Accessibility of Antivenoms in India

Syllabus: GS2/ Health

Context

• Despite being the largest producer and consumer of antivenoms, India accounts for almost 50% of global snakebite deaths.

Snakebite Envenoming 

• The snakebite envenoming (poisoning from snake bites) was classified by the World Health Organisation (WHO) as a high-priority neglected tropical disease.
• An estimated 1.8 – 2.7 million people worldwide are envenomed annually. 
• Snake Bites in India: In India, around 90% of snake bites are caused by the ‘big four’ among the crawlers – common krait, Indian cobra, Russell’s viper and saw scaled viper. 
• In India, around 58,000 deaths occur of an estimated 3-4 million snake bites annually.

Strategy for developing anti-venom

• Antivenoms: Antivenoms are purified antibodies designed to neutralize venoms or specific venom components. They are produced using antibodies generated by animals that have been injected with controlled doses of venom.
  • They are included in the WHO Essential  Medicines List.
• Antivenoms making process: To make life-saving antivenoms, scientists enlist the help of horses that live on specialized ranches.
  • The animals are injected with a tiny, harmless dose of venom, which causes their immune systems to produce antibody proteins that attack and disable the venom toxins.
  • Then the antibodies are collected and used to treat people who have been bitten or stung.

Challenges in Accessing Antivenoms

• Geographical Barriers: Remote areas lack nearby healthcare facilities with antivenom supplies.
• Limited Venom Coverage: Indian antivenoms primarily target the “big four” snakes (cobra, krait, Russell’s viper, and saw-scaled viper).
  • Other venomous species, such as the king cobra and pit vipers, remain uncovered, leading to ineffective treatment and poor outcomes for victims.
• Cultural and Social Factors: Superstitions and cultural practices in rural areas delay timely medical intervention.
• Economic Constraints: High production costs limit accessibility for economically disadvantaged populations.
• Infrastructure and Logistical Issues: Cold storage requirements are unmet in rural areas due to insufficient power and infrastructure.
  • Improper storage degrades antivenom, reducing its effectiveness.

Way Ahead

• The National Action Plan for Prevention and Control of Snakebite Envenoming (NAP-SE) aims to prevent and manage snakebite envenoming, with the goal of reducing deaths and cases of disability by half by 2030.
• Innovative Antivenom Development: Researchers are using recombinant DNA technology to develop synthetic antivenoms that are free from animal-derived proteins, ensuring greater safety and efficacy. 
• Diagnostic Advancements: Portable venom-detection kits and rapid diagnostic tools are being introduced to guide the effective use of antivenoms, ensuring timely and appropriate treatment.

Source: TH