Snakes bite the poorest regions hardest

Published online 27 October 2022

Snakebite mortality remains high in certain parts of the world, with lower-income countries and war-torn regions bearing the highest burden.

Lara Reid

The Arabian cobra is a venomous snake species endemic to the Arabian Peninsula.
The Arabian cobra is a venomous snake species endemic to the Arabian Peninsula.
Roland Weihrauch/dpa/Alamy Live News
Although global deaths from snakebite venom are declining, mortality remains disproportionately high in lower-middle income and low-income countries. The World Health Organization set a target to halve snakebite mortality by 2030, but an in-depth study of global data suggests this goal will be missed without significantly improving access to emergency medicine and healthcare. 

“The huge disparity between rich and poor countries is alarming,” says Nicholas Roberts at Weill Cornell Medicine in New York, who led the study with an international team including researchers in Saudi Arabia, the United Arab Emirates, Egypt and Iran. “Snakebite mortality is preventable with rapid access to anti-venom, ideally within six hours of a bite, and adequate medical care.” 

However, poor access to healthcare and insufficient education remains a significant challenge in many parts of the world, together with a dependence on traditional healers in certain regions. As part of the Global Burden of Disease study, deaths due to overall venomous animal contact have been estimated for many years, but there has not been a rigorous assessment of the global snakebite envenoming problem since the mid-2000s, due to a lack of quality data. 

Roberts and his team built a large repository of high-quality data on snakebite envenoming from 204 countries, gathering information from verbal autopsy and death registrations from 1990 to 2019. In 2019, 63,400 people died globally from snakebites – a 36% decrease since 1990 – but 54,600 deaths were in South Asia alone, and sub-Saharan African countries had the second-highest mortality rate, with between 1.4 and 1.2 deaths per 100,000 people. 

In the Middle East, two countries showed higher mortality rates than the rest of the region – Yemen and Sudan. Roberts is grateful to the Middle East-based researchers for their first-hand insights that helped frame the context of the problem. 

“Both Yemen and Sudan are experiencing ongoing wars and unrest that have impacted their healthcare systems and exacerbated existing socioeconomic challenges,” notes Roberts. “Conflict increases the risk of snakebite envenoming due to displacement; people are forced to live outdoors, bringing increased overlap with, and disturbance to, local wildlife.”

The team are hopeful that this updated global assessment, which also identifies where gaps in data coverage persist, will boost collaboration on venomous snakebite research. 

“We hope to create awareness among impacted communities and health officials about the need to address this,” says Roberts. “We also plan to repeat our survey and provide health officials with insights into progress and share strategies that work.”


Roberts, N.L.S., et al. Global mortality of snakebit envenoming between 1990 and 2019. Nature Communications 12, 6160 (2022).