Tackling the burden of envenomation in Africa: advances, challenges, and strategic priorities for enhanced diagnosis and treatment

Venomous animal envenomation remains a significant but neglected public health problem worldwide, with an estimated 5.4 million cases and up to 138,000 deaths annually. The burden is particularly acute in tropical and subtropical regions, especially sub-Saharan Africa, where rural and vulnerable populations face limited access to effective antivenoms and healthcare. Despite this, comprehensive data on envenomation incidence, clinical management, and outcomes remain scarce, hampering efforts to develop effective prevention and treatment strategies. This review synthesizes current knowledge on venomous animal diversity, epidemiology, and clinical manifestations globally, with a focus on Africa’s unique challenges. We examine critical gaps in antivenom production, distribution, and affordability, and highlight international initiatives, including the World Health Organization’s 2019 roadmap for snakebite envenoming control. Recent advances in diagnostics, therapeutics, and community engagement are discussed alongside persistent barriers to implementation. Finally, we propose strategic recommendations to strengthen surveillance, improve antivenom accessibility, and foster regional collaborations to reduce envenomation morbidity and mortality in Africa. Addressing these challenges requires coordinated global and local efforts to translate scientific advances into sustainable health outcomes for affected populations.