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Posted by Wes von Papinešu on October 13, 2000 at 20:11:19:
VANGUARD (Lagos, Nigeria) 09 October 00 My Battles Against Snake Bites - Dr. Nasidi
Before now, Dr. Abdulsalami Nasidi was relatively unknown. His name does not ring a bell in the medical profession, so to say. But his recent discovery of an anti-snake venom drug known as Echitab, has positively changed his profile. This drug, is a product of ten years old painstaking research study by the physician and his team of researchers.
Last week, the Federal Ministry of Health and the National Agency for Food, Drug Administration and Control (NAFDAC) certified his product as fit for public use for snakebite. Also, his product is said to have met all the basic local and international requirements. After Dr. Abalaka who recently claimed to have discovered a vaccine for the dreaded HIV/AIDS and whose claim is still a subject of legal controversy, Dr. Nasidi remains the second Nigerian scientist in recent times to turn out a medical research product.
In this interview with our correspondents, Charles Ozoemena and Sam Ogboifo in Abuja, Dr. Nasidi talks about his new discovery and its effectiveness. He also reveals how he got government's nod and his plans for further research study.
Sir, you recently developed an anti-venom drug. Could you explain its potency against snakebites?
The drug is anti-venom which neutralises the poison of snake. When snake bites somebody, it injects a lot of venom. If you are unlucky it injects plenty, or half of it or even nothing at times. It all depends on how lucky the person is. When a snake is very hungry, it usually injects a lot of the venom. So what is required is to get within a short period of time an anti-venom vaccine to neutralize the poison quickly. In Nigeria, the most common snake with this poison is the carpet viper, Echis Ocellatus, a small tiny snake they call 'Paramole' in Yoruba, the Igbos call it Echieke.
The snake is seen everywhere in the country, particularly in the middle belt area, North Central, Northern Anambra, Enugu, Northern Oyo and Kwara State.
In fact, in the last three to four years the snake has driven people out of their villages. When there is flood, it moves into their high level where people live and farm. People are running away because they were dying everyday, particularly in Kwara, Borno and in many other states. So, we needed the venom that can neutralise the effects of its poison. We started thinking about it. And from 1990 to 1991, we started the work. We were in U.K. collaborating with a London university and with a British expert in veno poison, Mr. John London. We also worked with the centre for Pathology St. Bathlome Medical College; so, the anti-venom we developed is effective against this snake that is causing havoc in Nigeria and in West Africa.
Usually, most anti-venom drugs do not penetrate easily into the tissue. They remain in the blood circulating. But this called Echi-Tab quickly penetrates easily into the tissue, because the poison of the snake affects both the blood and the body tissue. Some people you see with amputated hands begging on the streets were farmers bitten by that snake. A lot of them you see on the streets with half legs, hands happened not only by accident but most of them bitten by this snake. It has a very dangerous poison. If you get to areas mostly affected, you will discover that 40 to 50 percent of people in the hospital were victims of this snakebite.
We would want you to be specific on the states with the highest number of this snake?
Usually, they are much in the Middle Belt area, particularly in Plateau, Gombe, Bauchi, Benue, Northern Enugu, Kwara State, Kogi State, Kaduna and Taraba. But Gombe has the highest number of cases followed by Taraba and Plateau states. Recently, we did a survey and we realised that even in Rivers State, the river snakes are causing a lot of havoc there. And at times the fishermen mistake them for fish and they are bitten by the snakes. So the country is faced with serious snakebites, and without treatment, we face a lot of danger. I heard recently from Taraba that 30 to 60 percent of people bitten by the snake dies. As a result, there was need for us to embark on this research. As you can see, it took us almost ten years to develop this vaccine. So when we got the candidates for the anti-venom we now started co-operating with the Liverpool School of Tropical Medicine and Hygiene and Oxford University, London.
What exactly motivated you into this research?
The motivation was that I did a lot of fieldwork. I go to the rural areas and I see the suffering of the masses. You go to cure one disease and you see others suffering from the bites. So, I thought I should risk my life and help. I approached the then Minister of Health, Prof. Olikoye Ransome Kuti who supported us fully, and Major-General Mohammedu Buhari (Rtd), through the Petroleum Trust Fund (PTF). He gave us a lot of support.
