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Consequences of Neglect: Analysis of the Sub-Saharan African Snake Antivenom Market and the Global Context

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  • Nicholas I Brown

Abstract

Background: The worldwide neglect of immunotherapeutic products for the treatment of snakebite has resulted in a critical paucity of effective, safe and affordable therapy in many Third World countries, particularly in Africa. Snakebite ranks high among the most neglected global health problems, with thousands of untreated victims dying or becoming permanently maimed in developing countries each year because of a lack of antivenom—a treatment that is widely available in most developed countries. This paper analyses the current status of antivenom production for sub-Saharan African countries and provides a snapshot of the global situation. Methods: A global survey of snake antivenom products was undertaken in 2007, involving 46 current and former antivenom manufacturers. Companies producing antivenom for use in sub-Saharan Africa were re-surveyed in 2010 and 2011. Results: The amount of antivenom manufactured for sub-Saharan Africa increased between 2007 and 2010/11, however output and procurement remained far below that required to treat the estimated 300,000–500,000 snakebite victims each year. Variable potency and inappropriate marketing of some antivenoms mean that the number of effective treatments available may be as low as 2.5% of projected needs. Five companies currently market antivenom for sale in Africa; three others have products in the final stages of development; and since 2007 one has ceased production indefinitely. Most current antivenom producers possess a willingness and capacity to raise output. However inconsistent market demand, unpredictable financial investment and inadequate quality control discourage further production and threaten the viability of the antivenom industry. Conclusion: Financial stimulus is urgently needed to identify and develop dependable sources of high-grade antivenoms, support current and emerging manufacturers, and capitalise on existing unutilised production capacity. Investing to ensure a consistent and sustainable marketplace for efficacious antivenom products will drive improvements in quality, output and availability, and save thousands of lives each year. Author Summary: Antivenom is the only specific treatment for systemic envenoming from snakebite, but remains unavailable to thousands of snakebite victims around the world. A cycle of inconsistent and low market demand, sub-optimal utilisation, rising costs and reduced output of antivenoms have resulted from long term under-investment in procurement and quality regulatory programs. This study provides a contemporary overview of the African antivenom market within the context of the global market. Globally, 35 companies sold at least 4 million vials of antivenom in 2007. Five companies had established African antivenom markets in 2010/11; three other institutions have antivenoms for Africa in development; and another ceased production indefinitely. Between 2007 and 2011, production of sub-Saharan African antivenoms rose from 227,400 to at least 377,500 vials, constituting ∼83,000 effective treatments for moderate envenomings. However, recent reports have identified that some products, which comprise up to 90% of the total antivenom supply in sub-Saharan Africa, may lack efficacy or specificity against relevant snake species. Despite this, revenues from antivenom marketed in sub-Saharan Africa increased from $6.6 million in 2007 to $10.3 million in 2010/11. The average cost of a stated effective treatment in 2010/11 was $124, and the price of antivenom is inversely proportional to the amount produced. Combined unutilised production capacity far exceeds the total projected antivenom needs for Africa.

Suggested Citation

  • Nicholas I Brown, 2012. "Consequences of Neglect: Analysis of the Sub-Saharan African Snake Antivenom Market and the Global Context," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 6(6), pages 1-7, June.
  • Handle: RePEc:plo:pntd00:0001670
    DOI: 10.1371/journal.pntd.0001670
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    1. Robert A Harrison & Adam Hargreaves & Simon C Wagstaff & Brian Faragher & David G Lalloo, 2009. "Snake Envenoming: A Disease of Poverty," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 3(12), pages 1-6, December.
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    1. Muhammad Hamza & Maryam A Idris & Musa B Maiyaki & Mohammed Lamorde & Jean-Philippe Chippaux & David A Warrell & Andreas Kuznik & Abdulrazaq G Habib, 2016. "Cost-Effectiveness of Antivenoms for Snakebite Envenoming in 16 Countries in West Africa," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 10(3), pages 1-16, March.
    2. Sayem Ahmed & Guibehi B Koudou & Maïwenn Bagot & François Drabo & Windtaré R Bougma & Caisey Pulford & Moses Bockarie & Robert A Harrison, 2021. "Health and economic burden estimates of snakebite management upon health facilities in three regions of southern Burkina Faso," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 15(6), pages 1-17, June.
    3. Abdulrazaq G Habib & Mohammed Lamorde & Mahmood M Dalhat & Zaiyad G Habib & Andreas Kuznik, 2015. "Cost-effectiveness of Antivenoms for Snakebite Envenoming in Nigeria," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 9(1), pages 1-7, January.
    4. Gaby Isabelle Ooms & Janneke van Oirschot & Dorothy Okemo & Benjamin Waldmann & Eugene Erulu & Aukje K Mantel-Teeuwisse & Hendrika A van den Ham & Tim Reed, 2021. "Availability, affordability and stock-outs of commodities for the treatment of snakebite in Kenya," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 15(8), pages 1-20, August.

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