Snakebite envenoming represents a significant yet often overlooked global health challenge. Millions are affected annually, leading to substantial morbidity and mortality. This issue disproportionately impacts vulnerable populations, particularly those in rural agricultural communities in tropical and subtropical regions. Its consequences extend beyond immediate injury, contributing to long-term disability and economic hardship for affected individuals and their families.
Countries with the Highest Incidence
South Asia and Sub-Saharan Africa bear the greatest burden of snakebite deaths globally. In 2019, an estimated 63,400 people died from snakebites worldwide. South Asia accounted for approximately 54,600 of these fatalities, representing 86% of global deaths. India alone recorded the highest number, with an estimated 51,100 deaths, equating to an age-standardized mortality rate of 4.0 deaths per 100,000 people.
Other South Asian countries with high incidence include Pakistan (2,070 deaths in 2019) and Bangladesh (1,170 deaths). In Sub-Saharan Africa, Nigeria had the highest number of deaths with 1,460 fatalities. Several other Western Sub-Saharan African countries, including Burkina Faso, Cameroon, Chad, Côte d’Ivoire, Ghana, Mali, and Niger, each reported over 200 deaths. The Democratic Republic of Congo in Central Sub-Saharan Africa had 545 deaths, while Ethiopia and Kenya in Eastern Sub-Saharan Africa recorded 499 and 349 deaths, respectively.
Understanding the Factors Behind Fatalities
Limited access to timely and effective antivenom remains a primary driver of snakebite fatalities. Many affected communities reside in remote, rural areas with inadequate healthcare infrastructure, making quick access to medical facilities difficult. Even when facilities are accessible, a shortage of appropriate antivenom or inability to afford treatment can delay or prevent life-saving interventions. Antivenom effectiveness also depends on its quality and storage conditions, which can be compromised in resource-limited settings.
A lack of public awareness regarding snakebite prevention and first aid also contributes to higher fatality rates. Many in affected regions may not know how to react immediately after a bite, sometimes resorting to ineffective traditional remedies that worsen outcomes. The prevalence of highly venomous snake species, such as Russell’s viper, kraits, and cobras in India, exacerbates the risk of severe envenoming and death. Agricultural practices often bring people into close contact with these snakes, increasing the likelihood of bites.
Global Efforts to Reduce Deaths
International and national initiatives are working to reduce snakebite morbidity and mortality. The World Health Organization (WHO) reinstated snakebite envenoming as a neglected tropical disease (NTD) in 2017. This classification aims to increase awareness, funding, and research. The WHO has set a target to halve the number of deaths and cases of snakebite envenoming by 2030.
Efforts include improving antivenom production and distribution, ensuring quality, affordable antivenom reaches the communities that need it most. Programs focus on strengthening healthcare systems in rural areas, including training healthcare professionals in snakebite management and providing necessary medical equipment. Community education initiatives are also underway to raise awareness about snakebite prevention, recognition of venomous species, and seeking immediate medical attention rather than relying on traditional remedies.