The World Health Organization today launched its first-ever global strategy for the prevention and control of snakebite envenoming, just one year after the World Health Assembly agreed on a resolution to fight this neglected cause of death and disability.

Snakebites, which occur mostly in developing countries among impoverished rural populations, lead to between 80,000 and 138,000 deaths each year, and over 400,000 amputations and other permanent disabilities, according to WHO.

The snakebite envenoming strategy ultimately aims to reduce by 50 percent the numbers of deaths and cases disability from snakebites by 2030. To achieve this, the strategy will pursue four objectives: empower and engage communities; ensure safe, effective treatments; strengthen health systems; and increase partnerships, coordination and resources.

Several speakers at the launch remarked on the swiftness with which the WHO established the strategy, only one year after the WHA resolution, and two years after snakebite envenoming was recognised as a neglected tropical disease by the WHO.

The strategy will be spread over three phases: a pilot phase will take place from 2019 to 2020 and be deployed in 10 to 12 high risk countries; then a scale-up phase from 2021 to 2024 will expand coverage to 35 to 40 countries; and finally a full roll-out of the strategy is set to happen between 2025 to 2030, covering all affected countries, and delivering some 3 million treatments.

Speakers insisted on the importance of engaging and educating communities, and of strengthening health systems and primary health care, which they said will be key in implementing the strategy. They also underlined the need for research and funding to develop and procure effective and affordable antivenoms.

Soumya Swaminathan, WHO Chief Scientist, commended the financial contribution to the strategy by Wellcome Trust, which will be invested in research for better treatment of snakebite envenoming. A lot of manufacturers are no longer producing antivenom, and there is no research and development taking place to develop more effective products that can be used at lower doses, she said.

“Australia is home to the world’s most dangerous creatures,” said Prof. Debra Thoms, Commonwealth Chief Nursing and Midwifery Officer of the Department of Health of Australia. The supply of antivenom, she explained, is dependent on public funding, because the volume of products is too small to attract industrial production. Domestic solutions only go so far, she said, emphasising that international collaboration and teamwork is necessary, with research and development as a priority.

Cathy Roth, Senior Research Fellow and Advisor on Infectious Diseases at the United Kingdom Department for International Development (DFID) underlined the importance of incorporating snakebite envenoming in the portfolio of development funding. Beyond just antivenoms, logistics and supply chains also need to be fine-tuned to allow for the administration of antivenom without delay. DFID, she said, launched a product development partnership to develop universal or regional antivenoms.

A delegate from Burkina Faso said the government is subsidising part of the treatment for the whole population, and brought the price down to US$4, which is still too high a price for the affected rural populations. He called for the WHO and industry to work on solutions for adequate quantity of quality, affordable antivenoms, and for countries of the South, such as India and Nigeria, to add their resources to the international effort to set up local production units so that antivenom needs are fulfilled.

Health Action International, which led civil society efforts pushing for a snakebite envenoming resolution at the WHO, released a statement yesterday. Ben Waldmann, manager of Health Action International’s Snakebite Project said WHO has an essential role to play in the stewardship of the strategy and to ensure it meets its main aims.

“To achieve these objectives, governments cannot be mere onlookers, but must be champions of the strategy, fully embracing its recommendations, and making sure they are enacted and sustained,” Waldmann said.

The launch was organised by the WHO, and co-sponsored by the governments of Costa Rica and Nigeria.

Image Credits: Catherine Saez.