Lok Sabha Question No. 1014 (UNSTARRED), answered on 2020-02-07
Subject: Snake Bite Deaths
Ministry: HEALTH AND FAMILY WELFARE
Asked by: T.N. Prathapan

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 1014 TO BE ANSWERED ON 7 th FEBRUARY, 2020

## SNAKE BITE DEATHS

## 1014. SHRI T.N. PRATHAPAN:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a) whether as per media reports India is considered as the high burden country in terms of snake bite death/ injury/disability and the policies and actions are not adequ t in this regard, if so, the details thereof al ong with recent snake bite and injury/disability reported, State/ UT wise;
- (b) the steps taken/proposed to address the issues related to reporting/non - reporting of the snake bite death/ injuries/disability and to implement the recent WHO's global strategy for prevention and control of snake bite envenoming in India;
- (c) whether the Government is considering a national strategy of snake bite envenoming to control, prevent and address the India specific situation and if so, the details thereof;
- (d) whether the Government is aware of some studies on quality of the Anti - Snake Venom (ASV)  and  its effectiveness  in  mitigating  snake  bite  and  the  WHO standards  not  being followed in ASV currently manufactured in India in terms of collection, storage, transport and purification and if so, the details thereof;
- (e) whether low price fixed for Indian ASV by DPCO is hampering its quality and putting lives in danger, if so, the details thereof; and
- (f) the measures taken/proposed to improve the manufacturing standard an d quality of ASV that is representative of snake species all over the country?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI ASHWINI KUMAR CHOUBEY)

- (a) : As per data available with Central Bureau of Health Intelligence (CBHI), under this Ministry the State/UT - wise details of cases and deaths reported due to snake bites, during last three years in the country are given in annexure.
- (b) & (c) : Indian Council of Medical Research (ICMR) has constituted a 'National Task Force for Research on Snake Bite in India' with the following national level multi - centric projects:
- I. Nationwide Study to estimate incidence, mortality, morbidity and economic burd due to snakebite in India
- II. ICMR National Snakebite Project (INSP) on capacity building of health system on prevention and management of snakebite envenomation including its complications.

Ministry of Health and Family Welfare has also issued directions to all the State to  includes  Anti  Snake  Venom  Serum  (ASVS)  in  the list  of  essential  drugs  of  the  State, procure these drugs locally for supply to Health Facilities for use to the needy per support the same under National Health Mission.

(d): As per information available i n public domain, one study has indicated that currently marketed  anti - venoms  were  found  to  exhibit  poor  dose  efficacy  and  venom  recognition potential  against  the  venom  of  neglected  snake  species  while  the  marketed  anti - venom formulations  are  meant  for  the commonly  found  four  snake  species.  The  snake  venom antiserum  is  required  to  be  manufactured  in  India  as  per  the  provision  of theDrugs  and Cosmetic Act, 1940 and r ulesframedthereunder .

(e)& (f) : The drug manufacturer s  in  the  Country  are  required  to comply  with  the standard s laid  d own  in  the  Indian  Pharmacopoeia  and  the  provisions  of  the  Drugs  & Cosmetics Act, 1940. As per the rules framed under the Drugs & Cosmetics Act, 1940, applicants  of  drug  manufacturing  units  have  to  mandatorily  submit  eviden ce  of  stability, safety of excipients, etc. to the State Licencing Authority.

Government have taken measures to ensure quality of the Drug , such as, amendment in  t he  Drugs  and  Cosmetics  Act,  1940  to  provide  stringent  penalties  for  manufacture spurious and adulterated drugs including making some offences cognizable and non - bailable , t he  testing capacities of Central Drugs Testing Laboratories under Central Drugs Standard Control Organization ( CDSCO ) are strengthened to expedite testing of drug samples i n the country, joint pre - inspection of manufacturing units before grant of licence, joint inspe of manufacturing units to ensure compliance with the conditions of license and the provisions of the Drugs & Cosmetics Act and rules as per risk based appr oach, etc.

