Tuesday, December 22, 2020

National Geographic: Bites That Kill

By Thomas Nicolon

    More than a hundred thousand people die from snakebites in rural communities every year, and many more end up with amputations and other disabilities. An important factor is a shortage of antivenom and storage facilities with reliable electricity, as well as a lack of money and a fear of Western medicine.
    In 2017, the WHO added snakebite envenomation to its list of neglected tropical diseases, and in 2019 announced a slashing in the number of deaths and disabilities from envenomation by 2030. Not only is it difficult for rural residents to get to a hospital, but the hospital is often too expensive or doesn't have enough equipment and expertise to treat the wound.
"Once the victim is at a treatment center, survival depends on two vital points: Is a reliable antivenom available? And if so, does the medical staff know how to administer it? Often in sub-Saharan Africa the answer to both is no."

Sometimes, traditional healers try to heal snakebite victims. Their botanical remedies may reduce swelling, but they cannot actually heal someone. If a patient has suffered a dry bit without any venom injection, a healer may falsely believe that their remedy works.

"Producing antivenoms is a long, expensive process, and because the vast majority of people who need them live in developing countries, such drugs are not big moneymakers." 

Antivenom is made from the venom of a snake itself, which is injected in small amounts into other mammals that produce the antibodies. But even when antivenom is made, there can be variation in the chemical composition of venom for the same species in different areas. Even when antivenom is effective, there often isn't enough of it and is too expensive where it is available.

"For all its effectiveness, Inoserp is not being produced in sufficient quantities. There’s a severe shortage of antivenoms more broadly: The number of vials in circulation is less than 5 percent of the one million to two million needed yearly in sub-Saharan Africa. And even if Inoserp were widely available, rural Africans—whose earnings may be no more than a few dollars a day—couldn’t afford it. Hospitals and pharmacies might charge $80 to $120 or more a vial, and most snakebite victims require several vials."

In order to make them more widely available and affordable, governments in poor countries need to step in. They also need to step in to prevent snakebites from occurring, for example encouraging people to wear shoes and use a flashlight at night. 

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