Over the years Nigeria has continued to expend huge amounts of hard currency in the importation of anti-snake venom vaccines. This is mainly because certain areas of the country are actually endemic to snake bites especially as rural farmers embark on their routine of crop cultivation and harvesting at different times of the year – leading to tens of thousands of deaths annually. As such snake bites are indeed a major healthcare concern that needs more concerted efforts at curbing the hazards. Recently, a team of researchers at the University of Jos developed what is termed the world’s first plant-based anti-snake venom vaccine. What’s more, according to the experts the vaccine which is a remedy for snake bites of various kinds is very cheap compared to the imported vaccines. PharmaTimes Editor, MORGAN NWANGUMA writes:
Looking back it has been found that long before now medicinal plants have been used in the treatment of snake bites and this was even attested to by the team of researchers that just unveiled the world’s first plant-based anti-snake venom vaccine. Over time rural dwellers in snake endemic areas in Nigeria have successfully employed herbs in traditional medicine as remedy for snake bites.
Snakebites have therefore been regarded as a serious problem in public health owing to their high morbimortality according to a publication in the Journal, Hindawi. It further states that majority of snake venoms produce intense local tissue damage, which are likely to lead to temporary or permanent disability in victims. The available specific treatment has been the antivenom serum therapy, whose effectiveness experts say is reduced against these effects.
Thus, the search for complementary alternatives for snakebite treatment has become ever relevant. There are several reports of the popular use of medicinal plants against snakebites all over the world. In recent years, many studies have been published giving pharmacological evidence of benefits of several vegetal species against local effects induced by a broad range of snake venoms, including inhibitory potential against hyaluronidase, phospholipase, proteolytic, haemorrhagic, myotoxic, and edematogenic activities. And so in the peer reviewed article titled: ‘Medicinal Plants for the Treatment of Local Tissue Damage Induced by Snake Venoms: An Overview from Traditional Use to Pharmacological Evidence’, it is hoped that an updated indication would have been made – showing the common use of medicinal plants as antiophidic agents with pharmacological studies supporting the uses, with emphasis on plants inhibiting local effects of snake envenomation.
A neglected public health issue
It is estimated that about 5.4 million snakebites occur worldwide each year with up to 2.7 million envenomings (poisoning from snake bites), and leading to around 81, 000 to 138, 000 deaths. In spite of its key influence on human health, this situation has remained neglected most of the time by national and international health authorities, funding agencies, pharmaceutical companies, patients’ organisations, as well as health advocacy groups.
As a result, in 2009 snake envenomation was included in the World Health Organisation’s (WHO) list of Neglected Tropical Diseases (NTDs). Envenoming and deaths resulting from snakebites are a particularly important public health problem in the rural tropics. It’s been found that the, “Populations in these regions experience high morbidity and mortality because of poor access to health services, which are often suboptimal, as well as other NTDs, which are associated with poverty.”
Records have it that rural and certainly poor sub-Saharan Africa, Asia, Latin America and parts of Oceania indeed house most of these cases. In Africa alone about 435, 000 to 580, 000 snake bites that need treatment occur annually, with an equally huge number becoming victims of serious disabilities like amputation.
And now, the opportunity has come for Nigeria to harness the advantages of her own home grown vaccine which has been developed by the team of researchers at the African Centre of Excellence in Phytomedicine Research and Development (ACEPRD) at the University of Jos. This was done in collaboration with the National Office for Technology Acquisition and Promotion.
Anti-venom has been the best suited remedy for tackling snake bites, the only snag being that it is usually a big problem recognising the right one apart from its affordability. The high cost leading to unavailability of treatment is the main problem confronting most of the people who require it, especially women, children and farmers in poor rural communities in low and middle-income countries. According to the World Health Organisation (WHO) however, untested or even fake antivenom products have over the years gained entry into some markets thereby
deflating the confidence reposed in antivenom therapy as a whole. This spurred widely held fears of the imminence of antivenom supply failure in Africa and in a number of Asian countries if strong and decisive measures were not quickly taken. The discovery of the plant-based anti-snake venom vaccine (called COVIP-Plus) which is also classified as the first of its kind in the world, has been rated as a major research finding in Nigeria.
