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抗蛇毒血清可及性的不平等:蛇伤中毒管理中的伦理问题。

Inequalities in access to antivenom: An ethical issue in the management of snakebite envenoming.

机构信息

Intensive Care Unit, Cayenne General Hospital, French Guiana, France; Tropical Biome and Immunopathology CNRS UMR-9017, Inserm U 1019, Université de Guyane, French Guiana, France.

Tropical Biome and Immunopathology CNRS UMR-9017, Inserm U 1019, Université de Guyane, French Guiana, France; Emergency Department, Cayenne General Hospital, French Guiana, France.

出版信息

Toxicon. 2024 Aug 28;247:108030. doi: 10.1016/j.toxicon.2024.108030. Epub 2024 Jul 14.

Abstract

Snakebite envenoming is a high-priority neglected tropical disease and antivenom is the cornerstone of treatment. Antivenom is listed among essential medicines and its access must be considered as a human right. Despite resolutions from various international organizations including the WHO, antivenom remains unavailable, unaffordable, and sometimes not targeted against the specific snake involved. Also, despite an expanding global antivenom market, some manufacturers have stopped production due to a lack of profits. However, justice and equitable access to care according to medical needs are among the four pillars of medical ethics. Overall, snakebite envenoming is a typical example of social and ethnic inequity in medicine. It is imperative that this issue be addressed from an ethical standpoint and that government laboratories take the lead in antivenom production.

摘要

蛇伤中毒是一种高度优先的被忽视热带病,抗蛇毒血清是治疗的基石。抗蛇毒血清被列入基本药物,其获取必须被视为一项人权。尽管包括世界卫生组织在内的各种国际组织都做出了决议,但抗蛇毒血清仍然无法获得、负担不起,有时甚至不是针对特定的蛇类。此外,尽管抗蛇毒血清的全球市场不断扩大,但由于缺乏利润,一些制造商已经停止生产。然而,根据医疗需求公正和平等地获得医疗服务是医学伦理的四大支柱之一。总的来说,蛇伤中毒是医学中社会和种族不平等的一个典型例子。从伦理角度解决这个问题,以及让政府实验室带头生产抗蛇毒血清是当务之急。

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