WHO Plans to Increase Treatment Access for Victims of Rabies and Snake Bites

WHO Plans to Increase Treatment Access for Victims of Rabies and Snake Bites

January 10, 2007

    GENEVA, Jan. 10 /Xinhua-PRNewswire/ -- Although more
than 12 million people each year are bitten by dogs or
snakes, or stung by scorpions, the world's capacity to
treat them is inadequate.  Effective treatment for these
conditions is critically dependent on therapeutic sera*,
but this essential drug is often unavailable or
unaffordable in the countries where it is most needed.  

    (Logo:
http://www.xprn.com.cn:9080/xprn/sa/20061102095006-51.jpg
)

      * A therapeutic serum is a pharmaceutical preparation
that contains 
        antibodies against one or more specific antigens. 
These 
        therapeutic sera are manufactured by fractionating
plasma collected 
        from animals (typically horses) that have been
immunized against 
        relevant antigens and that as a result develop
neutralizing 
        antibodies.  The plasma is pooled in batches of
tens to hundreds of 
        litres, and processed to extract the active
immunoglobulin fraction. 

    To address this neglected public health issue, the
World Health Organization (WHO) is creating a five-year
plan to boost production in developing countries, help
authorities forecast market needs and strengthen regulatory
capacity.  On 10 January, the health agency will bring
together the top experts in the area as well as recipient
and donor countries, international organizations and
manufacturers to agree to a global action plan.  

    Production of therapeutic sera in industrialized
countries is dropping due to inadequate profitability,
linked to uncertainty about the quantities needed. In
developing countries, affordability is an issue, and
production is also quantitatively limited and often does
not reach the quality standard required to make these
treatments effective and safe.  WHO estimates its plan to
boost access to treatment will cost US$ 10 million. 

    "We need to boost local manufacturers' capacity
and improve the delivery of products to remote rural
areas," said Dr Howard Zucker, WHO Assistant
Director-General for Health Technologies and
Pharmaceuticals.  "There are effective solutions that
could save millions of lives."    

    Rabies is the tenth most common cause of death due to
infections in humans.  It is 100% fatal but 100%
preventable when post-exposure treatment using therapeutic
sera is readily available.  An estimated eight million
people need to receive anti-rabies serum each year after
being exposed to animals suspected of carrying rabies. 
Almost half of those requiring the therapeutic sera and
those dying of rabies are children less than 15 years old. 
More than 99% of all human deaths from rabies occur in
Africa and Asia.  

    Close to five million snakebites and scorpion stings
are recorded each year in the world (mostly in Africa, Asia
and Latin America), 50 to 75% of which need treatment with
therapeutic sera to prevent death, amputation or severe
neurological disorders.  The main populations affected are
young agricultural workers and children.  Available
epidemiological data on the incidence of snakebites,
including the degree of associated mortality and long-term
morbidity are largely hospital-based and therefore
underestimate the true scale of the problem.  A majority of
snakebite victims seek traditional treatment and may die at
home unrecorded. 

    Since the 1970s, the number of manufacturers of
anti-venoms against African snakebites has dropped
dramatically.  It is estimated that there are one million
snake bites each year in Africa alone resulting in over
20,000 deaths and a much higher incidence of chronic
disability resulting from neurological sequelae and
physical handicap from necrotic effects requiring
amputation.  

    Over 10 million vials of anti-venom sera would be
needed to treat snake and scorpion bites worldwide, with an
estimated 2 million vials required for Africa alone.  An
estimated 16 million vials of anti-rabies serum would be
needed each year if current international guidelines for
post-exposure prophylaxis were to be fully implemented. 

    The crisis in the availability of therapeutic sera
calls for an international effort to facilitate the
transfer of technology to affected countries and address
major logistic problems in distribution, particularly in
ensuring maintenance of a cold chain.  In addition, a lack
of knowledge about the correct medical management of bites
and stings from venomous animals, including the appropriate
use of sera, further compromises the efficient clinical use
of the limited quantity of product available. 

    WHO is planning the following actions, which will be
discussed at the 10 January meeting:  

     -- Define a global standard for the production,
quality control, and 
        regulation of therapeutic sera to be used as
guidance by local 
        regulatory authorities and manufacturers;   
     -- Conduct regional educational workshops to help the
implementation 
        of quality and safety requirements for production
of therapeutic 
        sera following the principles of good manufacturing
practices; 
        Train inspectors and manufacturers on the critical
parameters of 
        the production of therapeutic sera; 
     -- Facilitate transfer of technology to developing
countries;  
     -- Establish a therapeutic sera pre-qualification
scheme based on WHO 
        experience in pre-qualification of other
therapeutic products; 
     -- Develop guidance and training materials on the
prevention, 
        diagnosis and management of diseases treatable by
therapeutic sera. 
   
    All press releases, fact sheets and other WHO media
material may be found at http://www.who.int .

    For more information contact: 

     Dr Ana Padilla, 
     WHO Scientist
     Tel:    [phone]
     Mobile: [phone]
     Email:  [e-mail] 

     Charlotte Wiback
     Media Officer
     Tel:    [phone]
     Email:  [e-mail] 

     Jacqueline Sawyer
     External Relations Officer
     Tel:    [phone]
     Mobile: [phone]
     Email:  [e-mail] 


SOURCE  World Health Organization