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THE NATIONAL (Port Moresby, Papua New Guinea) 14 February 08 High cost of anti-venom can be sliced: Snake expert (Malum Nalu)
Papua New Guinea can greatly reduce the high cost of snake anti-venom by switching to manufacturers in Asia or Central America, according to snake expert Dr David Williams.
Currently, the PNG Health Department pays K4,500 for a small vial of anti-venom but this can be reduced to less than K500.
“We hope that by switching to a manufacturer operating in Asia or Central America, we can reduce the final cost of anti-venom from the present K4,500 for Australian-made anti-venom to less than K500,” Dr Williams told The National.
“This is not a difficult proposition.
“There are already countries in Africa having anti-venom made for them in Central America at a cost of less than US$50 (K147) per vial.
“We have already submitted a detailed plan to the Health Department in relation to rationalising and improving anti-venom warehousing and distribution, by combining these functions with our epidemiological surveillance, and effectively removing the task of anti-venom distribution from the medical stores to a unit that we would run from the UPNG Medical School.
“This new anti-venom distribution facility would be accessible to dispense anti-venoms to hospitals and health centres 365 days a year, 24 hours every day.
“By matching distribution to the information we have on snake bite incidence, we could vastly improve service delivery, and more importantly stamp out the current problems of anti-venom theft and resale through the introduction of a range of measures for tracking individual vials of anti-venom.”
Snake venoms are mixed in a special emulsion and injected in tiny amounts into host animals such as horses.
Over several months the doses are gradually increased and these horses produce antibodies in their blood which neutralise the venom, so that eventually they can survive doses that would normally kill many horses.
When there are high enough antibody levels present, blood is taken from the horses and the antibodies for the snake venom are purified from it.
These antibodies go through several laboratory processes to ensure that they are safe for human use, and eventually are packaged in vials for use in the treatment of snake bite.
The technology was first developed in France more than 110 years ago, and remains relatively unchanged.
“Many developing countries produce their own anti-venom, and I believe that Papua New Guinea can also eventually do the same thing once the capacity has been built and personnel have been trained to do the work,” Dr Williams said.
High cost of anti-venom can be sliced

THE NATIONAL (Port Moresby, Papua New Guinea) 14 February 08 Anti-venom scam exposed
Port Moresby-based snake expert Dr David Williams gave details of the scam to The National yesterday as the Australian Broadcasting Commission prepares to screen a dramatic documentary exposing corruption in the Papua New Guinea Health Department, involving snake antidote, on its Foreign Correspondent programme next Tuesday night.
Papua New has some of the highest rates of snake bites in the world, and in some areas, more villagers die from snake bites than from malaria and HIV/AIDS.
Often, victims can’t get help because of poor transport and bad roads, and many medical clinics don’t stock expensive anti-venom. The antidote is imported from Australia, but at such inflated prices that the Papua New Guinea Health Department pays the equivalent of A$2,000 (K4,500) a vial. The high demand for anti-venom has helped create an illegal market, where doctors are accused of stealing anti-venom from medical stores and selling it back to their hospitals.Health Minister Sasa Zibe makes an appearance on Foreign Correspondent as he buys a vial of ‘suspect’ Indian anti-venom at a Port Moresby pharmacy for K2,500 as he is filmed on hidden camera.Dr Williams told of how anti-venom worth K4,500 a vial was stolen from the Area Medical Store at Badili in Port Moresby and sold to pharmaceutical companies, who in turn sold the medication at hugely-inflated prices, to the unsuspecting public.Dr Williams provided names of three major pharmaceutical companies – one of which is directly linked to a senior Health Department official – to The National.
He also told of a well-known Port Moresby doctor (named) who had offered vials of anti-venom to the Emergency Ward of Port Moresby General Hospital at K8,000 a vial, the question being where the doctor got the anti-venom from.The senior Health official works at the Area Medical Store, which orders anti-venom on behalf of the Health Department, from two pharmaceutical companies in which his family members are employed.
All these are happening as thousands of people all over the country continue to die from bites by the deadly Papua Taipan – the most venomous snake in the world, death adders and other snakes simply because anti-venom that is supposed to treat them is being stolen by Health Department workers in Port Moresby.
“I am the only person in PNG who is speaking up for the needs of snake-bite patients, and I see this as an important role, because unless awareness of the problem is raised, and unless the corrupt individuals, who are profiting from people’s suffering by stealing anti-venoms and selling them on the black-market are targeted by someone like myself, nothing will ever change,” Dr Williams told The National.
“There needs to be a specific investigation into the issue, and that investigations needs to be conducted in such a manner that the people who are implicated can be referred for prosecution.
“Companies that are knowingly selling stolen anti-venoms, or worse, anti-venoms from other countries that are not only useless for treating PNG snake bites, but also potentially dangerous in their own right, should have their licences to operate indefinitely suspended, and the principals of those companies should face prosecution for receiving and dealing in stolen goods.
“If their companies have dealings with the Department of Health, then these contracts should be cancelled.
“These people are killing Papua New Guineans through their greed and dishonesty and they should be made an example of. “This means that they should also be publicly named, so that the public can decide whether or not they wish to support these corrupt businesses or not.”
Dr Williams could not put a figure to lives lost because of this scam but “we do know that about 12% of the anti-venom delivered to the Area Medical Store at Badili between 1998 and 2003 disappeared without trace.
“This amounts to 416 vials of anti-venom worth nearly K1.24 million.
“Effectively this means that 416 snake bite patients may have missed out on receiving anti-venom at a health centre or hospital because of this discrepancy.
“At the same time, the Health Department paid a local wholesaler for 2,061 vials of anti-venom, yet, Area Medical Store records show 1,843 vials having been delivered.
“This leaves a discrepancy of 218 vials worth over K660,000.
“Again, this equals another 218 snake bite patients who could have received anti-venom, but did not.
“We will never know how many of the 634 patients, who may have been deprived of anti-venom, died for lack of it.”Dr Williams said the matter had been referred to former Health Minister Sir Peter Barter, who in turn had passed it on to the Police Fraud Squad, but nothing had been done since then.“What are we actually doing about it?” he said.“Half of the snake bite victims in this country are children.“The child who dies because of no anti-venom, who knows, one day he could have become a prime minister or a scientist.“We owe it to the future generations to sort this out.”*
Meanwhile, Dr Williams was almost killed by a Papua Taipan during the shooting of the Foreign Correspondent documentary. On a roadside just outside of Port Moresby, he was bitten by a Papua Taipan, all of which was filmed by the ABC crew and will be shown next Tuesday night. Minutes after the bite, Dr Williams was dangerously ill. There was no chance of survival without anti-venom.
He was rushed to a hospital, which had only one vial left.
Dr Williams’ near death experience was a striking demonstration of the alarming shortage of anti-venom in PNG.
Anti-venom scam exposed