Pretoria - Minister of Health Dr Joe Phaahla has been urged to alleviate the critical shortage of anti-venom in South Africa and on the continent.
This is in an open letter signed by 27 experts in the field of snakebite treatment, including highly experienced medical and trauma practitioners, as well as anti-venom and snake handling experts.
The letter calls for the prevention of a situation where life-saving care can no longer be provided to patients in need of healthcare assistance for snakebites.
“Anti-venom is a critical life-saving treatment in patients bitten by venomous snakes. It has excellent outcomes when used timeously and correctly,” trauma surgeon Professor Timothy Hardcastle, said. He is a member of the National Snakebite Advisory Group and the Trauma Society of South Africa.
The group offers a free national advisory support service to medical personnel, clinicians and centres in the public and private sectors needing to treat snakebite victims.
Since 2017 the group and its affiliated members have actively educated the public and healthcare professionals in facilitating the appropriate management of snakebites in southern Africa.
Commenting on the current situation, Hardcastle said the main source of reliable cost-effective anti-venom against the common major venomous snakes in South Africa and other parts of the continent is the South African Vaccine Producers group of products, namely the 10-snake polyvalent, the Echis monovalent and the Boomslang monovalent anti-venoms.
“There is no suitable alternative product approved for use in South Africa. At present our greatest concern is the unreliable production of the South African vaccine producers’ 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, but more than four months have passed and at present extremely limited numbers of polyvalent vials are left in the South African Vaccine Producers stores, he warned.
Meanwhile, a large backlog of orders has yet to be filled.
Certain public and private hospitals – located in high snakebite areas – have already run out of stock; others have preciously little anti-venom on hand.
There is also a shortage of anti-venom among veterinarians, currently unable to acquire any anti-venom. “There is no sign that these will be replenished soon,” Hardcastle said.
He warned that there is a serious risk of death from Black and Green Mamba, Cape Cobra and limb loss from other venomous snakes.
Boomslang bites are less common, but equire a specific anti-venom. Children, especially, are at high risk of poor outcomes. Patient medical management and hospital length of stay, are all adversely affected without early and appropriate administration of anti-venom, he explained.
“The inability and lack of expected delivery of anti-venom thus pose a major health risk, despite it being a listed drug on the Essential Drug List.”
The group appealed to the health minister to intervene by funding and approving emergency upgrades to allow improved functionality at the Johannesburg-based production plant.
The group of signatories have also implored Phaahla to ensure that procurement processes are effectively performed so that appropriate equipment, backup generators, reagents and other essential production items can be procured to significantly improve production to ensure a sufficient volume of anti-venom to restock the country.
The potential identification of alternative products covering South African snake bites could be tested to provide another option until the current anti-venom shortage is resolved.
An information campaign to warn the public to to take precautionary measures when in the natural environemtn should be run, Hardcastle said. The Poison Information Centre and African Snakebite Institute, which has a special free information app, offer information to the public.
Pretoria News