Until recently, the global response has been disappointing. Attempts to tackle this crisis over the last three decades have failed, and the domestic and international funds currently allocated by governments and donors to end snakebite remain extremely insufficient. As a result, snakebite victims—many of whom have limited financial resources and little political voice or power to demand affordable medicines themselves—pay for the cost of their own treatment and care. The launch of the WHO strategy, with its clear funding requirements, is a major step forward, and MSF hopes it will lead to successful and swift action.
“The toll that snakebite envenoming takes on people around the world truly represents a hidden epidemic,” said Dr. Gabriel Alcoba, MSF’s tropical medicine advisor. “We are encouraged to see that WHO’s snakebite strategy emphasizes empowering communities and strengthening health systems to reduce the global snakebite burden. The disease must be confronted in a holistic, patient-centered way, including through preventative health programs at the community level that can measurably reduce the risk of snakebite.”
Snakebite is curable, yet the vast majority of snakebite victims are unable to access effective treatment. Paying for all doses of antivenom needed for treatment can cost hundreds of dollars, and, especially in rural settings, care is often unavailable, partly because of a lack of referral or ambulance services and trained health workers. Due to the relatively high prices of antivenoms, people are often lured into purchasing unproven traditional therapies or cheaper antivenom products of questionable quality and efficacy, further contributing to the high rate of death and disability from snakebite.
Several pharmaceutical corporations—including Sanofi-Pasteur, which used to produce a product called Fav-Afrique that could be used to neutralize the venom of snakes common across sub-Saharan Africa—recently stopped the production of antivenoms intended for use in Africa because the products were not sufficiently lucrative. This lack of antivenom products specifically for use in Africa has exacerbated a supply crisis.
As the WHO’s strategy is rolled out by governments, concrete steps need to be taken to scale up access to safe antivenoms that already exist in the market and further prioritize the development of new and better tools against snakebite envenoming.
“Many more lives could be saved if all snakebite victims had access to timely and appropriate care, including antivenoms,” Potet said. “To ensure access to affordable, quality-assured antivenoms, the effectiveness of existing products must be urgently assessed, and additional funds must be pledged to develop an international mechanism to subsidize and guarantee a stable supply of antivenoms. Antivenoms must be available and free-of-charge to people affected by snakebite, for whom access is a matter of life or death.”
MSF admitted more than 3,000 patients to its clinics for snakebite in 2017, predominantly in sub-Saharan Africa and the Middle East. Around half of these people required antivenom treatment, which MSF provides free of charge. The majority of MSF snakebite patients were treated in Central African Republic, South Sudan, Ethiopia, and Yemen. MSF also treated a significant number of people in Tanzania, Kenya, Cameroon, Sudan, and Sierra Leone.