Introduction

Setting the scene with snakes and snakebites as an example

Snakebite envenoming is a neglected tropical disease, as are the envenoming and poisoning caused by a wide range of other terrestrial and aquatic animals.
When considering patients affected by envenoming or poisoning from aquatic or terrestrial animals, it is equally appropriate to describe them as 'neglected', especially if they live in socioeconomically disadvantaged parts of the world with dysfunctional healthcare systems.
The right to live without physical or mental harm, and the protection of the biosphere — to which both humans and venomous and poisonous animals belong — are under increasing threat, and are increasingly coming into conflict with each other. The people responsible for these alarming developments are not usually among those most immediately affected by their consequences, such as climate change, uncontrolled urbanisation, biosphere degradation and species extinction — at least not until it may be too late.

There are gaps in our knowledge of venomous and poisonous animals and their behaviour. We still need to improve our understanding of the pathophysiology of venoms and poisons in humans, and of the therapeutics that counteract their effects.
Interest in investing in the development of both new (e.g. “small molecules”) and established therapeutics (e.g. antivenoms) remains too low.
There is insufficient production and access to therapeutics of an appropriate standard (GMP), such as antivenoms (the specific therapy for envenoming) and antidotes (for poisoning).
The rapidly changing overlaps between the living spaces of humans, life stock and venomous and poisonous animals require greater attention, regulation and investment (e.g. due to changes in land use and the need to ensure safety at work and at home).
The key to providing treatment and saving lives is functional health services with trained personnel, sustained availability of equipment and materials, and access to financing.

Collecting key information about an illness or injury in a standardised way using the SAMPLE approach, such as exploring acute signs and symptoms and asking about allergies and medications.
Employing the ABCDE approach applicable to all medical emergencies. This includes clearing blocked airways, providing respiratory support if a patient stops breathing and administering cardiovascular treatment if circulation or heart function fails, etc..
Comprehensive ABCDE approach
ICRC Basic Emergency Care: approach to the acutely ill and injured

Antivenoms and antidotes are essential for treating envenoming and poisoning.
Specific therapeutics' require identification of the culprit.
A multitude of antivenoms are produced to varying standards. The quality and accessibility of antivenoms that meet appropriate standards varies widely around the world.
Great efforts are being undertaken to secure appropriate standards (GMP) and access for people in need.
WHO: Snakebite envenoming - A strategy for prevention and control
WHO: Antivenoms
WHO Snakebite Information and Data Platform