Snake bite is a tropically neglected public issue. The people most affected by snake bites, rabid dog bites and scorpion stings usually live in poor rural communities where medical resources are often sparse. The impact of these health issues, although dramatic and economically significant, does not appear as a priority in the design of national public health programmes. These are therefore the most neglected among today’s global health problems. The situation is particularly poignant because, in contrast to some other diseases, a highly effective treatment already exists: the timely administration of specific antiserum. Rabies, for instance, is entirely preventable even after severe exposure, provided post-exposure prophylaxis, completed with rabies immunoglobulin, can be given. Similarly, the mortality and morbidity of snake bites and scorpion stings can be reduced to very low levels by timely administration of appropriate antivenoms. The current situation of the management of potentially rabid mammal bites and envenomings by snake bites or scorpion stings worldwide is a global public health emergency. There is a lack of awareness of the magnitude of the problem by health authorities and politicians alike, due to both the scarcity of adequate statistics on the real impact of these diseases, and the lack of advocacy by and on behalf of the affected groups, mostly children and rural agricultural workers. Worldwide production of these antisera has declined, due to economic constraints that have forced the withdrawal of some private producers, and to the weakening of public-sector manufacturers in the public sector in many countries.
Moreover, the poor quality of some antisera and the resulting deficiency in their efficacy and safety, together with deficient distribution policies and inadequate training of medical and nursing staff requires an urgent international action. The gravity of this problem, and the complexity of its causes, demands from the public health community, and especially from the W.H.O and humanitarian international agencies, a concerted, rapid and effective global response to reduce the burden of human suffering incurred by rabies, and snake and scorpion envenomings.
- A multi component scenario is required, involving producers and regulatory authorities at national, regional and global levels, with an appropriate coordination by WHO and with financial support of the international community.
- We need competence, collaboration and coordination more than competition.