WHO announces new guidelines for production, regulation and control of snake antivenoms

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May 5 2010

With snake bites killing at least 100 000 people a year and countries facing a shortage of appropriate antivenoms, access to and information about available antivenoms is increasingly important. The World Health Organization (WHO) is publishing new guidelines for the production, regulation and control of snake antivenoms and a website with details on where the venomous snakes are located, what they look like, which antivenoms are appropriate, and where they can be obtained.

"Many countries have no access to the antivenoms they need. Others use antivenoms that have never been tested against their target snake venoms. So often when people get bitten, they can't get the treatment they need," says Carissa Etienne, WHO Assistant Director-General. "These new tools will help bring this to an end."

Global situation

An estimated five million people are bitten each year resulting in up to 2.5 million envenomings, at least 100 000 deaths and around three times as many amputations and other permanent disabilities each year. Bites by venomous snakes can cause paralysis that may prevent breathing, bleeding disorders that can lead to fatal haemorrhage, irreversible kidney failure and severe tissue damage that can cause permanent disability and may result in limb amputation.

Victims are mostly women, children and farmers living in poor rural communities, where health systems are not well equipped and medical resources are sparse.

Today, countries face a critical global shortage of appropriate, safe and effective snake antivenoms. A combination of factors has led to the present situation: poor data on the number and type of snake bites, difficulty to estimate the needs and define markets- combined with deficient distribution policies- have contributed to manufacturers stopping production or increasing prices of antivenoms. Poor regulation and marketing of inappropriate antivenoms, has led to a loss of confidence in the available antivenoms by clinicians, public health officials and patients.

The solution

Effective and safe antivenoms requires international collaboration. WHO urges regulators, producers, researchers, clinicians, national and regional health authorities, international organizations and community organizations to work together to improve the availability of reliable epidemiological data on snake bites, the regulatory control of antivenoms and their distribution policies.

The information in the guidelines will assist:

public health officials in determining what antivenoms are needed in their country and in drafting relevant national public health policies;
national medicines regulators in prioritizing antivenoms for registration and assessing safety, quality and efficacy of antivenoms to meet national public health needs;
procurement agencies in selecting appropriate antivenoms for national treatment needs;
antivenom manufacturers in developing plans for production and sale of appropriate antivenoms;
clinicians and health care professionals in treating snake bites;
general population in knowing and being able to identify which venomous snakes live in their area.

The guidelines provide details for the production, regulation and control of snake antivenoms while the online database identifies venomous snake species for which availability of appropriate antivenoms should be prioritized.