Prof Timothy Hardcastle, who is a member of the National Snakebite Advisory Group (NSAG) and the Trauma Society of South Africa, has explained that the main source of reliable, cost-effective antivenom against the common major venomous snakes in South Africa and other parts of the continent is the South African Vaccine Producers (SAVP) group of products, namely the 10-snake polyvalent, the Echis monovalent and the Boomslang monovalent antivenoms.
“Unfortunately, there is no suitable alternative product approved for use in South Africa – even under Section 21. At present,” Hardcastle added, “our greatest concern and challenge is the unreliable production of the SAVP’s products due to management, staffing constraints, animal welfare, unreliable generator capacity, machine breakdowns and refrigeration issues.
“There has been a promise of product since December 2022; however, more than four months have passed and at present extremely limited numbers of polyvalent vials are left in the South African Vaccine Producers stores, while a large backlog of orders have yet to be filled.
“Certain public and private hospitals – many of which are situated in high snakebite areas – have already run out of stock while others have preciously little antivenom on hand. There is also a shortage of antivenom among veterinarians who are currently unable to acquire any antivenom. There is no sign that these will be replenished anytime soon.
“There is a serious risk of death,” Hardcastle continued, “from Black and Green Mamba, Cape Cobra and limb loss from other venomous snakes. While Boomslang bites are less common they require a specific antivenom. In particular, children are at high risk of poor outcomes.”
Patient medical management, hospital length of stay, morbidity and mortality, he went on to note, were all adversely affected without early and appropriate administration of antivenom: “The inability and lack of expected delivery of antivenom therefore pose a major health risk, despite it being a listed drug on the Essential Drug List.”
The appeal from the NSAG to The Minister of Health is to intervene by funding and approving emergency upgrades to allow improved functionality at the Johannesburg based South African Vaccine Producers (SAVP) production plant.
*While the NSAG service is only directly available to healthcare practitioners and facilities, there are several resources available to the public. These include the Poison Information Centre and the African Snakebite Institute, which offers a special free information app from their website – https://www.africansnakebiteinstitute.com/app/
SOURCE: MNA on behalf of National Snakebite Advisory Group