Fig 7. The preclinical inefficacy of Indian antivenom therapy in snakebite hotspots.

This figure depicts the alarming preclinical ineffectiveness of commercial antivenoms in the major snakebite hotspots of India (highlighted in red circles). The relative differences in neutralisation potencies of antivenoms against the geographically distinct populations of N. naja (green vials) [71], D. russelii (yellow vials) and B. caeruleus (purple vial) [20] are shown in comparison to the venom source (for antivenom production) population in southern India. The red dotted lines on vials represent the marketed neutralising potency of the commercial products. Sampling locations have been indicated with uniquely coloured markers (top right box) on the biogeographical map of India that was prepared with QGIS 3.8.2 [35]. The intensity of purple clouds on the map is indicative of the estimated standardised snakebite death rates per million reported by Suraweera et al. 2020 [2], with the brighter regions representing the major hotspots.