Snake bites

August 10, 2023 Philip Swart

Snake bites kill more than 120,000 people each year and leave another 400,000 with life-changing disabilities, mostly in the poorest communities. Every 5 minutes approximately 50 people are bitten by a snake, of whom 25 people will be envenomed, 4 will be permanently disabled and 1 will die. In 2017, the WHO re-instated snakebite into its category A list of Neglected tropical diseases (NTDs), after it was removed in 2009.

Out of the 6.8 billion people who live in close proximity to venomous snakes, 750 million live far from health centres, and these health inequalities are reflected in the map below. LMICs also often lack the required infrastructure for adequate anti-venom distribution and there are also shortages of antivenoms worldwide: indeed if a clinic has a quantity of antivenom, it may not match the phenotype of the offending snake. The WHO has invested $136 million into ongoing research into snakebite, predominantly focusing upon the quality of anti-venom production, how this is regulated and investing in research to improve product safety, efficacy and clinical effectiveness.

The ideal situation would be to develop a universal antivenom that could be manufactured at scale and administered by minimally trained healthcare workers, without the associated anaphylaxis risk that accompanies current antivenoms. One problem is that many countries with a high prevalence of snakebites do not make antivenom in-country. Combined with potentially unsafe or ineffective products, this can undermine a local population’s confidence in antivenom as a useful treatment, which will in turn impact negatively upon morbidity and mortality.

It is important to join with these countries in collaborative scientific research, yet it is equally necessary to engage with, and educate, local healthcare workers and populations in order to challenge health beliefs and behaviours.

The African Snakebite Research Group is one such partnership that aims to do this. Established between the college and similar institutes in Nigeria, Kenya and Cameroon, it takes a holistic approach towards reducing morbidity and mortality, looking at snakebite in the wider context of the local community, as illustrated in this image that is proudly displayed in the foyer of the herpetarium.