Mexicans Respond to Global Antivenom Challenge

Every day, 7,400 people are bitten by a snake and between 81,000 and 138,000 people die from those bites every year. Snakebites can also cause disability and trauma to thousands but few companies are developing antivenoms. Mexican pharmaceutical Inosan Biopharma has developed a technology platform to streamline the development of antivenoms.

On May 23, 2019, snakebite envenoming was formally added to WHO’s list of neglected tropical diseases. “Snakebite envenoming is a neglected tropical disease resulting from the injection of a highly specialized toxic secretion by a venomous snake into humans usually under accidental circumstances,” explains Nature. After acknowledging snakebite as a neglected tropical disease, WHO developed the strategy to prevent and control this problem.

What are the main goals of the strategy?

On a podcast hosted by The Lancet Global Health, Bernadette Abela-Ridder of WHO’s Department of Control of Neglected Tropical Diseases broke down the key points of this program:

• Investment to get more antivenom options on health centers.
• Encourage innovation and development of antivenoms.
• Encourage universal health coverage to include snakebite envenom.

Thea Litschka-Koen of the Eswatini Snakebite Foundation said that the strategy should follow three pivotal concepts: prevent, act and train. Preventing snakebite by wearing basic personal protection should be encouraged. According to Litschka-Koen the most vulnerable communities often live in rural, poor areas but wearing shoes to go outside can be a start point. Abela-Ridder added that community education is urgent. Taking action by getting the person to a health center is critical. “Correctly applying first aid at first contact is crucial for the outcome therefore there cannot be home remedies.” Lastly, but most importantly, a correct training of health professionals at those remote centers would make an enormous difference on the outcome. Litschka-Koen also commented that so far, the market offers a single antivenom treatment but venoms are diverse.

Abela-Ridder highlighted the importance of improving logistics antivenoms to those living in vulnerable, remote communities as fast as possible as “people have to walk 3 three hours to get to a hospital with the proper supplies and treatments.” She added that empowering care givers to treat snakebites is critical, “to date, almost none of them can offer an in-depth coverage to the problem.”

According WHO, at present very few countries have the capacity to produce snake venoms of adequate quality and many manufacturers rely on common commercial sources, which may not properly reflect the geographical variation of the venoms. In addition, lack of regulatory capacity for the control of antivenoms in countries with significant snakebite problems results in an inability to assess the quality and appropriateness of the antivenoms.

Investing and developing antivenoms is no easy task as can be seen in their limited market offer. MBN interviewed Juan Silanes, CEO of Inosan Biopharma, who is one of these unique developers of antivenoms. On the interview, Silanes explained that antivenoms are complex and costly to produce and develop. However, to make their development accessible and safe, “we created a technological platform that allows us to simplify the antibody. We took our original development for antivenom and we divided it into three stages: venom selection, horse immunization, purification and lyophilization. Working with each individual stage and through the use of technology, we were able to reach a purifying stage that guarantees its safe use.” Silanes stressed that for the company, safety was a priority because its products are often used in precarious healthcare systems.

WHO states that a significant challenge in manufacturing antivenoms preparing the correct immunogens (snake venoms) but Silanes explained that “alongside the purifying stage, we were able to develop complex products that are multipurpose, having the ability to neutralize the venom from multiple snakes or scorpions.” Inosan Biopharma develops its products following FDA and EMA standards to guarantee the highest quality.