Supreme Court to Centre: Act Now on India’s Snakebite Crisis

Snakebites represent a significant public health challenge in India, leading to substantial morbidity and mortality, particularly in rural regions. The Supreme Court of India, on January 27, 2025, underscored the pervasive nature of this issue and urged the Union Government to collaborate with all States to enhance the availability of snakebite treatments across medical facilities.

Epidemiology of Snakebites in India

India bears a disproportionate burden of snakebite incidents globally. A study spanning two decades (2000-2019) revealed that the country recorded approximately 1.2 million snakebite deaths, averaging 58,000 fatalities annually. Notably, around 70% of these deaths were concentrated in eight states: Bihar, Jharkhand, Madhya Pradesh, Odisha, Uttar Pradesh, Andhra Pradesh (including Telangana), Rajasthan, and Gujarat. The monsoon months from June to September witnessed a surge in cases, accounting for half of the annual deaths.

Further studies have indicated that the annual snakebite death toll in India could be as high as 64,000, with Uttar Pradesh reporting the highest number of fatalities, followed by Madhya Pradesh and Rajasthan.

State-wise Insights

• Maharashtra: In the fiscal year 2018-19, Maharashtra reported 42,026 snakebite cases, the highest in the country. District-wise, Nashik emerged as a hotspot, recording 4,294 cases, the second-highest for any district in India during that period. Factors such as the presence of the Western Ghats and extensive agricultural activities, including grape farming, contribute to the high incidence in the region.
• Andhra Pradesh: In 2019, Andhra Pradesh reported 467 snakebite-related deaths, making it the state with the second-highest fatalities after Odisha. This marked a significant increase from previous years, with 117 deaths in 2018 and 85 in 2017. The rise underscores the escalating public health concern in the state.

Challenges in Snakebite Management

Several factors contribute to the high mortality and morbidity associated with snakebites in India:

1. Scarcity of Anti-Venom: The availability of anti-venom, crucial for treating venomous snakebites, remains inconsistent across many regions. This scarcity is particularly pronounced in rural areas, where healthcare infrastructure is often inadequate.
2. Delayed Medical Intervention: Geographical barriers, lack of transportation, and limited awareness lead to delays in victims receiving timely medical care, exacerbating the severity of envenomation outcomes.
3. Healthcare Infrastructure: Many primary healthcare centers lack the necessary facilities and trained personnel to manage snakebite cases effectively, leading to referrals to tertiary centers, which may be located far from the incident sites.
4. Data Deficiency: Underreporting and inconsistent data collection hamper the formulation of effective public health strategies. Many snakebite incidents go unreported, especially those managed by traditional healers or in private clinics.

Supreme Court’s Directive

Recognizing the gravity of the situation, the Supreme Court’s Bench, comprising Justices B.R. Gavai and S.V.N. Bhatti, emphasized the need for a coordinated national response. The Court highlighted the widespread prevalence of snakebite incidents and mandated the Union Government to engage with all States to develop and implement strategies aimed at improving the availability and accessibility of snakebite treatments in medical facilities nationwide.

Recommended Strategies for Mitigation

To address the snakebite crisis effectively, a multifaceted approach is essential:

1. Enhanced Anti-Venom Production and Distribution: Scaling up the production of anti-venom and ensuring its equitable distribution, especially in high-incidence areas, is crucial. Establishing regional anti-venom banks can facilitate timely access.
2. Training Healthcare Providers: Regular training programs for healthcare professionals at primary and secondary care levels can improve the management of snakebite cases, ensuring prompt and appropriate treatment.
3. Public Awareness Campaigns: Educating communities about preventive measures, first aid, and the importance of seeking immediate medical attention can reduce mortality. Utilizing local languages and culturally appropriate messaging can enhance outreach.
4. Infrastructure Development: Strengthening healthcare infrastructure in rural areas, including establishing well-equipped primary health centers and improving transportation facilities, can facilitate timely medical intervention.
5. Research and Data Collection: Implementing robust surveillance systems to collect accurate data on snakebite incidents and outcomes can inform policy decisions and resource allocation.
6. Community Engagement: Involving local communities in developing and implementing snakebite prevention and management strategies ensures that interventions are contextually relevant and sustainable.

Snakebites continue to pose a significant public health challenge in India, necessitating a comprehensive and coordinated response. The Supreme Court’s directive underscores the urgency of the situation and the need for collaborative efforts between the Union and State Governments. By implementing targeted strategies focused on prevention, timely treatment, and infrastructure development, India can significantly reduce the burden of snakebite-related morbidity and mortality.