Snakebites – it’s time to solve the world’s biggest hidden health crisis

Arguably the world’s biggest hidden health crisis, snakebites kill between 81,000-138,000 people every year. The burden of death and disability is greater than any other neglected tropical disease and equal to that of prostate or cervical cancer.

Another 400,000 people suffer life-changing injuries such as amputations. The worst affected are from the world’s poorest communities in rural Africa, Asia and South America. 

Professor Mike Turner, Wellcome’s Director of Science, said: "Snakebite is - or should be - a treatable condition. With access to the right antivenom there is a high chance of survival. While people will always be bitten by venomous snakes, there is no reason so many should die.

"Treatment has progressed little in the last century, and is too rarely accessible, safe and effective in the places where it is needed the most. It’s an incredibly challenging issue – there has been almost no investment in snakebite research over the last decade – but it’s also one that is solvable with support from WHO, national governments, industry and other funders."

This news comes ahead of the World Health Organization (WHO) publishing its first snakebite strategy on the 23rd May, which seeks to halve death and disability from snakebite by 2030.  

There is a global antivenom crisis; the world produces less than half of the antivenom it needs. In some regions much of that may not work – in Africa up to 90% is thought to be ineffective – and it is often not available or affordable to the people who need it most.

Antivenoms are made by injecting horses with venom – a 19th century technology with no common production, safety or efficacy standards and high risks of contamination and adverse reactions. These risks mean victims must be treated in hospital, far from the rural settings of most bites, and often too late to save lives and limbs. 

Despite these challenges, there has been remarkably little research into snakebites, only an estimated £30m was invested in 2008-2017. Existing technologies have not been applied to deliver better and safer treatments, and emerging technologies that could deliver a new generation of therapies are not being advanced.

Over the next seven years Wellcome aims to:

• bring antivenom production into the 21st century – working with producers to make antivenoms better, safer and cheaper, and helping build a regulatory system that gets more effective products to patients more rapidly
• develop innovative new treatments and generate an evidence base for which treatments work and why, through a clinical trials network. Encourage further funding by reducing the regulatory barriers that hinder investment 
• build and sustain snakebite as a global health priority by gathering more evidence on prevalence and economic cost to help integrate treatments into health systems and to create a more robust and resilient market.  

With prompt access to the right antivenom, even those bitten by the deadliest snakes should have a good chance of survival. In countries like the USA, Australia and Thailand, with good health systems and antivenom stockpiles, deaths are rare. 

Most patients in low-income countries are less fortunate. The cost of good snakebite treatments has been driven up by inefficient production, leading to their withdrawal from the market because poor communities cannot sustain the price. 

Professor David Lalloo, Director of Liverpool School of Tropical Medicine, said: "For many years, the challenges of obtaining research funding have severely limited advances in snakebite. This exciting initiative, coming ahead of the WHO’s first snakebite strategy, will enable the research on venoms and snakebite that is critical to enable us to reduces deaths and suffering from snakebite – a major problem for the rural poor in many resource poor settings."

Julien Potet, Policy Advisor (NTDs, Vaccines) Médecins Sans Frontières’ Access Campaign, said: "Our experience show us that with fast access to healthcare facilities, quality antivenoms and good clinical management, it is possible to prevent people from dying from snakebites. In our hospitals in Ethiopia, the Central African Republic and South Sudan, fewer than 1% of people bitten by snakes die when they have access to the right services and effective antivenoms. Now that the World Health Organization’s new strategy calls for deaths and disability from snakebite to be cut in half by 2030 and with financial contributions being made to back up this plan to ensure access to quality care and antivenoms, we can finally start meaningfully tackling this disease that affects the poorest of the poor."

More information

• Snakebites: making treatments safe, effective and accessible