Snakebite, the price for surviving underdevelopment

E. Ablorh-Odjidja

September 29, 2015

An article about snakebites and a pending shortage of anti-venom production was published in The Guardian some weeks ago. Even though the piece raised some concerns about development planning in Africa, I chose to ignore this particular article.

Then came another piece later, highlighting a pending shortage of drugs for snakebites.  And the signs of danger were written all over that piece.

it said Sanofi Pasteur, a leading drug manufacturer of the potent anti-venom drug "Fav -Afrique" was retiring the brand.  And concluded that the impact would fall hard on the developing world.

Some two weeks later, and another article by the same publication.  It said, "As cobras and vipers spread their deadly venom, it’s getting harder to save lives."

And the lives and the geographic areas  impacted in the bad news expressed in both publications didn’t shift in scope or place.

The same snakebite-prone parts mentioned in both articles remained and would suffer. 

The statistics on victims in Africa would remain grim, if not worse; considering the imperfections in data collection procedures in Africa.

It is stated that some 10,000 die from snakebites each year in some areas in Africa, particularly in a belt stretching from West Africa to the East African coast.

The looming peril of deaths, on account of anti-venom shortages, can be anybody's guess.  But, certainly, we shall soon have less and less of the anti-venom called "Fav-Afrique." 

Please note the name of the drug. It is not Fav-Europe. It is a pointer describing the market destination of the drug.

The name of the doctor (whistleblower) who drew attention to the pending anti-venom supply doom, was also not African, which circumstance must suggest that something could be amiss; the concern, at east, considering that there are virtually no poisonous snakebites in deep Europe.

The snakebites are already manifest.  But soon the shortage in anti-venom supply will hit Africa hard. 

Yet, our development planners are busy at work, building, or creating projects, many of which have little or no impact on the realities of the life we face in Africa, and snake bites are part of this life.

Snakebites are daily headaches for many of our people.

I have been told by a nephew (a medical practitioner) that snakebites are common in the Northern part of Ghana.  And that women are particularly the victims.

The reason being that women of the North are the farmers and caretakers of the burgeoning shea butter industry and that the shea tree is particularly known for harboring snakes, sometimes the deadliest ones.

Shea tree farms can be economic buttresses of the North.  But where does it say that we can’t take cognizance of the snake infestation problem in the development of plans for the farms?

The farms are not the lone factors in the snake infestation problem.  Bushy, unkempt neighborhoods in our cities and towns do contribute greatly to the problem.

A few years back there was the news story of a woman who was bitten by a snake while on a toilet seat at a public hospital in one of our major cities.

A snakebite while conducting daily ablution at a public hospital should bring to mind the extent of the risk. And since a conspicuous segment of our populations across Africa also do the same in the bush, this risk must be very high.

In this regard, women in the population are more exposed to the risk than men.  For privacy, they have to go deeper into the brushes for the same ablution, while men, because of the advantage of anatomy, can stand by the roadside, and from a safe distance, throw a stream adroitly into the brushes.

Snakes by nature are stealthy, dangerous and should be part of our public health concerns. 

But do our governments contemplate of the snakebites and the danger they represent to the public at large?

The World Health Organization (WHO) does.

The Guardian, in its latest publication the subject, quoted a former director of WHO, saying that "Snakebites cause severe disability, bring misery to families and kill thousands of people."

And continued " It is not just the death rate from snakebites that is raising concerns. .....Victims, who are often agricultural workers, lose legs or arms or fingers and can no longer hold down their jobs. Children’s limbs become gangrenous after being bitten by snakes and have to be amputated. They are blighted for life as a result. Girls have their marriage prospects ruined. The price of surviving a snakebite is often terrible.”

Deaths caused by snakebites, averaging about 10,000 a year in Africa, was also described by “Medicins Sans Frontieres,” in a recent report, as "Global Burden of Snakebites." 

The scope of the public health hazard and challenges are evident to others.  Should we not consider the problem ours first, before others do?

It was Medicins Sans Frontieres that also noted that " Dealing with snakebites is likely to grow harder in the next few years because existing stocks of the important antivenom Fav-Afrique will expire next June."

So what to do?

Of course, I am not a scientist. Neither do I know how anti-venom drugs are manufactured. But I have questions.

Aren't these snakes more with us in Africa than in Europe?

So how come we have waited all these years just so we can receive succor from Europe?

In the past, our medicine men and women knew how to protect us from snakebites.

The method was or is called "Mithridatism" a process whereby small non-lethal doses of known poison, including snake venom, were introduced into the bloodstream to build immunity in the subject for future protection against that same poison.

The effectiveness or uselessness of the "Mithridatism" method today is not the point of my statement. That the practice was once in Africa is license enough for me to ask why it has not been perfected or advanced?

Not surprising, the basic material for the production of anti-venom is already in Africa.  It is to be found in the very fangs of the snakes. From these fangs, the poison is the milk that ultimately is turned into an anti-venom drug.

So, what do we lack, knowledge, technical expertise, or funds to start local production of the drug?

Ever since I first read the Sanofi Pasteur announcement, I have been waiting to hear a policy statement from our government of Ghana as to what the plans are for the pending anti-venom shortage. I have heard nothing.

However, it should be an obvious effort, judging by the public health concern, to want to entice both expertise and funds to Ghana for local manufacturing of the anti-venom drug.

Sanofi Pasteur's announcement should even be considered an opportunity.  The Ghana Government should provide a tax-free haven for a qualified company. There is a belt of ready market stretching from the West to East coast of Africa, all poisonous snake territory, that can support the enterprise.

E. Ablorh-Odjidja, Publisher www.ghanadot.com, Washington, DC, September 29, 2015.

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