When we started, things were going very rough and at a stage we got some big countries and the present Minister of Health, Dr. Tim Menakaya. He became very interested on the issue and he is like God sent.
What were your initial problems?
Funding was our, problem. When we started, there was this hardship. But because it is a research and I was determined, I decided to continue, no matter the setbacks. Our major problem also was how do you neutralise the venom quickly, because you must get the type that must neutralise that venom quickly. And I think that the greatest achievement is that we've got it.
This now brings us to the issue of drugs/vaccines verification and potency. Some western countries believe that Nigeria lacks efficient and well-equipped laboratory to carry out medical research for vaccine production. If this is true, how did you carry out your research that resulted to this breakthrough?
The international community may be right, but the issue is that you can do research everywhere. The first thing you must do in carrying out a research is to identify the problem. If you can identify the problem, you can now set out your priorities to resolve the problem. The best way to resolve the problem is to look for where you can do the research, both here and anywhere in the world. As you said, we don't have the facilities to do the research here, but you can collaborate with people that can give you all the opportunities to work. And that is what one did. So, we went to London and worked in a laboratory, and we have research workers there who come here (Nigeria) too. So, to bridge that gap, you collaborate. If you want to catch up like India, you have to do this and even collaborate with countries that can start the manufacturing for you until you can come here and set up the facilities. That is how you can meet the international standard very fast. Through this effort we have managed to have anti-venom that is more potent than the one imported into the Nigerian market. You need up to 10 to 15 viles to cure one bite with the imported anti-venom. But this one we got, you need just about two viles. So, it is three to five times more potent than the one you have in the market. And the trial was conducted not by us, but independently by Oxford University and Liverpool. We gave them the anti-venom to go and try it in the field, and they came up with the findings that the anti-venom is very potent, acting faster and better than the one from South Africa which we were using before. So we have a scientific document and proof that we have a good anti-venom.
We've gone to NAFDAC for registration. We gave them the anti-venom for test. Usually, when they say they want to register it, and are processing the certificate of registration, that means they have accepted your product. This again means that we are meeting the Nigerian standard requirement and also working to meet the British standard requirement. That means we have reached a stage where we can now produce enmasse and make it available to the market.
Dr. Nasidi, how far have you worked with NIPRD?
NIPRD is pharmaceutical. But this is biological. But we are co-operating with them.
We might even take some few volumes to them. But presently, we are dealing with a company in UK.
(Cuts in) What company is that?
The company is called Micropharm. We have got the anti-venom now. We therefore have two options - come to Nigeria, produce it and market it in Nigeria. That will take time for us to meet up with the international market. That is wider market that can enable us sell the product in Ghana and everywhere. So we felt we could use the option of getting a small company in UK that would be involved in the pharmaceuticals. We do the bulk of the reduction in our laboratory and give them to fill and package for us. They process it according to the international standard. By so doing, you bridge the gap of getting the anti-venom to the people quickly instead of wanting to put up the facilities and company here. We can start and work on a small scale before we gradually set up one in Nigeria.
So, does it mean that we don't have a drug manufacturing company in Nigeria that you can collaborate with to produce the anti-venom?
As I told you, we don't have any biological company in Nigeria. We are now putting one at Yaba in Lagos. We are yet to finish it. What we have in Nigeria are mainly pharmaceutical companies involved in packaging tablets and syrups. We want an already registered pharmaceutical company with biological facilities. Not that the ones in Nigeria are not fit, but not for the one we are doing. Within the next one year, the Yaba laboratory will be ready because we are trying to bring it to international standard. Also, the facilities are being expanded so, Vom and Yaba are candidates for this type of research work
(Cuts in) Is the venom vaccine injectable and is it a preventive against the snakebite?
It is injectable, but not preventive. It is not also a vaccine per se. Look at it showing us the finished product in transparent) injection bottle. It is in powder form. This is among the first batch produced in 1994. I kept it here since 1994 and somebody was bitten by the snake this year and we used it on him and he got cured immediately. He survived. It comes in package like this with an injection liquid. The next batch will come with its syringes so that you can mix it with the liquid and administer.
