The Need for Full Integration of Snakebite Envenoming within a Global Strategy to Combat the Neglected Tropical Diseases: The Way Forward

Abstract

Snakebite envenoming constitutes a serious medical condition that primarily affects residents of rural communities in Africa, Asia, Latin America, and New Guinea [1], [2]. It is an occupational, environmental, and domestic health hazard that exacerbates the already impoverished state of these communities [3]. Conservative estimates indicate that, worldwide, more than 5 million people suffer snakebite every year, leading to 25,000–125,000 deaths, while an estimated 400,000 people are left with permanent disabilities [4]–[7]. Eight thousand amputations are thought to be performed annually in Africa alone [8]. However, community-based surveys illustrate that the actual burden of human suffering is likely to be even greater [9], [10]. Despite this global impact, snakebite has received little attention from the global health community, the pharmaceutical industry, governments, and public health advocacy groups, and has a disappointingly low priority in the global health research agenda. As a consequence, the paucity of health programs addressing snakebite at national, regional, and global levels allows deaths or maimings of snakebite victims to continue. This burden of suffering could be significantly reduced because effective preventive and therapeutic resources are available, but, because of systemic neglect, they are not delivered in many regions. There has been progress in highlighting the neglect of snakebite. Thus, the inclusion of snakebite in the WHO list of Neglected Tropical Diseases (NTDs), and the development of initiatives by the WHO and its regional offices [1], [11] as well as by the Global Snakebite Initiative (GSI) [6] and other efforts at national and regional levels, have improved the global awareness of this disease. However, the impact of these projects has been rather limited, particularly in light of the progress made in control of the helminthic NTDs.