Snakebite: The Forgotten Tropical Disease We Can No Longer Ignore

By Chris Williams

When most Australians think about snakebite, they imagine one of our country’s iconic venomous snakes—a Brown Snake in a paddock, a Tiger Snake beside a wetland, or a Red-bellied Black Snake crossing a bush track. We know the risks, we know to call 000, and thanks to excellent first aid, modern ambulance services and world-class hospitals, the vast majority of Australians who suffer a venomous snakebite survive.

But that’s not the reality for much of the world.

Every year, an estimated 138,000 people die from snakebite envenoming, while another 400,000 or more are left with permanent disabilities, including amputations, blindness, chronic pain and severe tissue destruction. These aren’t isolated tragedies—they occur year after year, primarily in some of the world’s poorest rural communities. 

For that reason, the World Health Organization classifies snakebite envenoming as a Neglected Tropical Disease. It’s a title that surprises many people, but sadly, it’s well deserved.

A disease of poverty

Unlike many other medical conditions, snakebite overwhelmingly affects people who can least afford it.

Farmers harvesting crops barefoot. Children walking to school. Families living in simple homes surrounded by long grass. Communities where the nearest hospital may be several hours away, and where antivenom may be unavailable or prohibitively expensive.

In Australia, we’re fortunate.

If someone is bitten by a venomous snake, an ambulance is usually only minutes away. Pressure immobilisation bandaging is widely taught, antivenoms are readily available, and doctors have extensive experience treating envenoming.

In many parts of sub-Saharan Africa, South Asia and Latin America, the situation couldn’t be more different.

Victims often have no transport, little access to healthcare and may first seek traditional remedies before eventually arriving at hospital—sometimes too late.

The remarkable thing about antivenom

One of the most surprising aspects of snakebite treatment is that the basic method of producing antivenom has changed very little in well over a century.

Scientists inject carefully measured amounts of venom into animals—usually horses—to stimulate an immune response. Antibodies are then harvested, purified and turned into antivenom.

It’s an ingenious process.

It has saved countless lives.

But it’s also a technology dating back to the late 1800s.

Imagine if heart disease, cancer or diabetes were still being treated using technology that hadn’t fundamentally changed since before the invention of antibiotics.

That’s effectively where snakebite medicine has been for decades. 

A new generation of treatments

The exciting news is that researchers around the world are finally beginning to change that.

One of the leaders in this field is Professor Nicholas Casewell and his team at the Liverpool School of Tropical Medicine. Together with researchers including Dr Steven Hall, Keirah Bartlett, and collaborators from Denmark, Canada, Costa Rica and the United States, they’re developing entirely new ways to combat snake venom. 

Rather than relying solely on traditional antivenom, these researchers are asking a different question:

What if we could stop venom before it causes catastrophic damage?

One of their most exciting discoveries involves a drug called varespladib.

Originally developed for an entirely different purpose, varespladib blocks an enzyme known as phospholipase A₂—a major component found in many medically important snake venoms.

In laboratory studies involving African spitting cobras, the drug dramatically reduced the devastating tissue destruction that often leads to permanent disability or amputation. 

That’s an extraordinary step forward.

More than saving lives

When we talk about snakebite, most people focus on mortality.

But survival is only part of the story.

Many victims live with lifelong disabilities.

Entire sections of muscle can die.

Skin can literally rot away.

Hands and feet may require amputation.

People can lose their livelihoods because they can no longer work.

This is why research into drugs like varespladib is so important. Even if traditional antivenom ultimately saves a patient’s life, preventing local tissue damage could mean the difference between returning to work and living with permanent disability.

Faster treatment in remote areas

Another exciting area of research is the possibility of medications that can be given before patients reach hospital.

Current antivenom usually needs refrigeration, trained medical staff and careful monitoring because allergic reactions can occur.

Small-molecule drugs such as varespladib have the potential to be carried into remote communities, administered far earlier, and buy precious time while patients travel to definitive medical care. Clinical trials are already exploring this possibility. 

If successful, this could transform snakebite treatment across large parts of Africa and Asia.

Better diagnosis is also coming

Another challenge is simply identifying which snake caused the bite.

In Australia, pathology laboratories can perform venom detection in certain circumstances, but many countries have no practical diagnostic tools at all.

Researchers in Denmark, including molecular biomedicine researcher Cecilie Knudsen, are developing rapid diagnostic tests that could identify the venom responsible within minutes, allowing clinicians to administer the most appropriate treatment much sooner. 

That might sound like a small improvement, but in snakebite medicine, minutes matter.

Australia still has lessons to teach

Despite having some of the world’s most venomous snakes, Australia has one of the lowest snakebite fatality rates anywhere.

That’s no accident.

Our success comes from decades of public education, the pressure immobilisation technique, rapid emergency response and well-developed antivenoms.

It’s proof that snakebite doesn’t have to be a death sentence.

But it’s also a reminder that these advances should be available to everyone—not just people fortunate enough to live in developed countries.

Why this matters to all of us

As someone who has spent decades working with snakes, I see two very different sides of these animals.

On one hand, snakes are fascinating, ecologically important creatures that deserve our respect and protection.

On the other, snakebite remains one of the world’s most overlooked medical emergencies.

The answer isn’t to fear snakes.

Nor is it to wage war against them.

The answer is education, conservation, better medical science and ensuring that the latest treatments reach the people who need them most.

The research being led by scientists such as Professor Nicholas Casewell, Dr Steven Hall, Keirah Bartlett and their international collaborators gives genuine reason for optimism. For the first time in generations, we may be entering a new era of snakebite treatment—one that moves beyond century-old technology towards faster, safer and more effective therapies. 

For a disease that has been neglected for far too long, that’s very welcome news indeed.