The World Health Organisation (WHO) recently flagged the need for an international initiative against snakebite ‘envenoming’, a life-threatening condition caused by venomous snakebites. The call came during the 71st World Health Assembly held in Geneva where a resolution was adopted, urging to accelerate and coordinate global efforts in controlling this perilous disease. India, which currently manufactures only polyvalent anti-snake venom (ASV), is an active participant in this resolution.
Significance of the Resolution for India
India carries a significant burden of snakebite cases, with around 50,000 fatalities reported annually, although WHO suggests that the real number could be tenfold. Out of the nearly 300 varieties of snakes found in India, 52 possess venomous properties with distinctly different poisons, thus, making the situation more complicated. The country’s primary government-owned ASV manufacturer is Haffkine Bio-Pharmaceutical Corporation Ltd, a company that has been operating for close to 120 years.
Challenges in Addressing Snakebite ‘Envenoming’
A significant barrier to effective snakebite management in India comes from inadequately trained doctors and a deficient supply of ASV. Producing ASV entails complex procedures that require multiple permissions from the forest department. Besides, horses are necessary for testing, demanding extensive space. These hurdles often deter private companies due to financial unfeasibility. At present, India produces about 1.5 million vials of ASV per year, a number that falls short of the estimated annual requirement by two-thirds. The studies also revealed that many primary health centres frequently refer patients elsewhere, resulting in the loss of the critical ‘golden hour’ when emergency treatment is likely to yield the best outcomes.
The Role of Polyvalent ASV
A monovalent ASV, derived from the venom of a single snake species, can treat bites from that specific species alone. While it offers efficiency, it proves ineffective if the snake species responsible for the bite is not accurately identified. On the other hand, a polyvalent ASV amalgamates venoms from four of India’s most poisonous snakes – the cobra, common krait, Russell’s viper, and saw-scaled viper. Despite being more wasteful in terms of venom use and requiring more vials for patient treatment, its broad-spectrum efficacy makes it more beneficial.
Recommendations for Improvement
Improving health infrastructure is a key strategy to combat snakebite ‘envenoming’. This includes training doctors better and ensuring the availability of ASV. Another concerning issue is the reducing potency of ASV over the past years, suggesting a need for comprehensive research to determine the most effective venom combinations. In addition, considering how a snake’s venom composition can vary with its habitat, diet, and environmental factors, scientists should ensure that their research incorporates these variables for more effective results.
