Dr. David Williams
Throughout Latin America the lance-headed vipers of the genus Bothrops are the major cause of snakebite death and disability. Pictured here is a fer-de-lance (also known as Terciopelo), Bothrops asper from Costa Rica.
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Snakebite envenoming: Member States provide WHO with clear mandate for global action

25 May 2018
Departmental update
Geneva
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 The 71st World Health Assembly today adopted a resolution formally providing the World Health Organization with a strong mandate to develop a comprehensive plan to support countries in implementing measures for increased access to effective treatment to people who get bitten by venomous snakes.

“The resolution provides WHO with a clear mandate to work with affected countries, partners, stakeholders and industry” said Dr Ren Minghui, WHO Assistant Director-General for Communicable Diseases. “We need to work with everyone to coordinate multifocal measures that can save lives and in most cases life-long disabilities resulting from envenoming”.

Discussion around the resolution, proposed by several Member States and coordinated by the governments of Colombia and Costa Rica, was strongly supported by more than 31 countries.

“The Government of Costa Rica is highly satisfied with the resolution which represents a big step forward in the global efforts to reduce the burden of snakebite envenoming,” said Ambassador Elayne Whyte Gómez of Costa Rica.

The adoption of the resolution follows last year’s recognition of snakebite envenoming (poisoning from snake bites) as a neglected tropical disease and the recommendation by WHO’s Executive Board in January 2018 to the Health Assembly.

WHO has already set up a working group to prepare a strategic plan to assess and address the global burden of snakebite envenoming, especially in mid- to low-income countries. The plan, being developed by the 28-member working group of experts, is expected by the end of 2018.

“Our focus is to find integrated, cost–effective and sustainable approaches to lessen the impact of snakebite envenoming on the health and socioeconomic status of mostly poor people who are exposed to this problem,” said Dr David Williams, a member of the core working group, who also heads the Australian Venom Research Unit at the University of Melbourne. “The aim is to reduce the scale of the problem by achieving a 50% reduction in deaths and disabilities by 2030.”

The plan builds on WHO’s concept of Universal Health coverage and seeks to ensure that snakebite victims are included in the drive to achieve the 2030 Sustainable Development Goals.

 

Global burden

About 5.4 million snake bites occur each year, resulting in 1.8 to 2.7 million cases of envenomings. It is estimated these result in the deaths of 81 000–138 000 people a year and leave another 400 000 with permanent disabilities.

Most victims are poor rural dwellers and many are women and children, who are prone to suffer more severe effects due to their smaller body mass.

Bites by venomous snakes can cause acute medical emergencies. These include severe paralysis that may prevent breathing, bleeding disorders that can lead to fatal haemorrhage, irreversible kidney failure, and severe local tissue destruction that can cause permanent disability and amputation.

Effective treatment of snakebite envenoming is currently unavailable in many countries. Where treatment is available, the cost can be prohibitive. The long-term effects of poor-quality treatment can drive vulnerable people further into debt and poverty.