IST 2015 Oxford Press Release (IST 2015 Oxford Press Release)

30 September 2015

INTERNATIONAL SOCIETY OF TOXINOLOGY – PRESS RELEASE – FOR IMMEDIATE RELEASE

Venom experts say death & disability from snakebite up to double current estimates 

WHO and governments need to correct data & prioritize snakebite as a killer disease

Oxford, 30 September, 2015 – Venom experts attending the International Society of Toxinology (IST) biennial [every 2 years] meeting presented new evidence showing that snakebite deaths, disability and DALYs lost are more than twice current WHO and Global Burden of Disease estimates. They called on WHO and governments to reinstate snakebite as a Neglected Tropical Disease (NTD). They warned that not only are antivenom stocks running dangerously low, but there is also a real crisis in the quantity and quality of antivenoms in rural areas, where they are needed most. Where there is antivenom, too often health staff do not have the training or know how to administer it safely or effectively to patients.

“Snakebite kills more people than other Neglected Tropical Diseases combined, but is almost completely ignored and grossly underestimated – WHO and governments need to adjust their data and rank snakebite where it belongs, as a very real public health and medical concern, which needs funding, training and focus.” Said Prof. Alan Harvey, President of the International Society of Toxinology.               

Over 400 leading scientists, toxinologists and clinicians came together over five days to exchange research findings and information in Oxford. They showed how great improvements could be made quickly and cheaply in the treatment and management of snakebite – if there is the political will at a global and national level:

·         They reaffirmed the size and severity of the clinical problem. A summation shows that snakebite kills up to 200,000 per year, this is twice the currently accepted estimates.¹ This includes new evidence that 46,000 people die of snakebite in India alone (WHO estimates 10,000) and 6,000 in Bangladesh.

·         From Nigeria to Nepal to Papua New Guinea, there is a real crisis in the quantity and quality of antivenoms available. There is an urgent need to improve the training of medical staff to diagnose and treat snakebite.

·         Anti-venom is produced using 100 year-old methods. New research promised improved understanding of the composition of venoms and design techniques to manufacture antivenoms – including proteomics.

Despite high mortality levels, in 2013, WHO demoted snakebite from an NTD to a “neglected condition” with no formal programme and in 2015 dropped it altogether. WHO no longer has staff or expertise allocated to snakebite. WHO needs to reinstate snakebite as a leading Neglected Tropical Disease. From a disease burden perspective, it should be ranked in the top three or four diseases, with a program to treat and prevent snakebite.

“We humans and our primate cousins have an innate fear of snakes and other venomous animals – so our instinct is to run away. Unfortunately this revulsion for snakes has clouded the judgement of Ministers, donors and WHO leadership to the point where they are ashamed to admit and do anything about the public health burden of snakebite.” Said Prof David Warrell, International Congress of Toxinology Co-Presidents and medical doctor. “The sad thing is that the evidence is there – we can do so much with so little – but there needs to be a degree of political leadership and honesty about death and disability from snakebite.”  He concluded.

The Global Burden of Disease report, published in the Lancet three weeks ago, also grossly underestimates the severity of the problem. Contact with venomous animals accounts for 3 million DALYs around the world – this includes snakebite, scorpion stings, spiders, stingrays, jellyfish, insects etc. One DALY can be thought of as one lost year of “healthy” life. New data presented in Oxford show that snakebite alone accounts for at least six million DALYs lost – including 320,000 in West Africa alone and 3 million in India – without factoring in chronic complications.²

Snakebite mainly affects people living in rural areas. With no health facilities nearby, and unable to afford expensive treatment, many either turn to traditional healers or don’t seek care at all. This suggests that the number of victims is probably higher than officially reported. If available, antivenom treatment can cost up to US$250-500 per victim, representing the equivalent of four years of salary in the countries concerned. Subsidizing antivenom costs so that patients pay little to nothing is crucial to improve access to this life-saving treatment.

For further information or comment, please call:

• Professor David Warrell cell: +44 7785242978, or email warrell@ndm.ox.ac.uk

• Professor Alan Harvey cell: +353 87 210 7547, or email Harvey@dcu.ie

The 18th World Congress on Animal, Plant and Microbial Toxins (25-30 Sept) concludes today. It is the premiere scientific meeting for the International Society on Toxinology (IST)  http://www.toxinology.org, to explore the structural, pharmacological, evolutionary and clinical aspects of “natural toxins”. Founded in 1962 by a group on scientists and clinicians interested in advancing the science of toxinology. The first international meeting was held in 1966 in Atlantic City, USA and it’s Journal, Toxicon, was first published in 1963.

¹WHO currently estimates that annually at least 100,000 people die from snake bites, and around three times as many suffer from amputations and other permanent disabilities. http://www.who.int/mediacentre/factsheets/fs337/en   

²Just published and presented at IST – estimates of lack of funding in snakebite and allocation of donor funds to Neglected Tropical Diseases http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0004088