Snakebite: a forgotten problem

When Alexander the Great invaded India in 327-325 BC he was said to be impressed by the arrow heads poisoned with lethal venom from the Russell viper and the advanced clinical acumen of Indian doctors in managing snakebite.1 In 2009 the World Health Organization added snakebite to its list of neglected tropical diseases, hoping to reduce its burden on so many marginalised populations.

“We need to act now to deal effectively with this problem, which causes severe disability, brings misery to families, and which kills thousands of people,” said Lorenzo Savioli, director of the department of control of neglected tropical diseases at WHO.2 However, policy makers, clinicians, and the general public have largely ignored the snakebite problem, even though it kills thousands of people each year and causes social, economic, and personal misery to many more.

Ghulam Nabi Azad, the union health and family welfare minister of the government of India, told the Lok Sabha, India’s lower house of parliament, in April 2012 that only 1440 people had died from snakebite in India in 2011.3 WHO, however, predicts as many as 1 841 000 envenomings and 94 000 deaths globally, with India having the most of any country, with an estimated 81 000 envenomings and 11 000 deaths a year.2 The Million Death Study4 estimated some 45 900 deaths from snakebite in India in 2005, about the same number as those from HIV/AIDS.5