An Update on Antivenom in Kenya
Despite the promise of a cure for snakebites in 1894, when French Scientist Calmette invented sérum antivenimeux, neglect of snakebite as a public health issue has resulted in technological stagnation of manufacturing processes for this vital drug, and lack of commitment from countries who need to procure it. This lack of progress denies treatment to the people that need it the most. Use of outdated technology and small-scale production makes antivenoms expensive to produce, denying them to poor victims in less developed countries like Kenya. Governments, who have many health issues competing for the same small pool of resources, often favour procurement of treatments for routine use (e.g., antibiotics), infectious diseases (e.g., malaria), major noncommunicable diseases (e.g., heart disease or cancer), and emergencies (e.g., Covid-19 or cholera) over medicines such as antivenom. This often results in antivenoms being in very short supply if they are available at all. In many cases the cost of purchasing them is left to victims, who must pay even higher commercial rates at pharmacies and dispensaries. Many simply cannot afford it.
For many years, Bio-Ken and now TAAF have supported communities and clinics across Kenya by providing SAVP Polyvalent, an effective, but more Southern Africa specific antivenom produced in South Africa. Improvements in Kenya’s regulation of medicines that required manufacturers to register their products and provide evidence that they are manufactured according to strict international standards of Good Manufacturing Practice (GMP) have since resulted in sub-standard antivenoms being withdrawn from the market.
Fortunately the World Health Organization (WHO) have been working on a number of initiatives to improve the availability and quality of antivenoms in the region, and they have recently approved the use of PANAF-Premium, a polyvalent antivenom manufactured by Premium Serums and Vaccines Pvt.Ltd (PSVPL), in specific doses for use in Sub-Saharan Africa including Kenya. PSVPL, an Indian owned company, was founded in 2009 by a group of Veterinary doctors with the aim of producing effective and safe life-saving antivenom/antitoxin products. PSVPL’s facility is located in Narayangaon, near Pune city, where water is abundant and the air is clean. The company’s manufacturing facility is spread over an area of 8 acres and three farms totaling an additional 10 acres which are homes to 850 horses. The welfare of these animals is a top priority for the company, and they are given a special diet to keep them in prime condition. The horses for Pan African AV production are immunized against venoms of Sub-Saharan Africa’s 14 medically significant (venomous) snakes. The final product is freeze-dried and packaged, and the dry product can be stored at up to 30 degrees centigrade without the need for refrigeration, which is a huge benefit for the African market.
PSVPL has gone through a long journey to go through the WHO qualification process which started in 2016. In 2019, their manufacturing facility was approved and in March 2023, WHO approved PANAF for use against 24 different species of venomous snake, including Cobras and Mambas. The advanced manufacturing technologies used to reduce impurities and protein content also help to eliminate anaphylactic reactions which have been associated with the use of Antivenom in the past. The Taylor Ashe Antivenom Foundation (TAAF) is working with Premium Serums to educate healthcare professionals and encourage the use of antivenom for snakebite. Early signs are positive, and a post-marketing surveillance of the product is being followed closely.