According to statistics published by the World Health Organization (WHO), at least 20,000, and possibly as many as 94,000, deaths occur each year from snakebites. The vast majority of snakebites occur in developing countries where there is a reported shortage of antisnake venom (ASV). In a series of articles published in Wilderness & Environmental Medicine, Ian Simpson and his colleagues analyze the shortage of ASV in developing countries and suggest practical solutions.

They find fault with the current approach espoused by many experts who recommend producing more ASV and focusing on increasing the quality of an already unaffordable product. Simpson explains in the June 2008 issue that the cause of the shortage is not only lack of production, but also overuse of current resources. An extensive review in India and Pakistan, two of the countries with the highest mortality, led to a model that proposes how to use ASV effectively. This model shows that ASV is being wasted when victims receive ASV unnecessarily, receive too much ASV, or receive ASV that is not effective.

In the March 2009 issue, Simpson and Robert Norris address this problem by introducing a new marketing model, the “4 Ps Model,” which will help get the right “Product” (the correct type of ASV) to the right “Place” (facilities with staff who are trained to use it effectively and efficiently) for the right “Price” (producing an ASV that is more economical) through better “Promotion.”

In the September 2008 issue, Simpson explains that the lack of ASV production is based on faulty economic analysis by experts in the field, who concentrate on ASV financial support from donors instead of sound economic analysis and providing potential suppliers with adequate information to enter the market.
 
Simpson suggests using an alternative model that produces greater quantities of ASV for less cost. Recent studies have shown that whole immunoglobulin ASVs are as safe as pepsin-digested alternatives, and if precipitated by caprylic acid instead of ammonium sulphate, give much higher and more economic yields of antibodies.

In the June 2009 issue, Simpson and Ingrid Jacobsen explode the myth propounded by some experts and the WHO that ASV cannot be provided sustainably and affordably except by charitable donations. The authors conclude by noting two main barriers that discourage new producers: (1) continual references to difficulties of ASV production and (2) failure to provide a sound economic analysis that demonstrates financial incentives.

The authors provide practical guidance on how to construct an ASV production unit, what the key costs are, and how to produce a safe, low-cost ASV that provides adequate financial returns to manufacturers, thus ensuring adequate long-term supply. The authors’ goal is to show that the ASV problem is readily solvable if manufacturers are given clear guidelines on efficient production, thus avoiding a precarious reliance on donors.

The overriding conclusion of the series is that the shortage of ASV in developing countries cannot be solved by imposing developed-world standards or by relying on philanthropic donor support. Innovative solutions need to be implemented and implemented quickly.

Wilderness & Environmental Medicine is the official journal of the Wilderness Medical Society and is dedicated to providing valuable information to medical and allied health professionals. Since 1987 the journal has published articles on all aspects of wilderness medicine. For more information about the society, see http://wms.org.

Media Contact:
Robin Barker
Allen Press, Inc.
800/627-0326 ext. 410
rbarker@allenpress.com