Did you know that as many as 81,000-137,000 people die of snakebites every year? The number of those suffering amputations and permanent disabilities due to snakebite envenoming is thrice more than the overall deaths caused by snakebites. Snakebite is one of the most neglected public health issues in tropical and subtropical countries. If the experts are to be believed, there are nearly 3,900 species of snakes worldwide, out of which 600 are venomous. “Snakebite problems cause great human, social, and economic burdens on over one billion poor people, particularly those from low and middle income countries,” says Dr. Ren Minghui, Assistant Director-General, Universal Health Coverage, Communicable and Non-communicable Diseases, World Health Organization (WHO).
Following a request by several United Nations Member States, WHO formally listed snakebite envenoming as a high priority neglected tropical disease in June 2017. In the same year, it established a Snakebite Envenoming Working Group. After several rounds of deliberations, the group came up with a global snakebite strategy in May 2019. The objective was to bring down the mortality and disability rates caused by snakebites to half by 2030.
One of the concerns for the Working Group was insufficient healthcare systems in countries where the economic burden of treatment is high, often leading to mortality and morbidity that are preventable. “When a venomous snake bites a victim, time is truly of the essence. Milliseconds can spell the difference between life, death, and primitive permanent disability. Speed is crucial,” says Dr. Samira Asma, Assistant Director-General for Data, Analytics, and Delivery for Impact, WHO.
To achieve its 2030 goal, WHO has now launched the Snakebite Information and Data Platform, which is a confluence of technology with data science and geography, using a state-of-the-art solution ArcGIS. The Platform will serve as a hub with range maps depicting venomous snakes, identifying photos, and information supported by an integrated anti-venom products database. “This platform was developed with support from technology partner Esri, academic partner University of Geneva and the Foundations and our colleagues from the Department of Neglected Tropical Diseases,” adds Dr. Asma.
Back in 2010, WHO had listed on its website 10 medically important venomous snakes and the distribution maps for each of these species. Over the years, these maps provided valuable resources and played an important role in improving information on snakebites. The new platform is meant to be more interactive and provide information in real time. It will work as a resource to inform both private and public health practitioners, and policymakers, to take more timely decisions by identifying and locating anti-venom stockpiles in health facilities that are closest to the populations in need by using real time and reliable spatial data. This will empower communities to locate their nearest anti-venom treatment facilities.
“This important Open Access Data Platform will help locate problems and identify solutions, thus shortening the time to save lives. The platform reflects the steps WHO is taking under the leadership of Dr. Tedros Adhanom Ghebreyesus to transform itself into a truly modern, data-driven organization,” emphasizes Dr. Asma.
“We want this platform to become a one-stop-shop and a central space for collaboration and data sharing, and access to information and snakebite envenoming for Member States, the scientific community, industry, and public in general,” says Dr. Minghui.
Experts believe that the new platform will help in better surveillance and epidemiological reporting of snakebite accidents. “When we first envisaged developing a platform like this a decade ago, the real problem was the technology. We thought of it in terms of just state distribution maps to show where the different types of animals are found and the difference between animal biology, animal ecology, how animals interact with their environments, and how that influences human health,” explains Dr. David Williams, Technical Officer, Regulation and Qualification Department, WHO. He adds: “The new mapping tools will give us the ability to improve surveillance, epidemiological reporting of snakebite accidents. There is a disease part available on this platform where we plan to incorporate DHIS2 module in future, with countries to be able to use and report their statistics every year. It will enable us to improve the distribution of anti-venoms and map system capabilities with a really wide range of data from many sources, all into one place.”
The use of anti-venom is crucial for controlling the complications arising from snakebite envenoming. According to WHO, a significant challenge in the manufacturing of anti-venoms is the preparation of the correct immunogens (snake venoms). At present, very few countries have the capacity to produce snake venoms of adequate quality for anti-venom manufacture, and many manufacturers rely on common commercial sources. Additionally, lack of regulatory capacity for the control of anti-venoms in countries with significant snakebite problems results in the inability to assess the quality and appropriateness of the anti-venoms. Less than 2% of Africans currently have access to anti-venoms.
Further, poor data on the number and type of snakebites leads to difficulty in estimating needs, and deficient distribution policies contribute to manufacturers reducing or stopping production or increasing the prices. Dr. Diogo Martins, Policy and Advocacy Lead for Snakebite at Welcome Trust, points out three main goals for collaborating with WHO:
“We are helping WHO with future stockpiling programs by supplying suitable anti-venoms at the regional level. We are also contributing in setting up target product profiles to reduce variability in product development and commercialization,” he says.
Due to rising temperatures and recurring climatic events like floods, wildfire, drought and heat waves, snakes are changing their native habitats, intruding into human spaces. Research suggests that snakes will have slithered their way to northern Canada by 2050 and could be sunning themselves in northwestern Alaska by 2100. “Climate change is acting as a factor due to which some species of snakes, like in Latin America, are expanding their range to higher altitudes, slopes and further south in South America. We want to introduce things like habitat suitability model of where venomous snakes are found now, as well as the potential to where they may be found in the future. So, in terms of disaster preparedness, at WHO, we have done some work with people working with disaster preparedness around the world to understand what provisions should be made for snakebites and similar emergencies. We are working to make sure the right guidance is available for particular geographic areas,” says Dr. William.