Annexure State/UT- wise Cases and Deaths due to Snake Bite during the years 2016 -2018

| S. No.   | State /U.T        | 2016     | 2016   | 2017     | 2017   | 2018 (Provisional)   | 2018 (Provisional)   |
|----------|-------------------|----------|--------|----------|--------|----------------------|----------------------|
| S. No.   | State /U.T        | Cases    | Deaths | Cases    | Deaths | Cases                | Deaths               |
| 1        | Andhra Pradesh    | 20,809   | 28     | 20,953   | 85     | 25,964               | 117                  |
| 2        | Arunachal Pradesh | 43       | 0      | 37       | 0      | 13                   | 1                    |
| 3        | Assam             | 265      | 0      | 810      | 0      | 2,318                | 0                    |
| 4        | Bihar             | 3,334    | 11     | 2,848    | 14     | 2,924                | 31                   |
| 5        | Chhattisgarh      | 3,533    | 60     | 4,109    | 52     | 4,148                | 33                   |
| 6        | Goa               | 620      | 1      | 1,189    | 8      | 1,025                | 1                    |
| 7        | Gujarat           | 5,872    | 72     | 6,209    | 49     | 7,064                | 50                   |
| 8        | Haryana           | 814      | 4      | 944      | 6      | 977                  | 7                    |
| 9        | Himachal Pradesh  | 1,587    | 23     | 1,465    | 9      | 2,105                | 30                   |
| 10       | Jammu & Kashmir   | 1,357    | 0      | 1,422    | 1      | 1,391                | 1                    |
| 11       | Jharkhand         | 749      | 15     | 788      | 2      | 481                  | 2                    |
| 12       | Karnataka         | 9,730    | 46     | 8,084    | 28     | 7,507                | 30                   |
| 13       | Kerala            | 3,019    | 12     | 3,608    | 13     | 4,189                | 11                   |
| 14       | Madhya Pradesh    | 5,010    | 113    | 5,346    | 96     | 2,646                | 39                   |
| 15       | Maharashtra       | 29,629   | 67     | 16,708   | 35     | 18,707               | 32                   |
| 16       | Manipur           | 118      | 0      | 150      | 0      | 50                   | 1                    |
| 17       | Meghalaya         | 405      | 0      | 282      | 2      | 327                  | 0                    |
| 18       | Mizoram           | 205      | 0      | 278      | 0      | 368                  | 0                    |
| 19       | Nagaland          | 106      | 0      | 136      | 0      | 245                  | 0                    |
| 20       | Odisha            | 15,405   | 120    | 15,274   | 147    | 8,003                | 98                   |
| 21       | Punjab            | 1,511    | 8      | 918      | 3      | 1,421                | 4                    |
| 22       | Rajasthan         | 4,929    | 32     | 6,720    | 45     | 5,810                | 30                   |
| 23       | Sikkim            | 242      | 2      | 130      | 0      | 117                  | 1                    |
| 24       | Tamil Nadu        | 16,277   | 44     | 13,668   | 38     | 14,027               | 50                   |
| 25       | Telangana         | 13,729   | 96     | 2,975    | 2      | 3,306                | 9                    |
| 26       | Tripura           | 430      | 1      | 779      | 1      | 813                  | 2                    |
| 27       | Uttarakhand       | 194      | 3      | 128      | 0      | 208                  | 2                    |
| 28       | Uttar Pradesh     | 6,640    | 118    | 7,448    | 128    | 7,623                | 73                   |
| 29       | West Bengal       | 25,481   | 138    | 31,072   | 268    | 36,229               | 203                  |
| 30       | A & N Islands     | 294      | 0      | 195      | 1      | 208                  | 5                    |
| 31       | Chandigarh        | 3,089    | 36     | 1,294    | 9      | 829                  | 14                   |
| 32       | D & N Haveli      | 609      | 9      | 626      | 7      | 733                  | 4                    |
| 33       | Daman & Diu       | 51       | 0      | 99       | 0      | 130                  | 0                    |
| 34       | Delhi             | 200      | 4      | 263      | 2      | 168                  | 1                    |
| 35       | Lakshadweep       | 0        | 0      | 0        | 0      | 0                    | 0                    |
| 36       | Pondicherry       | 2,147    | 5      | 1,695    | 9      | 1,957                | 3                    |
|          | Total             | 1,78,433 | 1068   | 1,58,650 | 1060   | 1,64,031             | 885                  |