Antivenin Shortage in Sub-Saharan Africa

Sanofi Pasteur is a French biomedical corporation—the vaccination division of Sanofi-Aventis Group, the world’s third largest drug company. The company produces “Fav-Afrique” a highly effective snake antivenin cocktail used to treat bites from Sub-Saharan Africa’s ten most poisonous snakes…or I guess I should say they used to make Fav-Afrique.  Snake antivenin is difficult and expensive to produce: making Fav-Afrique involves keeping and milking extremely poisonous snakes and then giving this venom to large domestic mammals such as sheep and horses.  A course pf Fav-Afrique costs around $500.00—which is big money in Sub-Saharan Africa—and the production was already heavily subsidized by NGOs and governments.  Yet somehow the entire affair was not economically feasible for Sanofi Pasteur.   There are a limited number of fairly shelf-stable doses left, but the earliest anyone is going to make a comparable product is 2018.

This job looks hard

Snakebites are not particularly deadly here in the United States where snakes kill maybe 2 people a year, however the reptiles of Southern Africa are more formidable…while medical and emergency infrastructure there is a lot poorer (and there are far more people who live closer to the ground) so an estimated 10,000 to 20,000 people a year die of snakebite in Sub-Saharan Africa.  That is a huge number—for comparison the 2014 Ebola outbreak which (rightly) scared the bejeezus out of everyone “only” killed 6,500 people.

All of this makes me wonder anew about the way incentives work in the broader affairs of the world. I understand why medical companies don’t want to mess with a process which is dangerous and complicated yet provides little (or no) profit.  Would you want to do that? Pro-market adherents (who increasingly strike me as bastards) would probably argue that the price of a course of antivenin should be much much higher (which is the case here in America with our sky-high health care costs)…but who would then pay for it in Africa?  Should we not have antivenins—even though we know how to make very fine ones which could save many lives?

By the way, Médecins Sans Frontières is a good organization

It seems likely that powerful NGOs like the Gates Foundation and Médecins Sans Frontières will step in and take over Fav-Afrique–once they build an organization to master the complicated process of producing it.  Perhaps the entire flurry of media attention (like this article) is a useless kerfluffle designed to get frightened people to read articles…but I don’t feel like it is.  I feel like this whole error begs larger questions of how our system works and doesn’t work.   I don’t have any answers to macro-scale resource allocation questions, but I can see the invisible hand of the market trembling and doing dastardly and stupid things and it bothers me.

Tanzanian Puff Adder (Bitis arietans)

Of course all of this also begs question about what these ten super-poisonous African snakes are and where and how they live. I can answer questions about these amazing and formidable mambas, vipers, cobras, and puff adders!  I will be writing more about them in weeks to come…so even this poisonous cloud has a scaly silver lining.

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