Enough snake anti-venom, but state hospitals running low

MiD DAY investigated the reason for this shortage, only to learn that though the state boasts of a state-of-the-art state-run pharmaceutical firm that manufactures superior quality anti-venom kits, it has ironically failed to make the most of this advantage.u00a0

Availability issue? Vials of life saving anti-venom

Bites on the rise
Though there are no official figures available on the number of snakebites in Mumbai, statistics indicate an annual requirement of 70,000 vials
of anti-venom serum in Maharashtra, giving a clear indication about the magnitude of the problem.

Haffkine Bio-Pharmaceutical Corporation Ltd, a company owned by the state government, manufactures emergency kits containing freeze-dried polyvalent snake antivenin. Ironically, these kits are more in demand in other Indian states like West Bengal and Gujarat, even countries like Pakistan and Sri Lanka, than in the state of Maharashtra, where they are manufactured.

Gujarat procures approximately 62,335 vials and West Bengal obtains over two lakh vials per year from Haffkine. Haffkine is finalising deals to supply over two lakh vials to Pakistan and Sri Lanka.

Maharashtra, on the other hand, ordered a negligible number of anti-venom kits ordered in the last year.

"When we went in for production of anti-venom kits in August 2011, our aim was to reach out not only to the cities, but also to the rural areas. Our serum is in powder form and can be stored at higher temperatures. In spite of all these benefits, only two of the over 3,000 gram panchayats in the state have shown interest in our product," said the institute's Managing Director Prakash Sabade.

The kits are being sold to gram panchayats and other ancillary agencies at subsidised rates of Rs 1,255 for three vials and Rs 1,955 for five vials. "It is a life saving kit, with a shelf life of five years. The anti-venom can be administered for all type of poisonous snakebites," said Sabade.

State not a buyer?
There have been reports that Haffkine is not a supplier of anti-venom kits to the government, since the latter has not issued a fixed price list for subsidised medicines obtained from state-run agencies like Haffkine for the past two years. The allegation is that the government has instead been procuring the same from private agencies. Sabade refrained from commenting on the issue but confirmed that agencies like the state police force, forest department and tribal development department are not on their buyers' list.

Details available with MiD DAY indicate that the state government also slept on a letter dispatched by Haffkine for over a year, and responded only this July, ordering 60,000 vials of the anti-venom.

"We have ample supply of high quality anti-venom for Maharashtra, what we are supplying others is the surplus and on humanitarian grounds. It takes over eight months to produce the anti-venom, from the time it is milked from the snake, said Sabade.

Snake bites on the rise
Bharat Joshi, a government-certified snake catcher, said up to 600 snakebites are reported annually from the city and Thane. The number is on the rise owing to extensive construction work, which destroys snake burrows, forcing them to enter human habitats. "Last week I was called to catch a Russell's Viper from BKC, close to the American Embassy," Joshi said.

He added that state-run primary health centres usually stock anti-venom serums, but it is uncertain if the stocks are sufficient.

"In cases like cobra bites, a single patient can require up to 20 vials of anti-venom, so a centre cannot claim to have ample stock if they just have five vials. Ignorance, combined with lack of adequate medical facilities, is the cause of deaths rural areas, where tribals seek alternate treatments like mantras, herbs and worship," claimed Joshi.

The other side
Public Health Minister Suresh Shetty said that he had taken stock of the situation on Wednesday, and found that there was no shortage of
anti-venom in the state, either in cities or in rural areas.

"There were some issues about Haffkine supplying large amounts of their anti-venom to other states. We had a meeting last week to resolve the issue and they were categorically told that first priority should be given to the state and its agencies. Any surplus can be given to other states or countries," said the minister.

He added that the state government had a strict policy for procuring medicines, including anti-venom, which cannot be moulded to favour any particular company.

"It appears that other medicines produced by Haffkine are being clubbed with the life-saving drug on the price list as a marketing strategy, which is not correct. A cough syrup cannot be compared to the utility of an anti-venom," he added.

Dr Vijaykumar Gavit, minister of medical education, was unavailable for comment.u00a0