (WHO).

Sanofi said earlier this year that its Sanofi Pasteur division would stop making​ one of the most effective treatments for snakebite - FAV-Afrique - claiming low-cost alternatives from producers in India, Brazil and Mexico had made the product unprofitable.

FAV-Afrique is a polyvalent product that counters the toxins of some of the world's most deadly venomous snakes.

The WHO says that the prospect of FAV-Afrique stocks running out in 2016 is causing "dismay"​ among public health experts and advocates, and it has released first call for manufacturers to submit products for assessment.

"This first call is specifically for manufacturers of anti-venoms intended for use in sub-Saharan Africa,"​ notes the WHO, which will accept submissions until February 2016 and has waived the usual fees to help encourage producers to come forward.

Around five million people are bitten by snakes every year, resulting in around 125,000 deaths and leaving 400,000 people disabled or disfigured. In sub-Saharan Africa, one of the most affected regions, about the WHO estimates that 30,000 people die from snake bite each year.

A recent editorial​ in the British Medical Journal​ (BMJ) by David Williams of the University of Melbourne in Australia took a slightly different tack, however, saying that FAV-Afrique's withdrawal from the market will make little difference to most people in Africa.

The high cost of the drug - around $540 per four vial treatment - meant that "the product simply never reached them in the first place", leaving many people in Africa reliant on treatment from traditional healers.

Snake oil?

Compounding the issue is that unscrupulous individuals have taken advantage of poor regulatory oversight in some countries and introduced unapproved and counterfeit anti-venoms into the market - with data from Ghana and Chad indicating that fatality rates rose after the use of these products.

Describing snakebite as a forgotten problem, Williams maintains that gaps in the supply of anti-venoms in the last few decades has "cumulatively cost millions of lives, maimed millions more, and contributed to the burden of poverty and disenfranchisement that lingers heavily over many nations."

Williams would like the WHO to restore snakebite to its list of neglected tropical diseases, and should incorporate snakebite in current and future work plans for this disease category.

Medical charity Médecins Sans Frontières (MSF) has tried to mobilise international efforts to tackle the problem, and sponsored a symposium in September to draw attention to the problem.

"We are now facing a real  crisis so why do governments, pharmaceutical companies and global health bodies slither away when we need them most​?" said MSF's snakebite medical advisor Gabriel Alcoba.

"Imagine how frightening it must be to be bitten by a snake - to feel the pain and venom spread through your body - knowing it may kill you and there is no treatment available or that you can’t afford to pay for it?"

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