Climate shock | Snakebite deaths reveal systemic failures

Kerala has recently been facing a concerning public health crisis of a growing incidence of snakebite deaths driven by rising temperatures and climate change. Human-animal conflicts are not new to this state.

The state’s unique geographical structure, characterised by extensive forest cover along with high population density, has gradually pushed plantations and agricultural activities closer to forested regions.

As a result, recent years have witnessed a growing number of human–animal conflicts, including crop destruction, elephant-caused fatalities, and leopard incursions into populated areas. This makes the recent rise in snakebite cases not just an ecological issue, but also a public health and governance challenge.

Rising climate-induced heat shocks are reshaping human-animal interactions. The spike in human–animal conflicts highlights how emerging climate-linked public health challenges can create new vulnerabilities.

Snakebite incidents aren’t just isolated medical emergencies, but are a combined outcome of governance structures, socio-economic conditions, public health systems, and ecological changes. This makes snakebite mortality a climate-sensitive governance challenge that requires a systems-based approach to understand and address its multidimensional nature.

In 2017, the World Health Organization recognised snakebite envenoming as a high-priority neglected tropical disease. In response, the Ministry of Health and Family Welfare has adopted a National Action Plan for the Prevention and Control of Snakebite Envenoming (NAPSE), which aims to reduce snakebite-related deaths and disabilities by half by 2030.

Venomous snakebites can cause paralysis, breathing failure, haemorrhage, permanent disability, and even limb amputation. In India, the highest prevalence of snakebites is reported in West Bengal, Odisha, Tamil Nadu, Andhra Pradesh, and Maharashtra. Odisha has integrated snakebite management into broader disaster management plans.

Research shows that snakebite mortality is associated with poverty, institutional gaps, and ecological vulnerabilities. This is especially true in the rural and tribal regions of Odisha, where dependence on agriculture for livelihoods is high, and farmers walk barefoot in open fields, increasing their vulnerability to snakebites.

Thus, making agricultural workers, children, and people in rural or poorly built homes remain vulnerable. Although anti-venom treatment is available locally in Odisha, there have been cases of limited availability and accessibility of such medication in remote regions.

Delayed access to healthcare increases fatalities, with India accounting for half of global snakebite deaths. Timely administration of the right dose of an appropriate anti-venom remains critical to saving lives. Local government bodies and health workers can play a crucial role via basic clinical training, early diagnosis, and bedside interventions.

The paradox of Kerala, a state with a robust healthcare system and a higher per capita income than Odisha, is that it continues to face a serious public health challenge in the form of snakebite-related deaths.

Kerala must utilise its local bodies more effectively to ensure the timely availability of anti-venom and raise public awareness about reducing snakebite fatalities through training programmes for students.

Optimal use can be derived by making anti-venom widely available, training ASHA and Anganwadi workers in first-aid, and identifying hotspots during heatwaves and monsoon. Co-ordination across primary healthcare centres and disaster management authorities is essential in addressing this growing climate-linked challenge.

Such incidents are expected to increase globally in the coming years. Climate change is driving venomous snakes, being ectothermic animals that depend on external temperatures for survival, to migrate toward cooler regions, many of which overlap with human settlements.

Recent studies indicate that global warming has already contributed to the redistribution of venomous snake populations across South Asia, North and South America, Sub-Saharan Africa, and West Asia over the past decade.

South Asian countries have witnessed a notable rise in snakebite incidents. Identifying snakebite hotspots vis-à-vis climate change, timely availability of effective antivenoms, and strengthening public awareness are among the key pillars of an effective snakebite management strategy.

In India, existing guidelines address snakebite management at multiple levels, but not in all states. For example, the State Relief Commissioner of Odisha provides prevention tips and first-response guidance, while the National Health Mission offers comprehensive clinical guidelines.

In March 2024, the National Action Plan for Prevention and Control of Snakebite Envenoming was launched, targeting a 50 per cent reduction in deaths by 2030 through a ‘One Health’ approach. However, these frameworks overlook the ecological degradation aspect, which is bringing humans and animals closer. This critical gap, if addressed, can significantly strengthen prevention efforts.

Digital health and AI-driven applications can play an important role in reducing snakebite mortality by improving public awareness, enabling faster emergency response, facilitating access to medical guidance, and strengthening co-ordination between communities and healthcare systems in vulnerable regions.

We posit that from Kerala’s forests to Odisha’s farms, snakebite deaths are not just medical emergencies but an early sign of a climate-driven public health crisis that existing governance frameworks aren’t sufficient to address.

Megha Jacob is Assistant Professor, Department of Economics, Jesus and Mary College, University of Delhi. Swosti Subhrajyoti Sahoo is PhD scholar, Department of Policy and Management Studies, TERI School of Advanced Studies, New Delhi. Sukanya Das is Professor, Department of Policy and Management Studies and Dean (Research & Partnerships), TERI School of Advanced Studies, New Delhi.

(Disclaimer: The views expressed above are the author's own. They do not necessarily reflect the views of DH.)