CLODOMIRO PICADO INSTITUTE: ANTIVENOM SERUMS FOR THE WORLD


The ICP distributes approximately 100,000 bottles of anti-venom serum per year and works in cooperation with more than 115 entities in 31 countries.

In 1970, the Clodomiro Picado Institute (ICP) was founded, but the search for solutions to snake bites was started by “Chlorito” Picado since decades before in the Laboratories of San Juan de Dios Hospital in San José.

Today, the first antivenoms materialized in the country in 1967 are reflected in thousands of bottles that are sent to various countries in the world by the ICP to combat snake bites.

UNIVERSIDAD spoke with José María Gutiérrez, research professor at the Clodomiro Picado Institute (ICP), about the work of the ICP and its perspective of the world snake bite crisis in light of they recent documentary (Minutes to Die).

How does the ICP contribute to the fight against snake bites in Costa Rica?

-The ICP has developed a comprehensive strategy that combines a program of scientific-technological research to understand the biology of snakes, the composition of poisons, the mechanism of action of poisons and the immune response to them, as well as to improve the technology to produce antivenoms. Antivenoms are produced and distributed to the CCSS, an active social action program is developed for communities at high risk of bites, and personnel from health sector are trained in the treatment of patients bitten by snakes.

How does the ICP evaluate the work of the State, health entities and public policies against the fight of snake bites in the country?

–The success of Costa Rica in the management of the problem of the snake bites is a result of the combination of different factors. The existence and work of the ICP is a fundamental factor, but so is the development that has had the public health in the country. The fact that there are hospitals, clinics and Ebais in the whole national territory and highly competent and committed health professionals, who have been trained in the management of this bites, allows the bite patients to be treated quickly and in a efficient manner, which reduces the risk of death and complications.

In contrast to the documentary Minutes to Die, recently published, what is the underlying problem that we really face, in addition to the clear risk of thousands of people dying in seconds?

– The problem is that the snake bites mainly affect vulnerable social sectors, in conditions of poverty, in rural areas (farmers, herders, indigenous populations, etc.). As they are sectors with a little political voice, this problem has gone very unnoticed (with notable exceptions such as Costa Rica and Brasil) by the health authorities, the research agendas and the big pharmaceutical companies.  As the antivenom serums are drugs with a little economic return, pharmaceutical companies have not been interested in the production of serums. This had led to a crisis of shortages of serums in many parts of the world, specially in sub-Saharan Africa and parts of Asia.

How many bites are in Costa Rica per year and how many victims?

–Between 500 and 600 cases per year. Of them, between zero and three persons die every year, and there is a not very well determined number of people who survive, but they are left with some physical or psychological sequel.

How many serums has the ICP produce so far? How many leave the country?

The ICP serums reach 15 countries. ICP produces: polyvalent serum (used in Central America and some countries in South America), anticoraine serum (used in Central America), polyvalent serum for veterinary use (used in Costa Rica) and serum EchiTAB-plus-ICP (distributed to several Africa countries).

Which is an indicator of the beneficiary population of the ICP antivenoms?

–The ICP distribute aproximately 100,000 bottles of anti-venom serum per year. Each treatment employs between five and ten bottles, depending on the severity of the cases. That is, each year between 10.000 and 20.000 people benefit from these serums.

How, from the ICP, the challenge of giving access to the most excluded populations to quality health care before a snakebite is analyzed?

-The philosophy of the ICP, which is the philosophy of the UCR, is the combination of academic excellence and the pursuit of the common good in the social sphere. The attention of people bitten by snakes requires the generation of new knowledge to better understand poisonings and to constantly improve anti-venom serums; In addition, it implies health institutions must have human resources, medicines and adequate service provision points. Access to serum and effective treatment is a human right, so this attention should not be seen from a mercantilist perspective, but rather from the perspective of social rationality and human rights.

How much it worth healing from a snake bite, if it does not end in the unpleasant news of a lost life?
-This is a hard fact to give because there are great variations. For example, in the United States of America, the treatment of antivenom serum for a person can cost about $ 40,000, since the product is extremely expensive. In other countries, the public health system provides treatments at no cost to patients, as is the case in Costa Rica. In many poor localities of Asia and Africa, patients and their families must pay for the serum, which immerses them in a vicious circle of poverty, since they must sell animals or acquire loans in order to pay for the treatment. To the cost of the serum it is necessary to add the possible cost of treatments of recovery of the sequels.

Jafeth Mora Rojas



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