title: A multicomponent strategy to improve the availability of antivenom for treating snakebite envenoming.
abstract: Snakebite envenoming is a common but neglected public health problem, particularly in impoverished rural regions of sub-Saharan Africa, Asia and Latin America. The only validated treatment for this condition is passive immunotherapy with safe and effective animal-derived antivenoms. However, there is a long-lasting crisis in the availability of these life-saving medications, particularly in sub-Saharan Africa and parts of Asia. We herein advocate a multicomponent strategy to substantially improve the availability of safe and effective antivenoms at the global level. This strategy is based on: (i) preparing validated collections of representative venom pools from the most medically dangerous snakes in high-risk regions of the world; (ii) strengthening the capacity of national antivenom manufacturing and quality control laboratories and their regulatory authorities and establishing new facilities in developing countries through technology transfer, as an integral part of efforts to develop their biological products industry; (iii) getting established laboratories to generate antivenoms for various regions of the world; and (iv) getting governments and relevant organizations to give snakebite envenoming due recognition within national and international public health policy frameworks. These ways of making antivenom available should be complemented by actions to improve health information systems, the accessibility of antivenoms, the training of medical and nursing staff, and community-based education. Such a multicomponent strategy involving stakeholders on many levels could help consolidate sustainable improvements in antivenom availability worldwide.
authors.affiliation: Instituto Clodomiro Picado, Universidad de Costa Rica, San José 11501, Costa Rica .
authors.forename: José María
authors.initials: JM
authors.lastname: Gutiérrez
authors.affiliation: Graduate Institute of Biomedical Materials and Tissue Engineering, Taipei Medical University, Taipei, Taiwan, China .
authors.forename: Thierry
authors.initials: T
authors.lastname: Burnouf
authors.affiliation: Alistair Reid Venom Research Unit, Liverpool School of Tropical Medicine, Liverpool, England .
authors.forename: Robert A
authors.initials: RA
authors.lastname: Harrison
authors.affiliation: Instituto de Biomedicina de Valencia, Consejo Superior de Investigaciones Científicas, Valencia, Spain .
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Calvete
authors.forename: Ulrich
authors.initials: U
authors.lastname: Kuch
authors.affiliation: John Radcliffe Hospital, University of Oxford, Oxford, England .
authors.forename: David A
authors.initials: DA
authors.lastname: Warrell
authors.affiliation: Department of Pharmacology and Therapeutics, University of Melbourne, Parkville, Australia .
authors.forename: David J
authors.initials: DJ
authors.lastname: Williams
mesh_terms: D000818:Animals; D000997:Antivenins / Q000191:economics / Q000627:therapeutic use*; D003695:Delivery of Health Care; D003906:Developing Countries; D014943:Global Health; D006801:Humans; D012909:Snake Bites / Q000188:drug therapy*
chemical_list: D000997:Antivenins
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