Jameson’s green mamba wiggles and wraps around Mike Perry’s arm, but he doesn’t let go. In the greatest calm, he approaches the head of the snake, whose bite can cause death in three or four hours, to the small goblet covered with a transparent film. Slight pressure and the snake opens its mouth and sinks its sharp teeth into the plastic film before spitting its venom into it. In a few seconds, it’s over, Mike replaces the stunned snake with pliers in its glass cage before turning to another snake. This gesture, Mike Perry has accomplished “more than 140,000 times”: for 24 years, he has been collecting venom for the manufacture of antivenom. In his garden, white containers stamped “African reptiles
“A lot of hospitals can’t get antivenom right now,” said snake specialist Johan Marais, head of the Snakebite Institute at his residence in Pretoria. ” It’s a disaster. There are people who got bitten and had to change hospitals three times, there are people who died because of the shortage! At present, it is difficult to give precise figures on the number of deaths caused by the shortage, but hundreds of dogs are already paying the price. In Krugersdorp, a suburb of Johannesburg, Kurt de Cramer’s veterinary clinic receives poisoned dogs every month. In two years, a dozen died for lack of available antivenom. “We’re having a hard time getting a few vials. Veterinary clinics are not a priority. »
The polyvalent antivenom (SAIMR Polyvalent Snakebite Antiserum SAVP) treats bites from black mamba, green mamba, Jameson’s mamba, Cape cobra, forest cobra, ringed cobra, Mozambique spitting cobra, Gaboon viper, ringhal and puff adder. The South African production center also produces an antivenom for the boomslang, and another for two East and West African pit vipers: Echis ocellatus and Echis pyramidium.
The shortage, pending for two years, has especially worsened in recent months. “They’ve been short for a week or two before, but eight months ago they went off the rails, and since then they’ve produced almost nothing,” says Johan Marais.
In early April 2023, snake specialists and trauma specialists therefore sent an open letter to the Minister of Health calling on him to intervene, and to ensure that the production center urgently receives new equipment and a power supply from rescue. “The authorities deny the shortage,” laments Johan Marais.
For Mike Perry, the venom collector, the problem also comes from the size of the structure “far too small for current demand”. The three types of antivenom that SAVP produces are used by many countries in sub-Saharan Africa, which are therefore directly affected by the shortage. Especially since there are few alternatives: faced with high costs, other well-known antiveni producers ceased production, such as the French laboratory Sanofi in 2014. Antivenoms from Asia flooded the market , cheaper, but for Mike Perry and Johan Marais, their quality is questionable. The antivenom market remains very opaque and lacks regulatory frameworks and reference standards according to the WHO. The South African shortage risks aggravating a lack of effective antivenoms that affects not only Africa but also a good part of the southern hemisphere. And while a treatment for a venomous bite with the South African serum already costs between 800 and 1,500 euros, its shortage risks leading to a further increase in the price of antivenoms. Because the less antivenom available, the higher their price, making them less affordable and decreasing demand.
A vicious circle that worries the WHO, which classifies envenomings in its priority list of neglected tropical diseases. Worldwide, according to the institution, snakebites cause at least 81,000 to 138,000 deaths each year, and 3 times more amputations and other permanent disabilities (paralysis, blood disorders, kidney failure, etc.).
