Strengthening essential medicines policy to improve antivenom availability and affordability for snakebite envenomation in rural sub-Saharan Africa

Abstract

Snakebite envenomation remains a Neglected Tropical Disease (NTD) globally and in most sub-Saharan African countries; however, it causes the majority of morbidities, disabilities, and mortalities, affecting mostly the rural population who engage in agriculture, pastoralism, and hunting. Despite the inclusion of antivenom in the World Health Organization (WHO) Essential Medicines List, access to and affordability of safe and effective antivenom in rural areas in most sub-Saharan countries remain severely constrained by higher cost, a fragile supply chain, and policy implementation gaps. Consequently, preventable snakebite-related morbidities, mortalities, and disabilities persist in rural areas with higher incidences of snakebites. Therefore, this article examines the epidemiological burden of snakebite envenomation in rural areas of sub-Saharan countries, highlighting how the high cost and limited affordability of antivenom directly contribute to morbidities, mortalities, and disabilities, and urging for an urgent revision and strengthening of the implementation of the WHO and local Essential Medicine Policies.