Studies in India, by WHO show antivenom serums not working
Alerts have been sounded in a number of countries since last year against cough syrups manufactured by Indian firms. Now, snake antivenoms made in India are also under scanner in Kenya for poor quality.
The country is facing a major public health concern of snakebites after readily available antivenom serums from India were declared ineffective and recalled, according to officials.
The Kenya Medical Supplies Authority (KEMSA) recently issued an advisory to health practitioners across the country, calling for a mop-up exercise to rid the market of the ineffective snake antivenom. Health experts and studies in India and by World Health Organization (WHO) indicated the serums had become ineffective.
Authorities in Taita-Taveta County, an administrative unit in Kenya with the highest reported snake bite burden, have expressed concern over the shortage of snake antivenom serums following the KEMSA directive.
Since October 2022, the WHO has also put out alerts for at least seven ‘sub-standard’ cough syrups made by Indian firms, following deaths reported in several countries.
For decades, the Government of Kenya has been relying on antivenom serums from India and Mexico, namely VINS Snake Venom Antiserum and Inoserp Pan-Africa injection, respectively.
A study on the efficacy of the serums was carried out at the Indian Institute of Science’s Evolutionary Venomics Lab, along with herpetologists Gerard Martin and Romulus Whitaker. It was published in the PLOS Neglected Tropical Diseases journal.
The WHO wrote to Kenya through the Pharmacy and Poisons Board (PPB), calling for the withdrawal of two antivenoms.
The local population is now vulnerable after the mop-up exercise left limited antivenom brands from Mexico and Costa Rica, said Gifton Mkaya, the minister for health in Taita-Taveta County.
“This region is one of the hardest hit by persistent human-wildlife conflict, with rising cases of snake bites from the expansive Tsavo National Park and sisal estates, which are home to dangerous reptiles and other wild animals,” said Mkaya.
The situation could be the same or worse across Kenya, especially in areas with rampant human-wildlife conflicts, with most locals resorting to traditional herbs for survival.
Kenya is planning to partner with Costa Rica, a well-established antivenom manufacturer, to locally start manufacturing the drugs in the next three years, according to the ministry of health.
“To address this challenge, the ministry of health and researchers from the Institute of Primate Research (IPR), among others, have joined hands to fast-track antivenom research and production in the next three years,” said the ministry.
While addressing the press, George Omondi, the head of Kenya Snakebite Research and Intervention Centre (KSRIC) at the Kenya Institute of Primate Research, announced interim mitigation measures.
Despite confirming that health facilities across the country have reported shortages of anti-snake venom, Omondi warned against resorting to traditional herbs.
The IPR has written to KEMSA, asking them to replace the ineffective Indian drugs with two antivenom serums from Mexico and Costa Rica and approved for use in Kenya.
The situation is compounded by the Kenyan Parliament’s 2017 decision that phased out compensation for snakebites by Kenya Wildlife Services (KWS). They limited the payouts to injuries and deaths by elephants, lions, leopards, rhinos, hyenas, crocodiles, cheetahs and buffalos.
The move was part of the National Assembly’s attempts to tame KWS’s backlog of pending compensation claims, which stands at around Sh5 billion (Rs 299 crore), with snakebites accounting for over 60 per cent.
Official statistics estimate 15 to 20 Kenyans suffer snakebites daily, with some suffering injuries resulting in limb amputation or death. In sub-Saharan Africa, an estimated 314,000 snakebites cause between 5,900 to 14,600 amputations and 7,000 to 32,000 deaths annually.
According to experts, these estimated snakebite incidences could be very conservative or a gross underestimation of the real situation, considering some studies have shown up to 70 per cent of snakebite cases are unreported.
Globally, venomous snakebites kill at least 200 people daily, according to WHO. The severity of snakebites had been neglected globally for decades until WHO classified it among the Neglected Tropical Diseases (NTD) in 2017.
Besides the last few months surges due to antivenom stock-outs, cases of snakebites have dramatically been rising in the past decade.
Experts attribute the rise to global warming, saying changes in climatic conditions, especially in the tropics, have enabled snakes and other reptiles to move to previously cooler habitats.
Worsening dry conditions and human activities, like clearing forests, force the reptiles to encroach on human settlements in search of food and water, according to experts.
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