Each year, over 100,000 people die from snakebite envenoming, and more than 400,000 others are left with life-changing injuries, disfigurements and disabilities. These are not abstract statistics. They represent farmers who can no longer work their land, children who are forced to drop out of school, and families pushed deeper into poverty by medical costs and lost income.
Snakebite envenoming is one of the world’s most neglected tropical diseases (NTDs), yet it is both preventable and treatable. The reason it remains such a devastating problem is not scientific complexity alone. It is inequality. Snakebite overwhelmingly affects people living in rural, low-income settings, often in sub–Saharan Africa, South Asia and Latin America, where access to healthcare is limited, transport to clinics can take hours or even days, and the cost of treatment can be catastrophic for households already living on the edge.
In such rural tropical settings, snakebites can happen at almost any time, whether working in the fields, walking in the evening, or even when sleeping at home at night. Unfortunately, there are often many barriers to receiving effective treatment. Clinics may not have antivenom therapy in stock, staff may not be trained to manage the often complex signs of envenoming, and patients may delay seeking care because they cannot afford the journey or the treatment. By the time they reach a hospital, it can be too late.
Even when antivenom is available, the current generation of products have serious limitations. Antivenoms are made using a century old process of immunising animals, usually horses, with snake venom and then purifying the antibodies they develop. This approach has saved countless lives, but antivenoms are expensive, can cause adverse reactions in patients, have to be directly injected into a vein, and rely on refrigeration to keep the medicine stable. For this reason, antivenoms are commonly administered in hospitals that are often many hours or even days away from the site of the bite.
Another challenge is that each antivenom is limited to being effective against only certain snakebites due to variations in venom toxins between different snake species. This means that many different antivenoms are made globally, each serving only a certain geographical region, leading to challenges with the financial sustainability of these products. Because snakebite primarily affects low-income communities, there is often little commercial incentive for manufacturers to invest further in improving treatments, and uncertainties often remain as to which antivenoms are the most suitable for use in certain parts of the world. As a result, some countries rely on products of uncertain quality or face chronic shortages that leave health workers unable to treat patients who arrive in desperate need.
This is why snakebite is as much an issue of poverty as it is of biology. It sits at the intersection of weak health systems, underinvestment in NTDs, and global inequities in research and development. For too long, it has been treated as an unavoidable fact of life. It is not. It is a solvable problem, if we choose to solve it.
At the Liverpool School of Tropical Medicine, our Centre for Snakebite Research & Interventions (CSRI) is working to change this narrative. We are part of a global effort to move beyond the limitations of traditional antivenoms and develop new, more effective and accessible treatments that can be used safely in the communities that need them most.
One of the most promising areas of our current research is the development of small molecule drugs that can be taken as tablets immediately after a bite, even before a patient reaches a hospital. One of these drugs, known as DMPS, is already approved for other medical uses and we are now repurposing it for snakebite. DMPS targets the toxic enzymes responsible for causing bleeding and clotting disturbances in many snake venoms. In our recent studies in the lab, drugs like DMPS and other custom-designed inhibitors have shown the ability to neutralise key venom components and slow the progression of life-threatening symptoms.
Crucially, these treatments have the potential to be taken orally, which means they could be administered in the communities affected by snakebite - by health workers or even by patients themselves - buying vital time before hospital care is available. This is a fundamentally different model of snakebite treatment, one that recognises the realities of rural healthcare and prioritises early intervention.
We are now advancing these approaches into clinical trials, supported by major international funding and in close partnership with researchers, clinicians and communities in snakebite endemic countries. We hope that this work will fill the critical treatment gap that currently exists in those crucial hours after a bite.
Alongside drug development, we are also working to understand the inner workings of venom, strengthen clinical guidelines, and build research capacity in the regions most affected by snakebite. We collaborate with partners around the world via our key role in groups like the African Snakebite Alliance (ASA) and the Global Snakebite Taskforce (GST) to ensure that new tools are tested in real world settings and designed with local needs in mind. We engage with health ministries, the World Health Organization and non-governmental organisations to translate research into policy and practice, so that scientific advances do not remain confined to academic journals.
World NTD Day is a moment to reflect on the diseases that the world has chosen to ignore. Snakebite envenoming is one of the starkest examples of how global health priorities can fail those who are poorest and most marginalised. But it is also becoming an example of how things can change when attention, funding and scientific effort are finally directed where they are most needed, with recent investment in this NTD stimulating innovation and catalysing action.
We now have a real opportunity to transform snakebite care, to move from a fragile, inequitable system to one that is resilient, accessible and fit for purpose. The science is advancing. The solutions are within reach, but major challenges remain. What we need now is sustained political commitment and investment to ensure that promising research innovations will ultimately make it to the hands of the people whose lives depend on them.