Guinea-Bis­sau is­lands feel­ing the bite of an­tivenom cri­sis Bi­ja­gos is­lands re­puted for their snakes

Kuwait Times - - HEALTH & SCIENCE -

The vivid red wound at the base of Gina’s an­kle has re­mained open for three months and re­fuses to heal, leav­ing the Guinea-Bis­sau is­lander in con­stant pain. “I thought it was from a piece of wood,” she said, re­call­ing the day when a snake sunk its fangs into her leg. “They had to carry me back home be­cause I couldn’t walk,” she said, sit­ting in front of a thatched hut dec­o­rated with white sea shells.

Gina lives on Soga, a tiny speck of land that is one of the 88 is­lands of the Bi­ja­gos ar­chi­pel­ago, an At­lantic par­adise home to dol­phins, tor­tois­esand forests full of deadly snakes. Home to some 30,000 peo­ple, the is­lands are rec­og­nized by the UN’s world her­itage body (UNESCO) for their ex­cep­tion­ally di­verse ecosys­tems, but there is one crea­ture in par­tic­u­lar that thrives among the man­groves. “The Bi­ja­gos is­lands are re­puted for their snakes. All the dead­li­est species live there, in­clud­ing mam­bas and co­bras,” says Ais­sata Re­golla, a re­searcher at Guinea-Bis­sau’s In­sti­tute for Biover­sity and Pro­tected Ma­rine Ar­eas (IBAP).

“On cer­tain is­lands, our staff can’t walk more than five min­utes with­out see­ing one.” Gina should per­haps count her­self lucky. Ev­ery year around 125,000 peo­ple die af­ter be­ing bit­ten by a snake, 30,000 of them in sub-Sa­ha­ran Africa. Many more are left with life-chang­ing in­juries or am­pu­ta­tions. But find­ing an an­tivenom which is af­ford­able is be­com­ing in­creas­ingly dif­fi­cult, prompt­ing a warn­ing from the World Heath Or­ga­ni­za­tion last year. “The price of some an­tiven­oms has dra­mat­i­cally in­creased in the last 20 years, mak­ing treat­ment un­af­ford­able for the ma­jor­ity of those who need it,” the UN health agency said.

Long and com­plex process

On the con­ti­nent, an­tivenom treat­ments are not gen­er­ally cost-ef­fec­tive for the drug com­pa­nies that make them. In 2010, French phar­ma­ceu­ti­cals gi­ant Sanofi stopped pro­duc­ing its widely-used Fav-Afrique serum, which is ef­fec­tive against the venom of 10 dif­fer­ent snake species, with the last batch ex­pir­ing in June of this year. Sanofi Pas­teur, its vac­cines divi­sion, said it had been edged out by cheaper com­peti­tors. But sev­eral stud­ies have shown these low­cost ri­vals are far less ef­fec­tive in treat­ing bites, while the del­i­cate process of cul­ti­vat­ing an an­tivenom fur­ther com­pli­cates de­liv­ery.

“An­tivenom is a bi­o­log­i­cal prod­uct. You have to buy the venom, draw out the an­ti­bod­ies, pu­rify them... it’s an ar­du­ous and com­plex process,” ex­plains Jean-Philippe Chip­paux, a snake bite ex­pert at France’s In­sti­tute of Re­search for Devel­op­ment (IRD). “Gov­ern­ments, lo­cal author­i­ties and com­pa­nies should all make a con­tri­bu­tion. To­day no min­istry is ca­pa­ble of say­ing where the prob­lem lies, how many bites there are or where they took place.” Worst hit are chil­dren and farm­ers work­ing the land. Ca­cutu Avis earns his liv­ing cut­ting down trees in the for­est be­tween the coast and the vil­lage of Eti­coba. “The cacubas are the most deadly, gen­er­ally if they bite you, you are a goner,” he says, us­ing the lo­cal word for mam­bas. “They are often in the trees and palm leaves.”

Re­liance on heal­ers

Soga is half an hour from the larger is­land of Bubaque, which has a ba­sic hos­pi­tal, and more than five hours from the cap­i­tal, Bis­sau. But with a sin­gle dose of life-sav­ing an­tivenom cost­ing up to $150 (141 eu­ros) - often more than a month’s salary-many are forced to turn to tra­di­tional heal­ers. “Peo­ple have died in front of me at the heal­ers’ places, but oth­ers have sur­vived,” said Jose Nac­tum, direc­tor of the hos­pi­tal in Bubaque. “We don’t have an­tiven­oms adapted for dif­fer­ent species and we have a lot of dif­fi­culty iden­ti­fy­ing the type of snake,” he ad­mits.

An­tivenom must also be kept chilled in the fridge, yet only 10 per­cent of the coun­try has ac­cess to elec­tric­ity. Even for the new play­ers in the mar­ket, mak­ing the an­ti­dotes cost-ef­fec­tive is a huge chal­lenge. “An­tiven­oms don’t bring in enough for the big pharma houses com­pared with other prod­ucts,” says Juan Si­lanes, pres­i­dent of Mex­ico’s Inosan Bio­pharma, now Africa’s top provider of snakebite serum. “But if there is a prod­uct that’s fairly good, and at a good price, that could change things,” he adds. — AFP

NEW DELHI: Par­tic­i­pants and spec­ta­tors watch ro­bots dis­played at the World Robot Olympiad in New Delhi, In­dia. — AP

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