A recent advisory published on the 11th September 2026, by the South African Vaccine Producers (SAVP) regarding the unavailability of stock and production dates for future batches of antivenom to be released, caused some commotion. Too many people, this advisory indicated that antivenom is unavailable for the treatment of envenomation in Southern Africa and patients are going to die. However, this could not be further from reality.
The development of snake antivenom in South Africa began in 1901 by Dr Watkins-Pitchfont at the South African Institute for Medical Research (SAIMR) in Pietermaritzburg. After development and production, the commercialisation of antivenom was handed over to the SAVP at the National Health Laboratories in Johannesburg, South Africa. At the time, the SAVP were world leaders in antivenom production and additional types of antivenom were developed, saving hundreds of lives every year.
Today, the SAVP produce 4 different antivenoms for use in Southern Africa:
Antivenom is vital for any envenomation that risks loss of life or loss of limb. Each antivenom is supplied in liquid form, is required to be stored between 2 and 8C and has an expiry date of 3 years from date of manufacture. Treatment involves an initial dose and a follow up dose until symptoms improve.
The use of antivenom is the best course of action to treat an envenomation from medically significant animals. Without it, the patient may lose their life, their limb, become permanently disabled or suffer a long and extended recovery period. It is a miraculous drug that when required it is absolutely necessary. SAVP polyvalent snake antivenom is the most widely used antivenom in Southern Africa, without it, the effective treatment of snakebite would not be possible. However, when needed, monovalent Boomslang, scorpion and Latrodectus antivenom are equally vital in preventing death, loss of limb and ensuring a favourable outcome for the patient.
During and after Covid, the SAVP went through a tough time. Supply chain difficulties and internal challenges affected production to such an extent that some SAVP antivenoms were unavailable. The SAVP has moved on since then, and with new management and resources are getting back on track. Antivenom is not quick nor easy to produce. It is a costly production process that takes months to manufacture the final product from raw venom.
When the SAVP release an advisory indicating stock unavailability, it does not mean there is no antivenom to treat patients. Just like the panic buying of toilet paper during Covid created empty shelves in supermarkets, the sporadic availability of antivenom has resulted in medical organisations stockpiling large quantities of antivenom for their own use. Limited stocks and stockpiling exasperate antivenom availability for everyone else. Although the SAVP may have no stock of certain antivenom, it is available throughout southern Africa. The important question is where is this antivenom?
For many years, the SAVP were the only supplier of effective antivenom in Southern Africa. However, with the variable availability of their antivenom (importantly polyvalent snake), alternative suppliers were sought. The Eswatini Antivenom Foundation in partnership with the Instituto Clodomiro Picado, University of Costa Rica, developed a new lyophilised (powdered) polyvalent snake antivenom called Echitab-ICP or use in Eswatini.
Premium Serums in India manufacture a polyvalent antivenom (Panaf) which is widely used throughout Africa. Panaf has been registered for use in South Africa and has proven to be a highly effective equivalent to SAVP polyvalent snake antivenom. Both Panaf and Echitab are supplied in powdered form that does not require refrigeration and has an expiry date of 5 years from date of manufacture. There are the possibilities of SAVP equivalent antivenoms (Boomslang, Scorpion and Latrodectus) being developed by alternative manufactures.
In 2008 the World Health Organisation published guidelines for the production, control and regulation of snake antivenom immunoglobulins. One of those standards was that to ensure an uninterrupted supply of antivenom in a region, there should be 2 or 3 different manufacturers supplying antivenom.
As availability of antivenom from the SAVP begin to stabilise, and alternative and new antivenom become registered for use in Southern Africa, the availability of antivenom to the patient, and challenge of a single supplier of this life saving drug will be a thing of the past.
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