OPINION: Snakebites: The world’s biggest hidden health crisis

by Mike Turner | Wellcome Trust
Wednesday, 22 May 2019 12:22 GMT

Snakeman Raymond Hoser milks a Coastal Taipan for its venom in Melbourne, Australia, November 7, 2008. The Coastal Taipan is the second deadliest snake in the world. Its bite has enough venom to kill 50 adult human beings. Reuters/Mick Tsikas

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* Any views expressed in this opinion piece are those of the author and not of Thomson Reuters Foundation.

Snakebites kill up to 140,000 people a year, yet there's no reason so many should die

By Professor Mike Turner, Director of Science at Wellcome, the biomedical research foundation

In the time it takes you to finish reading this, someone in the world will die from a venomous snakebite. 

Despite affecting a huge number of people, it’s rare to hear snakebite spoken about as a health problem. But the global burden of death and disability due to snakebites is the same as prostate or cervical cancer; it’s higher than infectious diseases like rabies or dengue fever. 

Snakebites kill between 80,000 and 140,000 people every year: one person for every five minutes. Another 400,000 people suffer life-changing injuries, amputations and psychological trauma. 

These numbers are almost certainly an underestimate, too. Many bites and deaths go unrecorded. That’s why Kofi Annan, a former Secretary-General of the UN, describes snakebite as the “biggest public health crisis you have likely never heard of”. 

But it shouldn’t be. Snakebites are treatable. People who get the right, well-made antivenom have a very high chance of survival. While venomous snakes will continue to bite people, there’s no reason so many of those people should die. Clearly, the way the world currently responds to the challenge of snakebites is not right – now it’s time to choose a different path.

The lack of urgency, and attention, could be because those afflicted are the world’s poorest people. Most bites occur in rural areas of Africa, South-east Asia and South America, far from hospital care.

Victims are often the main breadwinners for their families but can’t afford to seek treatment at hospitals anyway. In many cases, treatment costs more than their yearly salary, and the long-term effects of injuries push many survivors and their families from poverty to destitution.

If they do make it to a treatment centre, it will often have no antivenom available. If there is some in stock, there’s a good chance it will be useless: until recently, the antivenom used in Ethiopia was effective only against Egyptian snakes, not Ethiopian ones. That’s not unusual for many countries around the world. 

And even if the antivenom is the right one, weak regulation and poor safety standards mean many batches are contaminated, so it may well cause an adverse reaction that will kill patients if the venom doesn’t.

Little wonder I’ve heard tales of doctors buying antivenoms with their own money to help their patients survive, and advocates bringing in the right antivenom in bulk from abroad.

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.

Antivenoms are still created using a 19th century technology – injecting venom into a horse and extracting antibodies. It’s shocking just how little this process has moved on in the last century.

And yet snakebite has been utterly neglected as a research and development issue. By our estimate, less than £30m has been spent on snakebite science in the past decade.

There are many modern advances that could be applied swiftly to make a big difference in a short amount of time to save more lives. This is why Wellcome is dedicating £80 million to transform the way snakebite treatments are researched and delivered

Governments and ministries of health will have to get involved to make sure these treatments work in local settings and can be integrated into standard care, so that any victim of snakebite can receive treatment in time.

This week, the World Health Organisation publishes its first snakebite strategy – an ambitious plan to halve snakebite deaths by 2030. If we are to stand any chance of making this a reality, we now need strong commitments and action from governments, funders, manufacturers and NGOs.

Unlike many diseases, there is a real opportunity to stop snakebites killing so many people in the near future. There is a clear path ahead. We just need to take it.