Can we say the verification process has followed internationally recognised procedures?
Yes. That is why we say we followed international procedures.
Did you publish your research work in any recognised medical journal?
Yes, we did. We published it in about three internationally recognised sources. One of it is in the Transcript of Royal Society of Tropical Hygiene. That is the one conducted by the Oxford University and the First Clinical Trial. Another one is the Institute of Pasteur Serum (ISER) Africa Anti Venom. There you will see it. We don't publish details of the content because of the patent. It is your secret.
Have you obtained a patent right for your Anti Venom?
We are working on that.
Has there been any assistance from the Nigerian government and international donor agencies?
Yes; we have received assistance from the Nigerian government, the Petroleum (special) Trust Fund (PTF) and the company called Therapeutic Anti-Body Incorporated, an American based company. The Federal Capital Development Authority (FCDA) was equally supportive.
Can you tell us precisely how much this research has cost you?
We estimated about ?.3 million pounds sterling and out of which we are getting from our British counterpart 1.8 million pounds. The Federal government has given us 3.4 million pounds. The Federal government financial commitment is for the pilot production. We estimated that we should be able to have 10,000 to 15,000 viles every year for the period of three years, enough for the treatment of these patients and the drugs are to be distributed in all the danger areas.
This also includes the final transfer of the technology to wherever we are going to produce it either in Yaba or Vom. And then of course, there is no Anti-venom in the market. South Africa is not producing any more. They just want to resume now and so far, almost two to three years, no Anti- Venom in the market except the few ones they are bringing in. And France has cut production for almost two to three years. Also, because of the difficulties in getting the product, it is not easy to get the right Anti-Venom. The one we produce now is very potent.
What is your relationship with the Nigerian Medical and Dental Council and what is the level of your involvement in this development?
The Nigerian Medical and Dental Council cannot be involved in this research because they regulate service delivery. But NAFDAC has been involved from the word go. They monitored everything we did and in fact we are in the last stage of getting everything finalised and documented.
Did you experience any sign of sentiment or an expression of racism in the process of working with your foreign colleagues to develop this vaccine?
Listen, and let me tell you that today no research is done only by one person and only by one country. If you check all these type of publications (displaying medical journals) you will see what I mean. And if you go to the Internet now, you will see three to four countries collaborating on a research work (pointing at a Laptop Computer). If Nigerians believe they want to do it alone, then it would be difficult because the work is moving so fast that you need to do a lot of things, even the courage to do it is not easy. Of course we (Nigerians) are the driving force behind this research. We did everything. They only allowed us to use their laboratory. The University of Jos is involved. We have two clinics both in Katagun and Zango in Plateau State where we conducted the research. They are also involved. As you can see I am not the only person. I am the research coordinator. I am the project leader but at the same time we have many other experts involved. So there is a team. We call ourselves Echitab Study Group. >From the word Echi Ocellatus which is a Latin name for the carpet viper.
What is the drug called?
Echitab-Therapeutic Antibody against Echi Occellatus.
How many are you in this group?
We are up to twelve.
How many Nigerians?
We are about two Nigerians. From the British side, they are about seven. From Lagos to East, our team is made up of the Yorubas, the Ibos, Hausas, everybody is involved. Both the black and white people. We are up to 18 in general. So you have the British, Nigerians, South Africans, Swedish and there is a South American working in London that is a member of our team. The beauty of it is that it boosted our initiative and our research.
Can it then be called a Nigerian product?
Yes! It is a Nigerian product.
Are you reconfirming to us that in the process of your working with t he foreign experts, they never displayed that racial sentiment?
Not at all. I have worked in more than six, seven countries, including USA, France, etc, when you are in research it is difficult for you to see element of racism. They come to you to ask for assistance. There is one lady studying her Ph.D. She gained a lot from us. They don't discriminate, not in this line of research. When you are doing a medical job and discriminate, they throw you away. They worked with us and we led the team. No magic about it.
What about here in Nigeria. Has there been any antagonism or professional gang up against your research by your medical colleagues?
