Estimating the Global Burden of Snakebite Can Help To Improve Management

Snakebite is a common medical emergency in developing countries in tropical regions. The only specific treatment is antivenom [1], but this is often unavailable in remote health centres, due to market failure [2,3]. In the 1980s in Africa, 150,000 to 200,000 doses of antivenom were sold annually, whereas current sales have fallen to less than 20,000 doses per year. The price of a vial of antivenom has risen by a multiple of 10 over the last 20 years. Today, with the global economic crisis, the treatment represents several months of the average income of rural families. In an emergency situation, there is insufficient time for families to sell their crops and livestock to buy the antivenom. The main reasons that the antivenom manufacturers use to justify such a dramatic price increase are the complexity and cost of antivenom production. But there are three other reasons for the escalating costs. First, the antivenom market is unstable. Second, there is little financial incentive for pharmacists and health centres to sell antivenom because they reap only feeble profit margins. Finally, there are no comprehensive data on how many doses of antivenom are required and where they should be distributed.