Access to antivenoms in the developing world: A multidisciplinary analysis

Access to safe, effective, quality-assured antivenom products that are tailored to endemic venomous snake species is a crucial component of recent coordinated efforts to reduce the global burden of snakebite envenoming. Multiple access barriers may affect the journey of antivenoms from manufacturers...

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Autores principales:	Julien Potet, David Beran, Nicolas Ray, Gabriel Alcoba, Abdulrazaq Garba Habib, Garba Iliyasu, Benjamin Waldmann, Ravikar Ralph, Mohammad Abul Faiz, Wuelton Marcelo Monteiro, Jacqueline de Almeida Gonçalves Sachett, Jose Luis di Fabio, María de los Ángeles Cortés, Nicholas I. Brown, David J. Williams
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Antivenoms Snakebite envenoming Health services accessibility Neglected tropical diseases Regulatory capacity Affordability Toxicology. Poisons RA1190-1270
Acceso en línea:	https://doaj.org/article/b2c397d294794db7b5b32adfc170db5b
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spelling	oai:doaj.org-article:b2c397d294794db7b5b32adfc170db5b2021-11-06T04:35:51ZAccess to antivenoms in the developing world: A multidisciplinary analysis2590-171010.1016/j.toxcx.2021.100086https://doaj.org/article/b2c397d294794db7b5b32adfc170db5b2021-11-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2590171021000229https://doaj.org/toc/2590-1710Access to safe, effective, quality-assured antivenom products that are tailored to endemic venomous snake species is a crucial component of recent coordinated efforts to reduce the global burden of snakebite envenoming. Multiple access barriers may affect the journey of antivenoms from manufacturers to the bedsides of patients. Our review describes the antivenom ecosystem at different levels and identifies solutions to overcome these challenges.At the global level, there is insufficient manufacturing output to meet clinical needs, notably for antivenoms intended for use in regions with a scarcity of producers. At national level, variable funding and deficient regulation of certain antivenom markets can lead to the procurement of substandard antivenom. This is particularly true when producers fail to seek registration of their products in the countries where they should be used, or where weak assessment frameworks allow registration without local clinical evaluation. Out-of-pocket expenses by snakebite victims are often the main source of financing antivenoms, which results in the underuse or under-dosing of antivenoms, and a preference for low-cost products regardless of efficacy. In resource-constrained rural areas, where the majority of victims are bitten, supply of antivenom in peripheral health facilities is often unreliable. Misconceptions about treatment of snakebite envenoming are common, further reducing demand for antivenom and exacerbating delays in reaching facilities equipped for antivenom use.Multifaceted interventions are needed to improve antivenom access in resource-limited settings. Particular attention should be paid to the comprehensive list of actions proposed within the WHO Strategy for Prevention and Control of Snakebite Envenoming.Julien PotetDavid BeranNicolas RayGabriel AlcobaAbdulrazaq Garba HabibGarba IliyasuBenjamin WaldmannRavikar RalphMohammad Abul FaizWuelton Marcelo MonteiroJacqueline de Almeida Gonçalves SachettJose Luis di FabioMaría de los Ángeles CortésNicholas I. BrownDavid J. WilliamsElsevierarticleAntivenomsSnakebite envenomingHealth services accessibilityNeglected tropical diseasesRegulatory capacityAffordabilityToxicology. PoisonsRA1190-1270ENToxicon: X, Vol 12, Iss , Pp 100086- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Antivenoms Snakebite envenoming Health services accessibility Neglected tropical diseases Regulatory capacity Affordability Toxicology. Poisons RA1190-1270
spellingShingle	Antivenoms Snakebite envenoming Health services accessibility Neglected tropical diseases Regulatory capacity Affordability Toxicology. Poisons RA1190-1270 Julien Potet David Beran Nicolas Ray Gabriel Alcoba Abdulrazaq Garba Habib Garba Iliyasu Benjamin Waldmann Ravikar Ralph Mohammad Abul Faiz Wuelton Marcelo Monteiro Jacqueline de Almeida Gonçalves Sachett Jose Luis di Fabio María de los Ángeles Cortés Nicholas I. Brown David J. Williams Access to antivenoms in the developing world: A multidisciplinary analysis
description	Access to safe, effective, quality-assured antivenom products that are tailored to endemic venomous snake species is a crucial component of recent coordinated efforts to reduce the global burden of snakebite envenoming. Multiple access barriers may affect the journey of antivenoms from manufacturers to the bedsides of patients. Our review describes the antivenom ecosystem at different levels and identifies solutions to overcome these challenges.At the global level, there is insufficient manufacturing output to meet clinical needs, notably for antivenoms intended for use in regions with a scarcity of producers. At national level, variable funding and deficient regulation of certain antivenom markets can lead to the procurement of substandard antivenom. This is particularly true when producers fail to seek registration of their products in the countries where they should be used, or where weak assessment frameworks allow registration without local clinical evaluation. Out-of-pocket expenses by snakebite victims are often the main source of financing antivenoms, which results in the underuse or under-dosing of antivenoms, and a preference for low-cost products regardless of efficacy. In resource-constrained rural areas, where the majority of victims are bitten, supply of antivenom in peripheral health facilities is often unreliable. Misconceptions about treatment of snakebite envenoming are common, further reducing demand for antivenom and exacerbating delays in reaching facilities equipped for antivenom use.Multifaceted interventions are needed to improve antivenom access in resource-limited settings. Particular attention should be paid to the comprehensive list of actions proposed within the WHO Strategy for Prevention and Control of Snakebite Envenoming.
format	article
author	Julien Potet David Beran Nicolas Ray Gabriel Alcoba Abdulrazaq Garba Habib Garba Iliyasu Benjamin Waldmann Ravikar Ralph Mohammad Abul Faiz Wuelton Marcelo Monteiro Jacqueline de Almeida Gonçalves Sachett Jose Luis di Fabio María de los Ángeles Cortés Nicholas I. Brown David J. Williams
author_facet	Julien Potet David Beran Nicolas Ray Gabriel Alcoba Abdulrazaq Garba Habib Garba Iliyasu Benjamin Waldmann Ravikar Ralph Mohammad Abul Faiz Wuelton Marcelo Monteiro Jacqueline de Almeida Gonçalves Sachett Jose Luis di Fabio María de los Ángeles Cortés Nicholas I. Brown David J. Williams
author_sort	Julien Potet
title	Access to antivenoms in the developing world: A multidisciplinary analysis
title_short	Access to antivenoms in the developing world: A multidisciplinary analysis
title_full	Access to antivenoms in the developing world: A multidisciplinary analysis
title_fullStr	Access to antivenoms in the developing world: A multidisciplinary analysis
title_full_unstemmed	Access to antivenoms in the developing world: A multidisciplinary analysis
title_sort	access to antivenoms in the developing world: a multidisciplinary analysis
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/b2c397d294794db7b5b32adfc170db5b
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Access to antivenoms in the developing world: A multidisciplinary analysis

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