Snake bite—the neglected tropical disease

Abstract

Last week, Médecins Sans Frontières drew attention to the fact that by mid-2016 sub-Saharan Africa will run out of one of the most effective treatments for snake bite, Fav-Afrique. Sanofi Pasteur stopped manufacturing the antivenom last year, and stockpiles will expire in June, 2016. Fav-Afrique is the only antivenom proven to be safe and effective to treat envenoming by all the different types of snake in sub-Saharan Africa, where an estimated 30 000 people die from snake bite and 8000 end up with amputations every year. No replacement product is likely to be available for at least 2 years. Globally, about 5 million people are estimated to be bitten by snakes every year, causing about 125 000 to die and 400 000 to be permanently disabled or disfigured. Snake bite has a mortality rate equivalent to one fifth of deaths due to malaria worldwide, and half of that due to HIV/AIDS in India. Yet snake bite is largely invisible to WHO, other international and national health agencies, many African governments, and to the big donors, and has been marginalised even within the neglected tropical diseases community. With its triad of high mortality, high disability, and substantial psychological morbidity, snake bite warrants high priority research. Robust data are needed to persuade donors and governments to subsidise antivenom development and distribution. It costs US$280–560 to treat one patient with Fav-Afrique (each vial is $140 and two to four are needed per bite). Cheap, safe, effective, and non-cold chain-dependent antivenoms are desperately needed. Other products by South African, Costa Rican, Mexican, and Indian producers need to be used in combination to neutralise different species' venoms, and need further research. Snake bite largely affects those aged 10–30 years old living in the poorest, most rural areas of the world, where health-care facilities are few and far between. Identifying key actions to reduce the public health neglect of snake bite victims is the aim of the 2-day meeting next week funded by the Wellcome Trust. Urgent implementation of the actions will be needed, which can only happen with the aid of major donors. Treating snake bites—a call for partnershipWe welcome the Editorial (Sept 19, p 1110)1 that highlights the devastating effect of snake bites on health and the fact that Africa could soon be deprived of access to one of the most effective snake bite treatments. Likewise, we appreciate the initiative taken by the Wellcome Trust in organising an event (Sept 22–23, 2015)2 that brought together key players to identify mechanisms to “reverse the public health neglect of tropical snakebite victims”. Full-Text PDF