Genetic variability in snake venom and its implications for antivenom development in sub-Saharan Africa

Snake venom, a complex mixture of proteins, has attracted human attention for centuries due to its associated mortality, morbidity and other therapeutic properties. In sub-Saharan Africa (SSA), where snakebites pose a significant health risk, understanding the genetic variability of snake venoms is crucial for developing effective antivenoms. The wide geographic distribution of venomous snake species in SSA countries demonstrates the need to develop specific and broad antivenoms. However, the development of broad antivenoms has been hindered by different factors, such as antivenom cross-reactivity and polygenic paratopes. While specific antivenoms have been hindered by the numerous snake species across the SSA region, current antivenoms, such as SAIMR polyvalent and Premium Serums & Vaccines, exhibit varying degrees of cross-reactivity. Such ability to cross-react enables the antivenoms to target multiple components from the different snake species. The advent of biotechnological innovations, including recombinant antibodies, small-molecule drugs, monoclonal antibodies and synthetic antivenoms, presents options for eliminating limitations associated with traditional plasma-derived antivenoms. However, challenges still persist, especially in SSA, in addressing genetic variability, as evidenced by inadequate testing capacity and limited genomic research facilities. This comprehensive review explores the genetic variability of snake venoms in SSA, emphasizing the venom composition of various snake species and their interactions. This information is critical in developing multiple strategies during antivenom development. Finally, it offers information concerning the need for extensive collaborative engagements, technological advancements and comprehensive genomic evaluations to produce targeted and effective antivenoms.