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Updated: June 30, 2013 12:33 IST

A biting issue

Bharat Dogra
Comment (2)   ·   print   ·   T  T  
King cobra: Collecting the poison for medicinal purposes. Photo: R. Vetri
The Hindu King cobra: Collecting the poison for medicinal purposes. Photo: R. Vetri

Rural hospitals are reeling under an acute shortage of anti-snake venom, paving way for superstition-based treatment

The entire public health campaign on saving snake-bite victims emphasises that the patients should be rushed to a hospital where they can be administered treatment based on anti-snake venom (ASV). Increasingly in India, however, the effectiveness of this message has been discredited as in most hospitals this life-saving medicine is simply not available.

Although India was once emerging as a pioneer in the manufacturing of low-cost ASV, making available this medicine at a much lower price than in Western countries, the situation changed once the manufacturing and supply were disrupted by arbitrary closure of some drug manufacturing facilities in the public sector. Even though some remedial action was later taken, the disruptions in production and supply continued.

The situation is such that even in the early stage of the monsoon season, when hospitals should be well-stocked with ASV, shortages are being reported in many hospitals, particularly where the bulk of rural patients come. Most of the victims of snake-bites are from poor farming and worker households in rural areas.

Every year, nearly 50,000 people die due to snake bites in India despite the fact that most of these lives can be saved by timely ASV-based treatment. The lack of medicine cripples the public health effort which further helps the persistence of superstition-based treatments. According to some of the prevailing superstitions, snake-bite victims should not be taken out of the door of the house, so precious time is wasted in breaking a part of the wall to take out the patient.

This kind of entirely irrational and harmful practices could have been checked effectively if a high rate of saving snake bite victims was achieved by the public health effort. However, as far as poor victims from rural areas are concerned, the chances of saving their lives have been increasingly reduced by the shortage of ASV.

There is thus a need for a strong public campaign to remove the shortage of ASV in our hospitals. While urgent short-term measures are also needed for this monsoon season, from a longer-term point of view, proper planning for increasing indigenous production of ASV is very important and India, which was once considered as pioneer in this field, certainly has the technical base for this. It will be very helpful if an impartial inquiry is also made into the earlier disruptions caused in indigenous production that created artificial shortages so that the vested interests behind this are exposed and do not again disrupt adequate indigenous production of ASV. It is an unfortunate situation if the bulk of the rural poor are denied a life-saving medicine which, however, can be purchased in big cities at a high profit margin.

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I agree. What India needs is a privately funded "not for profit but for people"organization to produce VERY low cost ASV. I would be very interested in being a part of such a project.

from:  Julian Craig
Posted on: Jul 2, 2013 at 06:36 IST

Thanks for this article, and snakebite is certainly a 'neglected tropical disease' - in
the words of WHO - in India and a major cause of mortality and morbidity in the
country and entire region, in fact. However, your photo caption discredits your
otherwise (fairly) accurate piece. The picture in your article is, in fact, a Russell's
viper (and not a King Cobra) and rather than saying "Collecting the poison for
medicinal purposes" it would be more accurate to have said "Extracting venom for
use in the production of anti-venom serum".

It would be good to add as well, that supply of antivenom serum is not the only issue
here, intra-specific regional variation in snake venom is a documented problem in
India, and one that is currently not getting nearly the amount of attention that it
should.

Also, I'd just like to point out that there are very low profit margins in antivenom
serum production in India - indeed this is part of the reason that supply is so
inadequate.

from:  Samir
Posted on: Jul 2, 2013 at 02:16 IST
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