New Model Addresses Perceived Worldwide Shortage Of Anti Snake Venom

Main Category: Public Health
Article Date: 19 Jun 2008 - 2:00 PDT

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Despite the rhetoric that there is a worldwide shortage of anti snake venom, evidence suggests that there is overuse of the current resources, according to a new paper. In the concept paper, a model is presented that could better enable policy makers to assess the amount and utilization of anti snake venom in their areas. The paper is published in the latest issue of Wilderness and Environmental Medicine.

The current argument for increasing the supply side of the anti snake venom (ASV) usage equation focuses almost entirely on providing more and better quality ASV. However, there is evidence that there is overuse of ASV on the demand side that could fulfill some of the perceived shortfalls, but this is not being considered in the debate, according to paper author Ian Simpson Snakebite Adviser to the Pakistan Medical Research Council. To assess the adequacy of the current ASV supply, it is useful to reconsider the relationship between supply and demand, Simpson says.

According to WHO published statistics, the two countries with the largest annual snakebite mortality in the world are India, with 50,000, and Pakistan, with 20,000. Together these two countries constitute approximately 55 to 85 percent of overall world snakebite mortality. An extensive review of the situation regarding supply and demand in these two countries led to the development of a model that can determine the actual supply/demand of ASV. The model assesses ASV usage according to two criteria: risk and wastage. The actual usage of ASV is segmented in the model into the following main areas:

(1) victims who receive too little ASV (high-risk/low-wastage)

(2) victims who receive ASV either unnecessarily or in too great a quantity (low-risk/high-wastage)

(3) victims who receive ASV that is not effective (high-risk/high-wastage)

(4) victims who receive ASV according to effective local protocols (low-risk/low-wastage)

The current proposition-there is a shortage of ASV and the solution is to simply produce more-addresses only a small part of the high-risk/low-wastage group and does not address the two high-wastage groups. In addition, many countries are using imported ASVs that are developed against similar species to those in their country in the belief they will be effective. This is very unlikely but is driven by dialogue that focuses solely on shortage of supply.

Until the high-wastage groups are recognized, resolved with training and local protocols, and moved into the low-risk/low-wastage group, the true requirement for ASV worldwide cannot be assessed.

To read the entire study, The "Worldwide Shortage" of Anti Snake Venom: Is the Only Right Answer "Produce More" Or Is It Also "Use It Smarter?"(Wilderness & Environmental Medicine, 2007; Vol. 19(2):99-107), click here.

Wilderness and Environmental Medicine is a peer-reviewed, quarterly medical journal published by the Wilderness Medical Society. For more information, visit http://www.wms.org.

Wilderness and Environmental Medicine