What can deliver snakebite medicine where it's needed?

SNAKEBITE is one of the world's most neglected health issues. In 2009, the World Health Organization (WHO) declared it a "neglected tropical disease". Yet this devastating problem is ignored by governments, research funders and public health organisations, leaving millions without adequate treatment.

In allowing this tragic situation to exist, governments are not only ignoring persuasive moral and economic reasons to improve treatment, but may also be in violation of legal obligations to provide access to antivenom.

The extent of the problem is difficult to quantify, but the WHO estimates there are 5 million cases annually worldwide, with up to half of victims experiencing effects from venom. Snakebites cause at least 100,000 deaths and up to 400,000 amputations each year. Millions more are bitten by spiders, scorpions and other venomous creatures, also without access to adequate medical care.

It is probable that snakebite causes more deaths and disability than many other tropical diseases, including dengue fever, Chagas' disease and leishmaniasis (The Lancet, vol 375, p 89). Despite this, snakebite treatment programmes receive little public health funding and struggle to attract the research effort and political resolve necessary to improve treatment options.

Antivenoms are a proven approach to reducing death and disability from snakebites, but safe and effective sources are in decline. In many parts of the developing world, access to antivenom is virtually impossible. Even where it is available it is sometimes not used, or used inappropriately, because of inadequate experience and a lack of equipment to administer it.