India’s snakebite crisis claims tens of thousands of lives every year

Devendra, a farmer in India, still remembers the moment a snake fanned his leg while picking mulberry leaves.

“I went to the hospital four days after I was bitten, when the pain became unbearable. But the delay cost me my leg,” he says in a short film released by the Global Snakebite Taskforce (GST), an initiative to reduce snakebite deaths and injuries.

But Devendra is still among the lucky few who survived. According to the federal government, about 50,000 Indians are killed by snakebites every year—about half of all deaths worldwide. Some estimates suggest the number could be even higher: Between 2000 and 2019, India could have seen about 1.2 million deaths, an average of 58,000 per year, the 2020 study said.

Now, a new report by GST has found that 99% of healthcare workers in India face challenges in administering antivenom – the life-saving antibody that neutralizes toxins in venom. Researchers surveyed 904 medical professionals in India, Brazil, Indonesia and Nigeria, the countries most affected by snakebites, and found similar barriers: poor infrastructure, limited access to antivenom and inadequate training.

Almost half of professionals reported that delays in treatment led to serious complications in their patients, including amputation, surgery or lifelong mobility problems.

In 2017, the World Health Organization (WHO) formally listed snakebite envenomation as a “high priority neglected tropical disease” due to the high number of deaths it causes. According to WHO, 5.4 million people are bitten by snakes worldwide every year and more than 100,000 die annually.

It also suggests that snakebite disproportionately affects poor rural communities in low- and middle-income countries.

In India, the central and eastern regions report the highest concentration of snakebite deaths and injuries, says Dr Yogesh Jain, a GST member and businessman from the central state of Chhattisgarh. He adds that people, including people from poor tribal communities who work in the fields, are most at risk.

In 2024, India launched the National Action Plan for Snakebite Prevention and Control (NAPSE) with a target of halving snakebite deaths by 2030. The plan focuses on better surveillance, improved pesticide resistance availability and research, improved medical capacity and public awareness campaigns.

Experts agree that this is a step in the right direction, but implementation is inconsistent.

“Snake bites in India are seen as a poor man’s problem,” says Jain. “That’s why there isn’t enough outrage or action on these completely avoidable deaths. When it comes to snakebite treatment, every second counts.”

He explains that snake venom enters the bloodstream within minutes, attacking nerves, cells or the circulatory system. Delay in antivenom administration may result in respiratory failure, paralysis, irreversible tissue damage, or organ failure.

However, delays in hospitalization are common in rural India where poor roads, remote hospitals and lack of ambulance services hinder timely treatment.

Last September, a pregnant woman in the state of Gujarat reportedly died on her way to hospital after her family had to carry her 5 kilometers (3 miles) in a bundle of cloth because no vehicle could reach their settlement.

Jain says some states are trying to improve access by stocking antivenom at primary and community health centers. But managing it properly has become a big challenge.

Many health workers are not trained professionals and are afraid to give antivenom because patients can sometimes develop adverse reactions.

“Antivenom is mixed with saline and injected intravenously over an hour, but many centers are not equipped to manage the side effects,” says Jain.

Another problem, he adds, is that many people in rural India still rely on faith healing or local medicine practices and go to the hospital only when their symptoms worsen, which can be fatal.

Gerry Martin, co-founder of The Liana Trust, which works to reduce human-snake conflict in the state of Karnataka, says another big hurdle is the availability of high-quality antivenom.

Currently, India has an antivenom that protects only against the “big four” snakes—spectacled cobra, common krait, Russell’s viper and saw-scaled viper—which are responsible for most bites. Antivenom is produced by injecting venom from these snakes into horses, whose antibodies are then used as a treatment for humans, Martin explains.

But there are dozens of other venomous snake species for which India has not targeted antivenom. These include the green pit viper commonly found in the northern state of Himachal Pradesh, the Malabar pit viper and the hump-nosed pit viper found in the southern states and several other species found in the north-eastern states.

Last year, a study conducted by AIIMS (All India Institute of Medical Sciences) in Jodhpur, Rajasthan highlighted this problem. Antivenom used to treat snakebites In 105 snakebite patients (where the species remained unknown), two-thirds did not respond well to treatment.

The study concluded that there was an urgent need for “region-specific antivenom in western India”.

For the past five years, the Liana Trust has been studying venoms from species outside of the big four to develop antidotes for them. But progress is slow, Martin says, because the process is labor-intensive and time-consuming.

He called on states to emulate the southern state of Karnataka’s government’s 2024 order that made snakebite a “notifiable disease” — making it mandatory for health professionals to report it to authorities — to combat under-reporting.

Jain agrees. He says, ‘The end of political will is death from snakebite.

“Governments must ensure that poor people don’t get poor health systems. They deserve better.”

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