Snake antivenom production in Ecuador: Poor implementation, and an unplanned cessation leads to a call for a renaissance

Snakebite envenomation is a global health problem. This health problem asymmetrically affects rural populations in developing countries to such an extent that it recently has been listed as a priority neglected tropical disease (NTD). It is estimated that 5.4 million individuals are bitten by snakes each year, causing at least 2.7 million envenomations and more than 100,000 deaths each year. Ecuador has one of the highest snakebite envenomation incidence rates in Latin America, mostly in the coastal and Amazonian provinces. Envenomations in these regions are the result of bites primarily by species of snakes belonging to the Viperidae family. Ecuador was able to locally produce antivenoms, however serious flaws were revealed in the antivenom production process, leading to the decommissioning of the existing facility. In the interest of public health, we have summarized the political and social setbacks experienced by the antivenom serum production plant in Ecuador, while encouraging resuming local production of snake antivenom to improve the responsiveness of the already overburdened health system. [Display omitted] •This is the first attempt to describe the current situation of anti-venom production in Ecuador.•Ecuador is a country with 17.5 million people, and every year, 1,600 people are bitten by snakes.•The lack of antivenom production is linked to higher hospital admissions due to snakebites in Ecuador.•From 2015 to 2017, at least 42, 883 antivenom vials have been imported from Costa Rica due to the lack of local production.