UN health agency plans to boost treatment for rabies, snake bites in developing world

With more than 12 million people suffering dog or snake bites and scorpion stings each year, the United Nations health agency today announced plans to boost the production of crucial therapeutic sera which can make the difference between life and death or crippling disability for millions of people in poor countries.

“We need to boost local manufacturers’ capacity and improve the delivery of products to remote rural areas,” UN World Health Organization (WHO) Assistant Director-General for Health Technologies and Pharmaceuticals Howard Zucker said ahead of a meeting tomorrow at the agency’s headquarters in Geneva of the top experts in the area as well as recipient and donor countries, international organizations and manufacturers.

“There are effective solutions that could save millions of lives,” he added, noting that rabies from dog bites, the tenth most common cause of death due to infections in humans, is 100 per cent fatal but 100 per cent preventable when post-exposure treatment using therapeutic sera is readily available.

It is estimated that there are 1 million snake bites each year in Africa alone resulting in over 20,000 deaths and a much higher incidence of chronic disability and physical handicap from necrotic effects requiring amputation.

To address this neglected public health issue, WHO is creating a five-year, $10-million plan to boost production in developing countries, including through technology transfers, helping authorities forecast market needs and strengthening regulatory capacity.

Production of therapeutic sera, a pharmaceutical preparation containing antibodies against one or more specific antigens, is dropping in industrialized countries due to inadequate profitability, linked to uncertainty about the quantities needed. In developing countries, affordability is an issue, and production is also quantitatively limited and often does not reach the quality standard required to make these treatments.

An estimated 8 million people need anti-rabies serum each year after being exposed to animals suspected of carrying the disease. Almost half of those requiring the therapeutic sera and those dying of rabies are children less than 15 years old. More than 99 per cent of all human deaths from rabies occur in Africa and Asia.

Close to 5 million snake bites and scorpion stings are recorded each year, mostly in Africa, Asia and Latin America, 50 to 75 per cent of which need treatment with therapeutic sera to prevent death, amputation or severe neurological disorders. The main populations affected are young agricultural workers and children.

Available epidemiological data on the incidence of snake bites, including the degree of associated mortality and long-term morbidity are largely hospital-based and therefore underestimate the true scale of the problem. A majority of snake-bite victims seek traditional treatment and may die at home unrecorded.

Over 10 million vials of anti-venom sera would be needed to treat snake and scorpion bites worldwide, with an estimated 2 million vials required for Africa alone. An estimated 16 million vials of anti-rabies serum would be needed each year if current international guidelines for post-exposure prophylaxis were to be fully implemented.