They can only gang up against you when you are not doing the right thing. If anything at all, I will say my colleagues are happy that we are doing this. Very few people will do what I am doing. I searched for the snakes myself and extracted the poisonous venom from these snakes by myself. It is a risky job. Somebody cannot be doing the job for you all the time. I have to go and be doing it myself. My colleagues here are excited. Nobody will go against this type of thing> Although there could be elements of jealousy, but from what I have seen generally, most of my colleagues are happy. A lot of them who read the journals that published the discovery have called and congratulated me.
At this juncture, how would you advise people like Dr Abalaka over his controversial HIV preventive and curative vaccines?
I respect Dr. Abalaka because he is a very brilliant person. Very intelligent. I would advise him to follow the normal process. It took us a whole ten years to develop our product and make it available to anybody who wants it for trial. We went to NAFDAC, gave it to them to test.
If Dr Abalaka calls on you and others to join him in his present research, are you prepared to offer your assistance?
We want to help him. Research is a teamwork. No body has monopoly of knowledge. As I am talking to you now you can drop an idea that will be very useful to what I am doing. The best scientists from Europe and America and from other countries work together. If you have good idea, they will buy it. Anybody can do what I have done now, in as much as you have the courage, patience and time. I advise him to brace up international requirement. If he has a vaccine, we are ready to work with him. He should bring the vaccine. Any thing he wants us to do for him we would assist, because we would be happy to lead him to anywhere to show our man has discovered cure for HIV. I am personally ready for that if he (Abalaka) is willing.
You know that the European Ader's Venom is poisonous. They have two or three types. So it became so difficult to actually do for all (discover the anti venom for all the snakes). They have also been researching on this like we are doing now for eight to nine years. So, we have to start with the anti-venom for the carpet viper. Fortunately, this snake is responsible for all bites in Nigeria and it is responsible for about 60 per cent of all deaths. If we can now solve this problem we can use this method to move into discovering anti-venoms for other snakes. If we carry it too much we would fail. With this one now, we are determined to continue to ensure we perfect our research so that we can give to Nigeria enough anti-venom.
Do we expect mass production of this anti-venom drug?
That is what we are doing at the moment. The president has approved this project. We are now ready to finalise the cost of mass production.
At what cost per drug?
Now that government has come in, it is as great achievement, because it would help. Ordinarily, the imported anti-venom in the market is very expensive. It costs between N2,000 to N5,000 per vile. At times you need as much as between eight to 15 viles for a person bitten by the snake. And unfortunately, the victims cannot afford the cost. With the fund given by the government, we shall bring the price to mere nothing and make it available to states and local governments, so that they can buy them and make the drugs available to their people.
Within the next three years, we shall make it available to rural farmers. The states and local governments shall pay just minimal money. And that would boost agriculture because the highest cases are recorded during early farming season and harvest period.
Product development used to take up to $200 million to $300 million. If this thing is pursued well, it could recoup the so-called ? million to ?0 million within those years because Ghana, Gambia, Gabon will buy it. They are all looking for it.
You have been in the medical profession for more than 20 years, what are the things Nigeria lacked its effort to encourage research and scientific development.
You see, the country has many personnel. We have brilliant people but it is a shame that the funding of research is so poor.
The Nigerian medical experts have to leave. In fact I have up to five chances to leave this country. I just decided to remain and finish this job.
Most of my colleagues that are so good are those overseas. Go to US, all the doctors you need are there. They have all you need to work. There is no good laboratory here. No money to work with. We believe so much in the oil. Look at the Ministry of Science and Technology, that ministry is poorly funded. They are not giving them anything.
The next most important ministries and usually the Ministries of Science and Technology and Health. So the scientists here are frustrated, they have nothing to work with.
I first refused to go now because I have a minister, Dr. Tim Menakaya who said you have such a product, you must finish it. I think some will ask why should a government be involved in this type of thing. In a developing country like this, government must be the prime mover of research because the private sector does not generate enough profit to be able to release funding.
So the government must boost research and technology. I decided to say and refuse to run away to another country. If I finish this project, I am a millionaire. We have done it and it is working. We are all Nigerians in the team. The British who came with us, if you don't do it they would do it for you.