How and why snakebite became a global health priority: a policy analysis.

Area of Science:

• Global Health Policy
• Public Health
• Neglected Tropical Diseases

Background:

• Snakebite envenoming was officially recognized as a neglected tropical disease (NTD) by the World Health Organization (WHO) in 2017.
• This recognition was followed by a World Health Assembly resolution in 2018 and a global target set in 2019 to reduce the burden of snakebite.
• Understanding the process and drivers behind snakebite's elevation to a global health priority is essential for public health strategies.

Purpose of the Study:

• To analyze the policy dynamics and network structures that led to snakebite's prioritization on the global health agenda.
• To identify the key factors and challenges influencing the inclusion of snakebite within the framework of neglected tropical diseases.

Main Methods:

• A policy case study approach was employed, utilizing in-depth interviews and a comprehensive review of both peer-reviewed and grey literature.
• The analysis was guided by Shiffman et al.'s established framework for understanding global health networks.

Main Results:

• Snakebite prioritization evolved through four distinct phases: pre-crescendo, crescendo, de-crescendo, and re-crescendo.
• The core network initially comprised academics and expanded to include civil society and state actors, enhancing engagement with WHO processes.
• Effective issue framing, particularly focusing on antivenom solutions amidst cultural perceptions of snakes, was pivotal in the re-crescendo phase.

Conclusions:

• Snakebite's current position on the global health agenda appears precarious, highlighting the need for sustained efforts.
• Key challenges include ensuring network legitimacy and addressing the WHO's criteria for classifying diseases as NTDs.
• Future prioritization analyses should incorporate temporal patterns and legitimacy dimensions for a more robust understanding.