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The Necessity of Developing and Implementing a National Program for Self-Sufficiency in the Production and Advancement of Next-Generation Antidotes Against Organophosphate Chemical Agents
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Mohammad Hadi Baghersad *   |
| Applied Biotechnology Research Center, Institute of New Health Technologies, Baqiyatallah University of Medical Sciences, Tehran, Iran , Hadibaghersad@bmsu.ac.ir |
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Abstract: (2 Views) |
Organophosphate (OP) poisoning, as a triple-threat issue with agricultural, medical, and security dimensions, represents one of the most complex challenges facing Iran’s healthcare system. By irreversibly inhibiting acetylcholinesterase, these agents can lead within minutes to respiratory failure, seizures, and death. National statistics indicate that thousands of poisoning cases are recorded annually in Iran, primarily due to occupational exposure to pesticides or suicide attempts, a substantial proportion of which result in death or long-term neurological complications. Concurrently, security threats arising from the potential illicit use of these agents necessitate a high level of national preparedness for rapid and effective response.
The current standard of care relies on a combination of atropine (a muscarinic antagonist), oximes such as pralidoxime (acetylcholinesterase reactivators), and a benzodiazepine -most commonly diazepam- for seizure control. Despite being life-saving, this therapeutic regimen suffers from significant limitations, including short drug half-lives, the need for repeated dosing and intensive monitoring, cardiovascular adverse effects, intrinsic toxicity of oximes, and -most critically- the lack of efficacy in preventing or treating organophosphate-induced delayed neuropathy (OPIDN). The substantial gap between clinical needs and available therapeutic options becomes even more critical when considering the country’s near-total dependence on imported supplies of these essential medicines -a vulnerability that may seriously jeopardize national health security under conditions of sanctions or international crises.
Drawing on a systematic review of global evidence and analysis of domestic data, this policy brief argues that long-term, targeted investment in basic research, translational studies, and technology development aimed at achieving a new generation of antidotes is not merely a medical necessity, but a strategic action toward national security and pharmaceutical self-sufficiency. The proposed strategies are structured around four core pillars: 1) establishing and strengthening multidisciplinary research infrastructures within leading academic institutions; 2) designing financial and incentive mechanisms to attract knowledge-based companies to this field; 3) revising and reinforcing supply chains and strategic stockpiles of existing antidotes; and 4) expanding international collaborations for technology transfer and participation in clinical trials. Implementation of this agenda requires sustained intersectoral commitment and dedicated funding, but its outcome would be the achievement of a unique national capability to protect public health and enhance national resilience.
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| Keywords: Organophosphate nerve agents, Antidote, Bioscavenger, Health security, Pharmaceutical self-sufficiency |
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Full-Text [PDF 508 kb]
(1 Downloads)
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Type of Study: Policy Brief |
Subject:
Marine Medicine
Received: 2025/11/26 | Accepted: 2026/01/27 | Published: 2026/01/30
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