Global Health Community Walks Away from Snakebite Crisis as Antivenom Runs Out

A boy, with an amputated leg due to lack of access to care after being bitten by a snake, on the banks of the Pibor River in Jonglei State. Up to 75 per cent of people cannot access even the most basic healthcare in South Sudan. Apart from a small Ministry of Health facility in Pibor town, MSF is the only primary healthcare provider for over 160,000 people in this part of Jonglei State.
Cédric Gerbehaye/Agence Vu
Click to hide Text

BASELTens of thousands of people will continue to die of snakebite unnecessarily unless the global health community takes action to ensure treatment and antivenom is made available, said the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) ahead of a symposium on this issue in Basel, Switzerland, this week.

French pharmaceutical company Sanofi, producer of Fav-Afrique, the world’s only antivenom proven safe and effective to treat envenoming from different types of snakes across Sub-Saharan Africa, stopped making this product at the end of 2014. The last batch of Fav-Afrique is due to expire in June 2016, and no replacement will be available for another two years, translating into more needless death and disability.

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

Snakebite is a major killer yet remains one of the world’s most neglected public health emergencies, as global health actors show worryingly little interest in the issue. Each year, an estimated five million people worldwide are bitten by snakes, out of whom 100,000 die and 400,000 are permanently disabled or disfigured. In sub-Saharan Africa alone, 30,000 people die from snakebite every year and an estimated 8,000 undergo amputations. The number of victims is likely to rise once existing stockpiles expire next year.

"Until a replacement product to Fav-Afrique is available, we hope that Sanofi can start to generate the base material needed to produce Fav-Afrique, and then find suitable opportunities within their production capacity to refine it into antivenom," said Julien Potet, neglected diseases advisor for MSF’s Access Campaign.

MSF increasingly treats snakebite in its field programs. This includes 300&ndash400 snakebite victims per year in Paoua, Central African Republic, and over 300 in Agok, South Sudan, in 2014. Many of the victims are children.

Snakebite mainly affects people living in rural areas. With no health facilities nearby, and unable to afford expensive treatment, many either turn to traditional healers or don’t seek care at all. This suggests that the number of victims is probably higher than officially reported.

If available, antivenom treatment can cost up to US $250–500 per victim, representing the equivalent of four years of salary in the countries concerned. Subsidizing antivenom costs so that patients pay little to nothing is crucial to improve access to this lifesaving treatment.

The World Health Organization (WHO) should play a leading role to tackle snakebite as a public health issue, but is still considering it as a "neglected condition with no formal program," despite the high mortality levels.

The global health community, donors, governments, and pharmaceutical companies should accept responsibility for their share of the neglect of snakebite as a public health emergency and take immediate, appropriate and collaborative action, said MSF.

Read the Briefing Document

A boy, with an amputated leg due to lack of access to care after being bitten by a snake, on the banks of the Pibor River in Jonglei State. Up to 75 per cent of people cannot access even the most basic healthcare in South Sudan. Apart from a small Ministry of Health facility in Pibor town, MSF is the only primary healthcare provider for over 160,000 people in this part of Jonglei State.
Cédric Gerbehaye/Agence Vu