SNAKE BITES

• India accounts for almost 80% of global snakebite deaths.
• The global target is to half the number of deaths & injuries from snakebites by 2030.
• At 4.50 per 1,00,000, only Somalia has a higher age-standardised death rate than India, with 6.5,  per 1,00,000.
• Despite the high number of deaths each year, there is no national strategy to address the burden of snakebite in India.
• Focus should be on the comprehnsive strengthening of primary healthcare systems concentrating on both access & quality of care across all health systems blocks.
• As snakebite affects the rural poor, a national strategy for snakebite brings in an equity focus.

• The global estimate of deaths due to snakebite comes 14 years after the previous one in 2008 & provides a more robust estimate.
• Previously it was known that half of the global deaths due to snake bites were occupied in India. 
• But the current study shows snakebite deaths in India are much higher at almost 80% of global deaths.
• This indicates a failing health system in India & Somalia leading to high deaths in those who are bitten by venomous snakes.
• Despite the high number of deaths each year, there is no national strategy to address the burden of snakebite in India.
• There is a recognition recently that snake bite is considered a public health problem with the Indian Council of Medical Research launching a national survey to estimate the burden.
• This helps to know the burden better, the absence of a specific national strategy to address snake bites implies there is no programme by the government to prevent snakebites/deaths/disabilities in those who are snake bitten.
• Preventing snakebite needs more than simple awareness programmes.
• This is because snakebite at its core is due to snake-human-environment conflict tied to many socio-cultural-religious aspects.
• Understanding the conflict & code signing community-based programmes for the prevention of snakebites which are tested through community randomised cluster trials are required.
• To bring down deaths, strengthening primary healthcare in India is required.

• There was a lot of focus on snake antivenom availability.
• There is a need for comprehensive strengthening of primary healthcare systems focusing on both access, and quality of cross-all health systems blocks, instead of focusing on snake antivenom availability.
• Improving primary health care is important for snake bites because it is an acute medical emergency.
• With new global estimates available, it might be expected that global health funders and philanthropists would invest in research programmes on snakebites in India.
• Having a national strategy to address snakebites would mean that investments are towards the need of the country in health system strengthening & community-based programmes.
• Instead of costly drugs & diagnostics whose intellectual property is held outside India or leading to vertical programmes.
• Because snakebite affects the rural poor, a national strategy for snakebite brings in an equity focus which will bring cross benefits for other neglected tropical diseases, which happen in the same communities.