Abstract:
Bharat Serums and Vaccines Ltd, India, marketed its multipurpose antiserum, clearly labelled ‘against African Snakes’, for use in Ghana. The Ghanaian Ministry of Health bought and distributed the antiserum to district hospitals based on information the Bharat company provided. Working in a remote regional or district hospital implies that you cannot order a specific drug or antivenom, you have to do with what the authorities think is best. We realised quite early that the Bharat antiserum did not work as effectively as the previous Pasteur AV antiserum against bites of the specimen of Echis prevalent in central Ghana. After having excluded all other causes for failure, such as inappropriate transport, storage or use, we immediately alerted the health authorities at the District, Regional and Central level as well as the local representatives of the company. The only answer we repeatedly got from government representatives as well as from Bharat local representatives: ‘The company says the antiserum is effective against African snakes’. No interest in further information from us was expressed. It took many more deaths, also from other districts, before it was realised at the Central Level that this antiserum was not useful in our part of the world. If now, after publishing our experience in an international journal, Visser et al.1 the company says it always had known (and we also could have known) that it would not work in Ghana, as the antivenom is not developed against the Echis snake from West Africa, we can only express our amazement about the marketing policies of Bharat Ltd. Since the Bharat Company is based on scientific expertise we expect the company to agree with our original conclusion that local clinical trials should be required before mass introduction of antivenoms in regions with no previous expertise with these antivenoms.