University of Melbourne researchers have been
awarded more than $1.4 million by the Australian National Health & Medical
Research Council to conduct the first ever randomised clinical trial of an
Australian snake antivenom.
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David ‘Snakeman’ Williams (right) holds a 3m
long Papuan taipan, one of the deadliest snakes in the world, with UPNG
researcher Owen Paiva. Pictures courtesy of DAVID WILLIAMS |
The study, to be conducted in partnership with
collaborators from the University of Papua New Guinea in Port Moresby will compare
the current CSL taipan antivenom with a new antivenom made in Costa Rica and
will take place in Port Moresby General Hospital, Papua New Guinea.
While similar numbers of snakebites occur in both
Australia and PNG, death following snakebite in Australia is rare, whereas in
PNG up to 200 people die from snakebites every year, partly because their health
system has not been able to afford to supply enough of the antivenom produced
in Australia.
Scientists from the Australia Venom Research Unit at
the University of Melbourne teamed up with colleagues from the School of Medicine
& Health Sciences at the University of Papua New Guinea in 2005 to
investigate snakebite problems in PNG, and this collaboration led them to
team up with a not‐for‐profit,
University‐based antivenom producer in Costa Rica
to produce a new, more affordable antivenom, that could eventually be
manufactured in PNG by UPNG scientists themselves.
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Papuan taipan
being milked for venom
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The taipan is a common and potentially deadly snake
in some parts of Australia and in PNG. Taipans have the most toxic venoms of
all land snakes, along with very long fangs and a very accurate bite, making
them some of the most dangerous snakes in the world.
Bites can destroy nerve and muscle tissue, cause
severe paralysis, bleeding problems, kidney injury and heart rhythm problems.
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The deadly Papua
taipan Oxyuranus_Scutellatus
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Dr Ken Winkel, Director of the AVRU, is excited
about this grant and what it will mean for the Australian and PNG communities.
“Funding from the grant will see the establishment
of a snakebite clinic within the Emergency Department of Port Moresby General
Hospital, and a clinical research laboratory at the neighbouring University of
Papua New Guinea Medical School” said Dr Winkel.
“The trial has been rigorously designed, and will be
carried out by a team of 13 Papua New Guinean doctors, nurses and scientists
led by two AVRU researchers based in Port Moresby” he said.
“The NHMRC funding enables us to conduct the trial
under the best possible conditions for patient safety and medical care, and
will significantly enhance the capacity to treat snakebites at the local
hospital, not just throughout the trial, but well
into the future.”
The University of Papua New Guinea’s Dean of
Research, Professor Teatulohi Matainaho is equally enthusiastic about the
benefits of the research.
“This research has accomplished a great deal in a
very short period of time, and will not only provide an opportunity to improve
the training of our medical staff and laboratory scientists, but also moves us
one step closer to potentially being able to manufacture our own antivenoms to
provide a sustainable solution to a very serious public health problem that
kills many Papua New Guineans” he said.
“Snakebites are an acute medical emergency.
Without antivenom many patients will die within 24
hours, but for a long time now, the cost of Australian antivenom has been
rising because of factors such as international exchange rate
fluctuations, and PNG has been able to afford less
and less of this lifesaving medicine” says Prof. Matainaho.
“If the new antivenom from Costa Rica is shown to be
as safe and as effective as the Australian antivenom, the cost of treating snakebites
could drop enormously, and we hope that a future technology transfer will
enable us to make the new antivenom here, providing a truly local solution, as
well as local jobs for our young scientists, and a unique training environment
for future biomedical research students” he says.
Snakebite places a significant burden on the
resources of Port Moresby General Hospital, with up to 300 cases being seen
every year, and the recruitment of a team of local doctors and nurses working
in a new snakebite clinic is expected to take some pressure off the hospital’s
Emergency and Intensive Care Departments.
“We expect that after the trial, the snakebite
clinic will continue to operate and deliver improved care to snakebite patients
in PNG, and we will work towards identifying sustainable funding to achieve
this outcome” said Dr Winkel.
“At the same time, this grant also enables us to
continue to build research capacity, and contribute to the training of young
scientists at the UPNG Medical
School.”
Prof Matainaho agrees, and said that the
establishment of laboratory facilities for undertaking the analysis of the data
obtained from the patients in the antivenom trial will also eventually benefit
the School more broadly.
“The Snakebite Project has already helped UPNG to
develop new infrastructure, research programs and projects for students” he
said, “and the new facilities that will be set up for the antivenom trial will
be a significant new resource that we expect will continue to operate after the
trial concludes.
“In light of recent discussions between Prime
Ministers of Australia and Papua New Guinea regarding better relations and
support in higher education, science and research, this project is a fine example
of how Australian and Papua New Guinean universities can partner with each
other successfully, and also provides an excellent model for other institutions
to follow”.
One of the UPNG researchers who will benefit
directly from the grant will be Owen Paiva, who has worked with the AVRU‐UPNG
Snakebite Project for several years, and carried research on the venom of
another of PNG’s venomous snakes, the small‐eyed
snake, for his Master’s thesis. “This is an amazing opportunity for Papua New
Guinean researchers to be involved in a major medical breakthrough that will
directly help the people of our country” he said.
“Right from the beginning it has been clear that
this project wasn’t just about doing research for the sake of research, but
that the objective was to save people’s lives and find a long‐term
solution to an important problem.
“Snakebite and antivenom research is truly
multidisciplinary so this project doesn’t just benefit one group of
researchers, because it involves clinical medicine, biochemistry and molecular
biology, pharmacology, immunology, microbiology and public health disciplines
like epidemiology and biostatistics.
“And if we eventually start to make the antivenom
here in PNG, we’ll also be creating jobs for scientists like myself in our own
country, as well as helping our people”.
Dr Winkel also sees potential benefits beyond PNG’s
borders.
“There is an urgent need to develop effective, high
potency antivenoms to affordably replace a number of low efficacy products in
Africa and Asia, and the success of this new, high potency, affordable Papuan
taipan antivenom, tested in a robust clinical trial, would offer proof‐of‐principle
and a path forward towards achieving this objective.”
He says the trial in Port Moresby is also very
important to Australia.
“Not only are we helping our closest neighbours to
develop their own capacity to become truly independent by developing local biotechnology
and research capacity, research skills and improved health for its population,
but we are increasing our knowledge of the effects of taipan snakebites, and
how to manage them successfully” he said.
“We are confident the results of the trial will inform
and improve snakebite management for the benefit of both countries” said Dr
Winkel.