Reasons and inspirations for the study
According to Prof. John Chinyere Aguiyi, Lead author and Centre Leader of ACEPRD, it was rather inspiring to embark on this study because of the dire need to make available reasonably priced and accessible anti-snake vaccine for people who continuously face the hazard of snake bites. These categories of people he said are usually rural farmers and children.
Also, one major inspiration for this vaccine development is what was noticed by researchers who were able to identify a particular seed that rural villagers living in snake endemic areas were used to taking each time they got bitten by snakes. “That was the trigger to go into the details of this research; and because it comes from a natural source, there are no adverse effects to it,” Aguiyi said.
First of all, before embarking on this study the researcher said that he went to search on the Internet to see if there was any such vaccine in existence, and discovered there was none “and that was what inspired me to go into this research.” He added that, “The average farmer or victim in the country cannot afford the imported vaccines or drugs.”
“When the taught first came to me, it was about making available cost effective anti-venom that will not have any form of adverse effect because what we have in the market today have adverse effects to which some people react. I am happy to say that what we have today has proven not to have any of such adverse effects at least in the animals for now,” he stated.
Challenges leading to the research
A lot of people get bitten by snakes every now and then and the imported vaccines or drugs have been very expensive. “We just had to look inwards and for over twenty years we have been working on this. But funding has been the usual problem even with this project, and after all the various efforts, this project has just started to attract some funding from the Bank of Industry (BOI). We have just finished trials on the laboratory levels and now we have to use human beings to confirm the efficacy of this vaccine as we embark on the clinical trials for this vaccine and it is very expensive. It is going to be a multi-billion naira project if we are able to get through,” the researcher said.
The government is needed to see this project through with the needed support. And experts say that immediately this project is completed it is bound to earn the country good income to the tune of billions of dollars.
Readiness of the product for the market
In an interview monitored via the NTA, the researcher said that right now the product is set for use except that it would necessitate endorsement for clinical trial prior to being commercialised and be made available. The researcher said the vaccine is ready for the market except that it cannot go to the market right now. “But it cannot go to the market until It has been proven to be effective and safe in humans, and that is where we are,” the study author remarked. “As soon as we are able to carry out the phase one clinical trial we will have much hope to finish the rest of the work.”
The researcher said, “By the time we carry out the clinical trials, we should be able to establish whether such adverse effects are found in humans or not. The major thing we have in mind is to bring down the cost of treatment of snakebite.” Duration wise the clinical trial should take about 14 months instead of the ideal of 12 months, but it’s been extended to beyond 12 months because after an individual is inoculated it takes an average immunity period of about twelve months.
A Vaccine for a variety of snake bites
The vaccine is actually broad-based unlike some of the drugs that are available to us right now which are specific to certain snake bites. But here, the researcher says that “even if you’re bitten by the three major kinds of snakes – Cobra, Adder, Viper, as long as you’re vaccinated with this vaccine, you have developed immunity against a broad spectrum of venoms of all these and other things like scorpions.” He further stated that, “It becomes imperative that we develop something for our own use from local source and that is what we have done. To crown it, the vaccine can be carried to any corner of Nigeria because it will withstand temperature.”
The uniqueness of this particular vaccine the lead author emphasised, includes the fact that – “The one in circulation has to be refrigerated otherwise it will lose its potency. They are purported to have been produced in Nigeria but we know where they are produced.” He added that COVIP-Plus is the first in the world because going through the various literatures you will not find a plant-derived anti-snake vaccine. “That is what made it to be unique. It was not a day’s journey; it took almost 24 years with potency and endurance,” Prof. Aguiyi said.
“And they (antivenoms) are often unsafe, triggering allergic reactions. That is because of the way antivenoms are produced: Venoms, milked from snakes, are injected at low doses into animals, typically horses, to trigger an immune response. Antibodies from the animals’ blood are harvested, purified, and then used as antivenoms. But people’s immune systems can react to the animal product,” he stated. It is also important to note that there is no particular age bracket or restriction when it comes to administering this vaccine, according to the researcher.