India’s snakebite crisis kills tens of thousands every year

Devendra, who was a farmer in India, still remembers the moment a snake bit its fangs into his leg while he was 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 working to reduce deaths and injuries from snakebites.

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

Now, a new report by the GST has found that 99 percent of healthcare workers in India face challenges in administering antivenom — the life-saving antibodies that neutralize venom toxins. 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 insufficient training.

Almost half of professionals reported that treatment delays had resulted in serious complications for their patients, including amputations, surgery or lifelong mobility problems.

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

It also states that snakebites disproportionately affect poor rural communities in low- and middle-income countries.

In India, a high concentration of snakebite deaths and injuries is reported in the central and eastern regions, says Dr Yogesh Jain, GST member and practitioner in the central state of Chhattisgarh. He adds that people working in farms, including those from poor tribal communities, remain the most vulnerable.

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

Experts agree it’s a step in the right direction, but implementation has been inconsistent.

“In India, snake bites are seen as a poor person’s problem,” says Jain. “That’s why there isn’t enough outrage or action against these completely avoidable deaths. When it comes to treating snakebites, every second counts.”

He explains that snake venom enters the bloodstream within minutes, attacking nerves, cells or the circulatory system, depending on the species. Delays in the administration of antivenom can lead to 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 prevent timely treatment.

Last September, a pregnant woman in Gujarat state reportedly died on the way to a hospital after her family had to carry her in a canvas sling for 5 km (3 miles) because no vehicle could reach their hamlet.

Jain says some states are trying to improve access by stocking antivenom in primary and community health centers. But proper administration remains a major challenge.

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

“The 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 healers or local medicinal practices and only go to hospitals when their symptoms worsen, which can be fatal.

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

India currently has antivenom that protects only against the “big four” snakes – the spectacled cobra, common krait, Russell’s viper and the saw-scaled viper – which are believed to be responsible for most bites. The antivenom is produced by injecting the 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 no targeted antivenom. These include the green viper commonly found in the northern state of Himachal Pradesh, the Malabar viper and the hump-nosed viper found in the southern states and many other species in the northeastern states.

A study by Aiims (All India Institute of Medical Sciences) in Jodhpur, Rajasthan, last year highlighted the problem. It was found that when the antivenom used to treat saw viper bites was given to 105 patients with snake bites (where the species remained unknown), two-thirds did not respond well to the treatment.

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

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

He called on states to emulate the 2024 order by the southern Karnataka state government, which made snakebite a “notifiable disease” – making it mandatory for health professionals to report it to authorities – to combat underreporting.

Jain agrees. “Snake bite deaths begin where political will ends,” he says.

“Governments should make sure that poor people don’t have poor health systems. They deserve better.”

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