Snakebite is a complex and neglected issue that requires a multifactorial strategy, including conservation, community engagement, scientific research and robust healthcare delivery, according to experts who recently participated in a Global Health Matters podcast.

In the most recent episode of Global Health Matters, host Garry Aslanyan speaks with Fan Hui Wen and Thea Litschka-Koen, snakebite gurus in Brazil and Eswatini, who reveal untold truths about snake bites in their communities and the complexities associated with producing and administering antivenom. He also talks with Diogo Martins, the research lead for snakebite at Wellcome in the United Kingdom.

How big is the snakebite challenge?

The World Health Organization estimates that 5.4 million people are bitten by snakes every year, and nearly 140,000 people die.

“The burden is quite big,” Martins says, explaining that of the 5 million people who are bitten each year, 2 to 2.5 million are venomous bites. “We’re talking about 100,000 deaths every year, and this is most likely an underestimation. And four times more of that will live for the rest of their lives with, unfortunately, amputations PTSD and that’s a huge burden.

“And we’ve done a little bit of desk research about how that compares with many other popular global health issues, and it’s actually quite a substantial amount of years lived with disability, and it’s quite expressive that people just do not know much about it because it feels a little bit remote to many of us, unfortunately,” Martins says.

How can we treat snakebites?

While antivenom is the best treatment for a venomous snakebite, many complexities are associated with producing and administering antivenom, the experts explain. In addition, according to Litschka-Koen, a lot of clinicians have no faith in antivenom, in part because of the ineffectiveness of the antivenoms that are currently on the market.

“There is no regulation regarding the effectiveness of the antivenom,” Litschka-Koen, founder and chairperson of the Eswatini Antivenom Foundation, says. “To produce antivenom is not difficult. To go through the pre-clinical trials it is incredibly costly.

“I had no idea how difficult and costly and cumbersome it was actually to produce this product. If it does happen, it needs to be very well regulated,” she continues. “It needs to go through the processes, and it needs to be monitored. Otherwise, we’re going to go back 10 years, and we’re going to be in the situation again where the doctors say, what’s the point of using antivenom? It doesn’t work.”

She says that countries can and should start producing their antivenom. However, if they do not, then good antivenoms need to be made accessible. Currently, many antivenoms carry a high price tag, making them out of reach for many people living in low- or middle-income societies.

“It’s inconceivable that … you can have patients having patients having to pay $100 in many geographies to solve one episode of a snakebite,” Martins notes. “We cannot have individuals that earn $1.50 a day and have the unfortunate circumstance of crossing paths with a venomous snake, and suddenly all of their savings are gone, not to even mention other impacts socially and economically.”

Listen to more episodes of Global Health Matters here.

Image Credits: TDR/Global Health Matters.