At the end of June 2016, the last remaining supplies of an important, safe, and effective antivenom expired.
The antidote, known as FAV-Afrique, is what Doctors Without Borders (MSF) has relied on to treat snakebites in sub-Saharan Africa. It can be used to treat bites from ten venomous snakes, including some of the most dangerous in Africa. That’s particularly useful in the common cases where a person doesn’t know what type of snake bit them.
While other antivenoms exist, no one knows yet if any of these potential alternatives will safely be able to fill the hole left by an antidote that can be used against so many different types of snakebite. They will have to use alternatives anyway, hoping they work.
“It’s a shame that a product that all experts agree was good was abandoned,” says Julien Potet, policy advisor for neglected tropical diseases at MSF. “We’re putting the lives of some patients at risk.”
The dire situation is no surprise — MSF, the World Health Organization (WHO), and others have known that Sanofi Pasteur had stopped producing FAV-Afrique years before.
MSF had hoped to convince the pharmaceutical company to accelerate the transfer of their technology to another company and to continue producing antivenom in the interim period, but that still hasn’t happened. Even if they find someone else willing to produce the treatment, Potet says it’ll take a couple of years for a new company to get production going and to get antivenom distributed.
In a statement emailed by a representative of Sanofi, the company explained that they ceased production of FAV-Afrique after lower cost products led to a “steep drop in orders” for their antivenom.
The statement added: “Sanofi Pasteur regrets the worldwide situation with respect to the supply of anti-venom immunoglobulins and is studying options that would enable the transfer of know-how to other biologicals producers who would be willing to take over the production.”
But the fact of the matter is, finding someone who wants to produce antivenom is not an easy task. A recent Nature News story explains that many pharma companies have stopped producing antivenom and only five of the 35 companies or governments who make antivenom make products for sub-Saharan Africa.
“In the absence of medicines, snakebite victims have been known to drink petrol, electrocute themselves or apply a poultice of cow dung and water to the bite,” Carrie Arnold writes.
More than anything else, this situation is just an illustration of a much more serious global problem with regard to access to treatment for venomous bites.
A larger and growing problem
The patients encountered by Doctors Without Borders are just a fraction of those affected by snakebites, both in Africa and around the world.