Transcript WHO Snake Antivenoms Website WHO Essential Medicines List  Animal (equine) derived blood products – – – – 2 | HIS/EMP: TBS/10/13 Snake anti-venom immunoglobulins Anti-rabies imunoglobulins Anti- tetanus.

WHO Snake Antivenoms Website
WHO Essential Medicines List
 Animal (equine) derived blood products
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Snake anti-venom immunoglobulins
Anti-rabies imunoglobulins
Anti- tetanus immunolglobulins
Anti-diphtheria immunoglobulins
POOR QUALITY AND POOR REGULATORY CONTROL:
Technology in the public domain
A - Collection of venoms
B – Horse Immunization
C – Starting material of
D – Fractionation &
Protocols
animal derived sera
Purification process
WHO Guidelines and Databases
ANIMAL DERIVED BLOOD PRODUCTS (2008-10)
 WHO Guidelines on production, control and regulation of
snake antivenom immunoglobulins
 WHO Database: clinically important venomous snakes
species and its worldwide geographical distribution
together with antivenoms for treatment of snakebite
envenomings
 WHO website hosting both the Guidelines and database
(maps, pictures, products, manufacturers)
http://www.who.int/bloodproducts/snake_antivenoms/en/
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WHO Database: Medically Important Snakes
Distribution maps, pictures & antivenoms
www.who.int/bloodproducts/snakeantivenoms
WHO Guidelin
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Data Sources: Distributions
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Primary species lists derived from information in
the WHO Antivenom Guidelines Annex 1.
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Accurate distribution limits in countries
determined from reference to:
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Published literature in books and journals;
Herpetological specimen collections in more than 60
major Natural History Museums worldwide;
If necessary, photographs of specimens and taxonomic
data requested from Museum curators to validate ID;
WHO Snake Antivenoms Website | November 7, 2015
WHO Database: Medically Important Snakes
Distribution maps, pictures gallery
Red or orange question marks (?)
(Indicates expected presence not
yet confirmed due to lack of
exploration
Allocation to CATEGORY 1 shown in red
(Indicates common, widespread species
that causes numerous snake bites with
high morbidity, disability or mortality)
Allocation to CATEGORY 2 shown in orange
(Indicates highly venomous and capable of
causing morbidity, disability or mortality, but
exact country data lacking, or less frequently
implicated in these countries)
www.who.int/bloodproducts/snakeantivenoms
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Data Sources: Antivenoms
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An antivenoms database was created using data
verified by individual manufacturers, providing:
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Manufacturer data (address and contacts)
Product data (venoms used for immunization, label
claims of species coverage)
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Production registration/licensing data sought
from 62 NRA’s in AFRO, EMRO, SEARO & WPRO
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Available literature on preclinical/clinical efficacy
and clinical safety reviewed
WHO Snake Antivenoms Website
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Photography
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Used a wide network of sources to obtain very high quality
images of each species, often representing several different
regional, sexual or age-related colour variations.
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Aim is to provide users with images that illustrate features
that may aid visual identification.
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Objective is to illustrate every species account.
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Photographers donate images.
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WHO web site: Target Audiences
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Central information source for data on the current
availability of antivenoms for specific species.
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Aimed at a wide audience, that includes:
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National Regulatory Agencies
Ministries of Health
Antivenom Manufacturers
Medical Professionals, Health Workers
Procurement Personnel in Industry and NGO’s
Objective is to use the web site to distribute
accurate data that can be used to plan
improvements to existing supply and distribution.
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Achievements
WHO made a "landmark" step in facilitating
validated information with regard to production,
control and regulation of snake antivenoms and
the appropriate antivenoms to be used in the
different countries and regions
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Two measures are essential:
a) the implementation of a global framework to
assess the quality, safety and efficacy of existing
products and
b) a procurement mechanism that will stabilize
the market for antivenoms and enhance access
for patients in need
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Next steps in the process
of capacity building
Extension of the WHO prequalification
programme to snake antivenoms and other
animal derived specific immunoglobulins
(e.g tetanus, rabies, diphteria) needed.
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Venoms production: Basic problems
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Venoms used for production need to be representative
of the snake populations in the territories where the
antivenoms will be distributed
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Technical capacity needs to be generated to assess the
neutralizing potency of antivenoms (preclinical
assessement)
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Venoms reference preparations may be a key
component in any global strategy aimed at increasing
the production and use of effective and safe
antivenoms.
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Consequences…
 The antivenoms produced using low quality, or nonrepresentative venoms are deficient in terms of
neutralizing potency and extent of coverage.
 The capacity to prepare high-quality
venoms is a key component in any
global strategy aimed at increasing
the production and use of effective
and safe antivenoms.
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Web site addresses
http://www.who.int/bloodproducts
http://www.who.int/bloodproducts/snakeantivenoms
http://www.who.int/bloodproducts/catalogue
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