From scarcity to sustainability: Policy pathways for equitable snakebite antivenom access in Africa

Abstract

Snakebite envenoming (SBE) causes substantial mortality and long-term disability in sub-Saharan Africa (SSA), disproportionately affecting rural and economically vulnerable populations. Antivenom is currently the only approved snakebite therapy, yet chronic shortages, fragmented supply chains, high prices, and inconsistent product quality continue to undermine access, exacerbated further by persistent gaps in human resource capacity and health system infrastructure. This article synthesizes existing evidence on antivenom access barriers in SSA and shares feasible policy solutions with a health systems lens grounded in ongoing regional capacity strengthening efforts, World Health Organization (WHO) guidance, and market-shaping experience from other global health initiatives. Although there are multiple bottlenecks along the access continuum, the article focuses on three interlinked challenges: i) underinvested research capacity; ii) fragile and insufficient manufacturing capacity and iii) lack of sustainable financing. Emerging political commitments in countries like Kenya, coupled with expanding research and manufacturing capacity in the region, offer an opportunity to build a resilient regional ecosystem. Learnings from pooled procurement and blended finance in other therapeutic areas indicate potential pathways for stabilizing markets, reducing prices, and incentivizing sustainable production. Strengthening antivenom access in SSA therefore requires a coordinated policy approach anchored in regional research networks, regional manufacturing and blended finance, which collectively offer a viable route to reliable supply, improved affordability, and improved outcomes for tropical snakebite patients.