Meet the doctor who wants to treat most snakebite victims with a single antidoteVishal Krishna
Dr Matthew Levin, who founded San Francisco-based Ophirex, has developed a low-cost, snake-agnostic antidote; he wants the molecule to be tested and manufactured in India where half the global snakebite deaths take place.
Think of him as a modern-day Indiana Jones. But one without the infamous fear of snakes! Dr Matthew Lewin has, for more than 20 years, been on expeditions around the world as an expedition doctor.
Matthew’s crusade against snakebite began in 2001 when a California Academy of Sciences researcher was killed by snakebite while on an expedition to Southeast Asia. Ten years on, in an expedition to the same region, Matthew started wondering how to solve the snakebite problem and bridge the gap between bite and hospital care (which is where more than 75 percent of snakebite deaths occur).
Matthew’s fieldwork – in the forests of Philippines, deserts of Mongolia, and farms in India - led him to realise that anti-venom was available for different snakes, but deciding which one to use was a problem.
Often, one did not know which snake had inflicted the bite. Over the years, he wondered why there couldn’t be a single antidote to snakebites.
The numbers pushed him to do something about the problem.
Snakebites occur most often in Asia, Africa, and Latin America, with rural areas facing the brunt. According to the WHO, about 5.4 million people get bitten by snakes every year, resulting in 1.8 to 2.7 million cases of envenomings (poisoning from snake bites). There are between 81,410 and 137,880 deaths, and around three times as many amputations and other permanent disabilities every year.
“These are lives worth saving,” says Matthew, 50, the Founder of the Center for Exploration and Travel Health and Snakebite Project at California Academy of Sciences, San Francisco. He decided to begin work on an antidote to all snakebites; this led to the launch of Ophirex, a public benefit corporation, in 2015.
The Ophirex story
Snakebites are treated with anti-venoms, which are fairly snake-specific, and antidotes, which are often called biotherapeutics and are basically small molecules that treat the symptoms of snakebite.
Matthew envisaged an inexpensive and foolproof, snake-agnostic antidote that would make treatment easy and cheap, and prevent deaths and injuries.
It was in 2013 that Matthew began voraciously researching the constituents of different snake venoms and began tracking the largest element in different snakes’ venom (krait, Russell's viper, saw-scaled viper and cobra). Every venom is a combination of enzymes, proteins, organic compounds, and peptides. Matthew read about current drugs that treat diseases with common elements from a snake venom.
He bought all the drugs on the market and started experimenting with them on bio-agents (red in colour) injected with snake venom (these turned light yellow in colour when the venom was administered).
The bio-agents in the vials remained yellowish till he used the constituents of the drug that treated sepsis; it then turned crystal clear. He did this a couple of times and realised he was on to something big. Further research on sepsis and its treatment led to the awareness that the drug used to treat sepsis could actually treat PhospholipaseA2 (PLA2), the largest constituent enzyme in a snake’s venom.
All this while, he continued work as MD of Emergency Medicine; his research on the antidote was done on the side, at home and in office.
In 2014, he went to Eli Lilly, the company that made the drug that treats sepsis and licenced the drug for an undisclosed price. The pharma major had shelved the drug, Varespladib, which blocks toxins in snake venom.
By identifying compounds with the potential to transform the treatment of snakebite, Matthew has now created small molecule therapeutics that can ensure treatment “anywhere, anytime, by anyone”. The potential of this innovation is huge – it can ensure hospitals, clinics, and doctors no longer need different anti-venoms to treat snakebites, and thousands of snakebite victims can be treated and saved.
The molecule is currently going through animal trials, which have largely proved successful. Ophirex now plans to launch human trials; it is working on permissions for this right now. It wants to partner with a pharma company who can fund the trials. The product will need to go through human trials for the next two years before it can be launched.
Matthew envisions a world where every farmer/soldier carries the treatment in tablet form and can go about their daily work without worrying about the danger of snakebites.
For about 100 years, there has been no innovation in the production of snake anti-venom. According to Transparency Market Research, the size of the anti-venom market is $1.7 billion. The Royal Society for Chemistry says the market is unfortunately dominated by drugs that are not efficient and have not gone through proper human trials, which results in a cheaper but ineffective product. Larger pharma companies have started production and supply to countries that need it the most but face competition from unverified manufacturers, and do not see the product as a money spinner.
Matthew found backing from two giants - the US Department of Defense, which has put in an undisclosed round in the company, and Jerry Harrison, Rock N’ Roll Hall of Famer and entrepreneur.
Jerry, one of the members, and guitar and keyboard player, of band Talking Heads, reveals why he invested in Ophirex. “I noticed that there was no innovation in the field of anti-venoms for a while now. It was logical to support the passion of a doctor who knows what he is doing,” he says.
Interestingly, Matt met Harrison in the most unlikely situation – at a party where Jerry announced that he would be happy to discuss any “crazy business ideas in the room”. That was 2015 when Matthew was struggling to find support for his idea. He immediately announced “I have one”, and that was that. Not long after, the US Department of Defense also came in.
The India connection
Matthew wants the product to be made in India, which is why he wants to bring the human trials of the molecule here. He is in talks with several pharma companies to bet on the company before they invest manufacturing in India.
The five-member Ophirex team believes pricing is key. “The reason for choosing India is because the cost of the drug can be brought down significantly. It can then be sold around the world at a much cheaper price. Only then will there be a balance of profits and social impact,” Matt says.
Sources in the pharma industry say the cost could vary between Rs 100 and Rs 180 crore for human trials, production and distribution.
It has to be said that Matt, whose home and office are filled with photos of his expeditions across the world, is quite the adventurer like Indiana Jones. But there’s a difference: he’s an adventurer with a social purpose.