Why are antivenoms not easily accessible in India?

Context: On New Year’s Day, five-year-old Mayuri lost her life to a snakebite in
Uttara Kannada district in Karnataka. The delay in receiving antivenom and the
unsafe conditions at her anganwadi tragically sealed her fate. A terrible
number, estimated 58000 snakebite cases, renders India the ‘snakebite capital’
of the world and in this regard antivenoms play a crucial role. Snake venom is
one of nature’s most lethal weapons, a complex cocktail of toxic proteins, each
tailored by evolution to immobilise, and in some cases to digest, prey and
defend against threats.

Key points

·       Antivenom: Antivenoms, or
antivenins, are life-saving medicines used to treat snake bites. Antivenoms are
the frontline defence. They work by specifically binding to the venom toxins to
render them ineffective, allowing the body’s natural defence systems to clear
them safely over time.

·       Lethality
of snake venom: Snake venom is one of nature’s most lethal weapons,
a complex cocktail of toxic proteins. Haemotoxins destroy blood cells and
disrupt clotting. Neurotoxins block nerve signals and paralyse.
Cytotoxinsdissolve tissue at the bite site. The effects are often fatal without
medical intervention.

·       Productions
of Antivenoms: French physician Albert Calmette in the 1890s
developed the first antivenom using horses, a practice that continues today. To
produce antivenom, healthy and mature venomous snakes are first captured from
the wild by trained experts who then “milk” the snakes to extract the venom. Next,
they immunise horses with increasing doses of venom over many weeks, allowing
their immune systems to produce antibodies. Over time, the horses develop a
robust immune response, producing antibodies that neutralise venom toxins.

·       Current
scenario of antivenoms in India: Polyvalent antivenoms
(PVAs) currently used in India targets multiple species. However, their
efficacy varies against less common snakes.

·       Issues
with Antivenoms in India: India is the world’s largest producer and consumer
of antivenoms in the world. However, access to timely medical care remains a
significant challenge for many Indians.

Ø  Administration
issue - Improper administration and inadequate facilities exacerbate the crisis.
Logistical issues, unequal access to care, superstitious beliefs, and cultural
practices often delay proper treatment in many parts.

Ø  Lack of
Infrastructure - Antivenoms often need to be transported in cold storage, however,
India’s rural parts lack the supporting infrastructure and power supply.