Snakebites: making treatments safe, effective and accessible

Every 5 minutes – roughly the time it will take you to read this page – approximately 50 people are bitten by a snake, of whom 25 people will be envenomed (injected with venom), 4 will be permanently disabled and 1 will die.

Snakebites are inevitable, but the resulting deaths and morbidity are not. With prompt access to well-made and well-selected antivenom, even those bitten by the deadliest snakes, from cobras to vipers, should have a good chance of recovery.

Three key problems are preventing this from happening:

• a global antivenom crisis – the world produces less than half of the antivenom it needs, and this only covers 57% of the world’s species of venomous snake
• a lack of research – with limited investment into snakebite, the emerging technologies that might deliver new treatments have not been properly investigated
• a weak regulatory framework – the current lack of regulatory controls is often allowing inappropriate products to be used.

Antivenom is currently the only medicine for treating snakebite and it is made by injecting horses with venom – a 19^th-century technology. There are no common production, safety or efficacy standards, which means there is a high risk of antivenom being contaminated and causing adverse reactions.

At present, victims of snakebite must be treated in hospital, where emergency care is provided, often far from the rural settings where they have been bitten. This delay means that treatment is often given too late to save lives and limbs.

An unstable market for snakebite treatments has driven their costs up. This leads to the withdrawal of treatments from the market because poorer communities cannot sustain the price.

Until now, venomous snakebites have never been regarded as a public health priority or as an issue of urgent concern. As a result, government and intergovernmental agencies have been slow to prioritise prevention of snakebites and integration of treatments into health systems.

We want to help transform the way in which snakebite treatments are researched and delivered. If successful, this will also serve as a model for other neglected tropical diseases (NTDs). Our ambitions are to:

Bring production of snakebite treatments into the 21^st century

We want to modernise antivenom production by enhancing the science and applying technology to make products better, safer and cheaper. We believe this can happen by working with the World Health Organization (WHO), antivenom producers, and other funders and delivery partners to build a regulatory system that gets more effective products to patients more rapidly.

Develop the next generation of treatments

We will kick-start development of new snakebite treatments and antivenoms by generating an evidence base for which treatments work and why. Through a clinical trials network, we want to bring together fresh expertise from different disciplines and overcome regulatory bottlenecks that hinder investment.

Build and sustain snakebite as a global health priority

We will generate evidence about snakebite’s prevalence and economic cost. This information will help to underpin the development of a more robust market and integrate treatments into health systems where snakebites have most impact, particularly in low- and middle-income countries.

Although the problem of snakebite is considerable, it is not intractable. Antivenom can be made safe, effective and accessible, and we know how to stimulate the development of novel therapies that will eventually make treatments significantly better.

There is an opportunity to address this health crisis and we want to change the way science, policy and regulation combine to address neglected diseases in the poorest countries.

Scientific expertise

​We are one of the major research funders and are working in partnership with leaders across different sectors to develop new and accessible treatments and antivenoms.

Policy environment

We want to support governments and regulators to develop procurement and clinical guidelines that are based on evidence and driven by local needs. This means collecting reliable data and strengthening surveillance systems to inform better decision-making

Influence and cross-disciplinary advocacy

Snakebite is now recognised as an NTD and the WHO has made it a priority. We also worked closely with the WHO to develop and implement the new WHO roadmap for snakebite envenoming. We want to build on this momentum and urgency and bolster global coordination.

Leadership

We will build and sustain partnerships with the public and private sectors we need to make a difference.

• Snakebite: the race to find a universal antivenom The Telegraph, 16 May 2019

A crisis in the production of antivenom is killing tens of thousands of people a year. Could new technology create a universal defence against snakebites? This report outlines how our work aims to 'transform the way snakebite is managed globally'. 

• Wellcome Trust investing £80m in snakebite treatment The Guardian, 16 May 2019

Health editor Sarah Boseley reports on our aim to develop new drugs that are affordable for health systems in developing countries.

• Snakebites: The world's biggest hidden health crisis Thomson Reuters Foundation, 22 May 2019

"It is time for the world to take snakebites seriously. We need a response that goes far beyond the altruistic acts of individual doctors and campaigners." Mike Turner, our Director of Science, shares the vision of the snakebites programme in this opinion piece.

• How to avoid snake bites BBC World Service, 23 May 2019

What are some of the precautions that people can take to prevent being bitten? Dr Bernadette Abela-Ridder, from the WHO, talks about global initiatives tackling snakebites worldwide.  

• Snakebites: the hidden health crisis that kills 200 people a day CNN, 23 May 2019

What happens to patients when they are bitten by a snake and are far from a hospital? This report from CNN outlines current antiquated treatments and the reality of being bitten by a snake.

The team is supported by a scientific advisory board and governed by an internal programme board. If you have any questions about our work, contact snakebites@wellcome.org.