Govt releases action plan to reduce snakebite deaths by half by 2030

The Union Health Ministry on Tuesday released a national action plan for management, prevention and control of snakebite envenoming so that disabilities and deaths due to it can be reduced by half by 2030.

Besides, a helpline number (15400), that provides immediate assistance, guidance and support to individuals and communities affected by snakebites, will be piloted in five states and Union territories -- Puducherry, Madhya Pradesh, Assam, Andhra Pradesh and Delhi -- under the National Action Plan for Prevention and Control of Snakebite Envenoming (NAPSE).

This initiative aims to ensure prompt access to medical care and information to general public.

According to the NAPSE, launched by Union Health Secretary Apurva Chandra, a majority of snakebite envenomation deaths and catastrophic sequelae can be avoided with prompt availability of safe and effective anti-venoms, timely transport and referral.

The NAPSE is a guidance document for the states and UTs and stakeholders to develop their own action plans specific to their needs, and aims at systematic reduction of snakebite envenoming risk through sustained availability of anti-snake venom, capacity building, referral mechanism and public education.

The strategic action for human health component includes ensuring provision of anti-snake venom at all health facilities, strengthening surveillance of snakebite cases and deaths in humans, strengthening of emergency care services at district hospitals and community health centres, including services for ambulance, institutionalisation of regional venom centre's and inter-sectoral coordination.

Thus the key interventions to reduce deaths due to snakebite include upskilling of medical officers for timely and standard treatment to ensure any victim of snakebite envenoming receives anti-snake venom (ASV) in time and his/her progress is monitored with timely referral/dosage.

Second intervention involves mass awareness which holds key for prevention of snakebite especially in high risk areas.

Thus the document is an effort to bring sporadic efforts undertaken by different industries, agencies and ministries under one umbrella with a systematic approach.

To summarise the NAPSE is a strategic document based on "One Health" approach and will enable India to reach the global target of reducing the deaths due to snakebite envenoming by half by 2030.

The strategic action for wildlife health component includes education awareness, anti-venom distribution, strengthening of the key stakeholders, systematic research and monitoring and snake venom collection and snake relocation.

The strategic action for animal and agriculture component includes prevention of snakebites in livestock, community engagement, etc.

According to WHO data, global snakebite incidences stand at around 5.4 million with about 1.8 to 2.7 million accounting to snake envenoming annually resulting in approximately 8000-1.3 lakh deaths and triple the number of amputations and permanent disabilities.

The WHO listed snakebite envenoming as a priority neglected tropical disease in 2017 and advocates developing a global strategy to halve the number of snakebite-induced deaths and disabilities by 2030.

The highest burden of snakebite envenoming is seen in Asia, Africa and Latin America.

Asia alone has around 20 lakh snakebite envenoming cases every year. Within the region, Bangladesh, India, Nepal, Pakistan, and Sri Lanka together constitute nearly 70 per cent of global snakebite mortality.

In India, approximately 50,000 fatalities result from an estimated 3 to 4 million snakebites each year, representing roughly half of all global snakebite-related deaths, according to the document.

Only a small proportion of snakebite victims across countries report to the clinics and hospitals and actual burden of snake bite is grossly under-reported.

As per the Central Bureau of Health Investigation (CBHI) reports (2016-2020), the average annual frequency of snakebite cases in India is around 3 lakhs and about 2000 deaths occur due to snakebite envenoming, the document said.

The "big four" snake species, including the common krait, Indian cobra, Russell's viper, and saw-scaled viper, are responsible for approximately 90 per cent of snakebite incidents.

The Ministry of Health and Family Welfare has also issued a National Snakebite Management Protocol in collaboration with WHO for use by medical officers for management of Snake bite cases in 2009 and updated in 2016.

To ensure the availability of ASV, states and UTs have been directed to include it in the list of essential drugs of the state, procurement of these drugs is supported under National Health Mission.

A national consultation was held for developing a dedicated NAPSE in July 2022.

Accordingly, the National Action Plan for Prevention and Control of Snakebite Envenoming in India was formulated in consultation with key stakeholders and experts.