The problems of snake antivenom
As poor and marginalized populations are particularly affected by snakebites, the market incentive to research and produce antivenoms is low. Antivenoms are often specific to one or a few snake species, whose distribution is restricted to smaller geographical regions. These antivenoms are only useful for a restricted population living in the specific area, thus making research and production less appealing from a commercial point of view.
Antivenoms are usually equine or ovine-derived serum products, and the production is complex and expensive. Preclinical and clinical testing, registration in individual countries are further hurdles that prevent companies to initiate development and production.
As a result of the lack of effective antivenoms, multiple antivenoms have been registered that lack transparent clinical, or even preclinical testing. Using ineffective antivenoms leads to a further loss of confidence in antivenom treatment. Therefore, more uniform regulation and execution of preclinical and clinical studies and licensing would be beneficial. For the African continent, the newly introduced African Medicines Agency (AMA) in Rwanda could be a way to improve the situation. Further, only a small proportion of antivenom is manufactured for international use, while most manufacturers produce only for national or regional use. This points to the importance of local production, which should be encouraged, especially in countries where snakebites are prevalent. As seen on the map on the right, this is especially needed for the African continent where the incidence of snakebites is high but local production is very low.