Load-shedding and renovations at the South African Vaccine Producers (SAVP) facility have led to a shortage of lifesaving antivenom, leaving the country dangerously unprepared for snakebite emergencies.
The National Health Laboratory Service (NHLS) said stockpiles of spider, scorpion and polyvalent antivenoms were depleted. Only boomslang antivenom remains available for distribution. Polyvalent anti-venom is used to treat all mamba, cobra, rinkhals and large adder species bites in Southern Africa.
NHLS spokesperson Mzi Gcukumana said the vaccine-producing facility underwent extensive infrastructure and equipment upgrades late last year. It is a licensed manufacturer and distributor of antivenom products, supplying public and private health-care facilities, depots and wholesalers who distribute them to animal health services.
Gcukumana said the upgrades were planned and necessary due to the deterioration of ageing infrastructure which had hampered compliance with good manufacturing practices at the sterile manufacturing unit.
“A steady power supply is important for controlled air and temperature conditions. Since 2021, frequent power outages and generator changeovers have affected equipment reliability.”
For a black mamba or a Cape cobra bite, you need about 12 to 13 vials. An average bite can cost R100,000, but for a serious bite which requires surgery it can cost R1m
— Johan Marais, African Snakebite Institutet
Due to the extent of the work required, antivenom manufacturing processes had to be temporarily discontinued, Gcukumana said.
“While in the middle of renovations, the project experienced delays due to postponed delivery of specialised equipment and the requirement to maintain required quality standards, both of which were aggravated by the rigorous regulatory environment for sterile manufacture.”
During this period, the stockpiles of antivenoms were depleted.
“The NHLS is now concentrating on the commissioning of the upgraded facility and is doing everything possible to speed up the final stages,” Gcukumana said.
Arno Naude of Snake Bite Assist said the shortage had already proved deadly.
“People are dying because of the lack of antivenom. Last week a small child died in the Western Cape, but because of the Popi [Protection of Personal Information] Act it can easily get swept under the carpet. South Africa used to supply other countries, which now are importing antivenom from elsewhere and are either getting fake drugs or antivenom that cannot neutralise the venom of the snakes in Southern Africa.”
He said hospitals either cannot treat snakebite patients or are using less anti-venom.
“Less antivenom might still save a life but possibly not a limb or the kidneys. Very few hospitals have antivenom as there has been a slowdown in delivery for a few years now. The ones that do have some cannot replenish stocks.”
Last month, 17-year-old Alexander Blignaut was taken to a private hospital in Ladysmith after he was bitten by a puff adder.
His mother, Maryann, said he was one of the lucky ones because there was antivenom available.
Johan Marais of the African Snakebite Institute said there were close to 4,000 bites a year in South Africa.
“There are about 900 hospitalisations and about 100 of those patients get antivenom. While nine out of 10 patients don't need it, those who do need it urgently. It is the only treatment for serious snakebites.
He said not all hospitals stock antivenom. “Hospitals are businesses. They stock what they want to. Antivenom is expensive. Polyvalent antivenom sells for just over R2,000 per vial. For a puff adder bite, you need to start with about six vials. For a black mamba or a Cape cobra bite, you need about 12 to 13 vials. An average bite can cost R100,000, but for a serious bite which requires surgery it can cost R1m.”
Marais said the shortage was concerning. “People's lives are at stake. Snakebites are by and large a poor man's disease. If you're out in rural Zululand, working in the field barefoot, you have a far higher chance of getting bitten. There's a lot of pain, swelling, blistering, tissue damage, surgery and amputations, and we don't always properly quantify the socioeconomic impact of this.”
Private security company Reaction Unit SA says it has responded to at least 80 calls this year from residents who found snakes on their properties.
“We've had a few snakebites and normally go to a hospital that has the antivenom, and we've had cases where no antivenom was available, but we usually phone around beforehand,” said company director Prem Balram.
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