As many as 137,000 people die from venomous snake bites every year. High quality antivenoms exist, but they're expensive and hard to make. In Australia, Billy Collett risks his life by milking hundreds of venomous snakes a week. Antivenom also requires plasma from animals like horses. We traveled the globe to learn why snake bites are still a global health emergency, and why antivenom production still requires animals.
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00:00 And you can see there an absolutely massive yield.
00:09 And that amount of venom there is enough to kill a couple of hundred grown men, no worries.
00:16 Billy Collette is collecting venom to help make life-saving medicine for snakebites.
00:21 These guys are literally one of the most toxic snakes on the planet.
00:25 Millions of people suffer venomous snakebites every year around the world.
00:30 If you get bitten by a rattlesnake, it's like having your hand smashed with a hammer.
00:34 The most common way of making antivenom is by first injecting snake venom into animals
00:39 like horses and then drawing their blood.
00:43 But producing it is expensive, and some parts of the world are facing a desperate shortage.
00:50 As many as 137,000 people die from snakebites each year.
00:55 We call these neglected tropical diseases, and it's really important that we find ways
01:01 to solve it.
01:03 So why are animals still used to make antivenom?
01:06 And what can we do to solve this hidden health crisis?
01:16 This lab is one of the only places in Australia milking snakes.
01:21 My mum in particular thinks I'm a lunatic because I wanted to do this for a job.
01:27 Billy cares for 300 deadly snakes.
01:30 Coastal taipans, eastern browns, tiger snakes, common death adders, and king browns.
01:37 First he prepares the milking cup.
01:39 So if you went to a nightclub or a pub and you asked for a shot, like fireball, this
01:43 is what they give it into.
01:45 I know a fellow that was bitten by a large coastal taipan.
01:49 Within about 15 minutes he was showing symptoms.
01:54 He was extremely nauseous, vomiting, sweating, and by the 20 minute mark he was almost unconscious.
02:00 He was bleeding out of his eyes, his gums, every orifice in his body.
02:04 He was in a coma for 11 days, but he did survive that bite.
02:13 So this is a tiger snake.
02:15 These guys are literally one of the most toxic snakes on the planet.
02:20 And you can see I'm using the snake hook here to keep the head away from my hand and the
02:25 rest of my body.
02:26 And when we're coming into the milking process, basically I drop the hook like that, I have
02:31 the snake in my right hand, we've got a soft pinning pad there, so this is basically like
02:36 a foam mattress.
02:37 I've got my pinning device which is a clear Perspex disc.
02:42 What we do is we flick the snake onto the pinning pad like that, apply the pinner, and
02:48 I can see exactly where its head is, and I can have my fingers right there ready to go.
02:57 And so that's the snake restrained.
02:59 And the next part is where I actually milk the snake.
03:10 So what he's going to do is he's going to think he's bitten me.
03:14 There we go.
03:16 Nice yield there.
03:18 And that amount of venom, that's enough to kill over 50 adult men.
03:27 There are about 600 species of venomous snakes around the world.
03:31 Concentrated in these hot spots, Australia is home to more than 100 of them.
03:36 Australia's got more venomous snakes than non-venomous snakes.
03:39 We're the only country in the world with that.
03:42 Each snake's venom is made up of a unique cocktail of toxins that attack your body.
03:46 A king cobra's venom often goes after the nervous system and can kill a human in 15
03:51 minutes.
03:52 A viper's venom can stop blood from clotting and cause internal bleeding.
03:57 And in rare cases, bites can stop your heart.
04:01 Each week, Billy milks over 100 different snakes, including this coastal taipan, one
04:05 of the most dangerous in Australia.
04:08 This venom could cause paralysis.
04:11 Taipans are so reactive and they're so smart and calculated, they do make me very nervous
04:18 to work with.
04:25 And you can see there an absolutely massive yield.
04:30 And that amount of venom there is enough to kill a couple of hundred grown men, no worries.
04:37 So, once we milk the snakes, we then freeze it, just in a basic freezer.
04:48 So, the venom's assored with the different species, and you'll notice taipan venom, once
04:54 it's frozen, is actually pink.
04:56 So all the different species have actually got different coloured venom.
05:00 Down here, we've got the tiger snake, and you can see it's like a light yellowy sort
05:06 of a colour.
05:07 Eastern brown's clear, the king brown is a really rich, deep, dark yellow, like you can
05:15 see here.
05:17 A few months later, when we've got enough together, we'll actually freeze dry it.
05:21 We turn this on, we set it to minus 56 degrees Celsius, and basically it freezes, freeze
05:28 dries and draws all that moisture out within about 48 hours, and we're left with this crystallised
05:34 product.
05:36 Freeze-dried venom is easier to transport and lasts longer.
05:40 Billy says the venom from his lab has saved over a quarter million lives in Australia.
05:45 It's a huge weight on our shoulders, but we're all extremely passionate and proud of the
05:52 work we do here.
06:02 And snakes aren't the only animals needed.
06:07 Horses are also key to making antivenom.
06:10 We're producing a medication, so the horses need to be healthy, need to be in a good body
06:15 condition.
06:19 Mauricio Aguardas is in charge of the farm run by Instituto Clodomiro Picado, Central
06:24 America's only supplier of antivenom.
06:28 His team injects horses with small doses of venom.
06:33 It's important they're precise.
06:35 Too much could hurt the horse.
06:37 It's a very dangerous process.
06:40 We need to be really careful with everything that we do here.
06:45 The horses will begin to produce antibodies, which will eventually become antivenom.
06:51 The healthier the horse, the more antibodies they produce.
06:56 Mauricio's team collects their blood every two weeks.
07:03 They wash and shave the horse's neck to prevent infection.
07:07 Then they extract blood from the horse's jugular vein.
07:11 It takes less than a half an hour to collect six liters.
07:15 Just one blood bag is worth over $500.
07:19 We separate the plasma, and from the plasma we separate the antibodies, and that's what
07:24 you get injected if you get bitten by a snake.
07:31 Scientists have used horse blood to make treatments since the 1800s.
07:36 Inspired by vaccine science of the era, the French doctor Albert Comet injected cobra
07:41 venom into rabbits and horses.
07:44 He used their blood to make an early version of antivenom.
07:48 Animals like horses are still used today, because they have a lot of blood to produce
07:52 antibodies at scale.
07:54 We're producing a medication that's able to save lives.
07:58 It's something that's very appealing and very rewarding.
08:09 This lab, nine miles away, receives the plasma from the farm and converts it into antivenom
08:13 that's safe to inject into humans.
08:16 It can protect against a wide variety of snakes, but it doesn't come cheap.
08:20 I would say that the cost of production would be around maybe $15 to $20, something like
08:27 that.
08:28 The lab produces roughly 120,000 vials a year.
08:32 They end up across the Americas and Africa.
08:35 Depending on the snake, we may require between 10 or 20 vials per person.
08:43 The sooner a victim is treated, the more likely they are to survive and recover quickly.
08:49 It's a recovery David Williams of the World Health Organization knows well.
08:53 He has survived six snake bites in his life.
08:56 The product we used in Papua New Guinea, we had a survival rate of nearly 99%.
09:04 But not everyone has access to quality antivenom, and as many as 137,000 people die from snake
09:10 bites each year.
09:12 And there could be thousands more unreported.
09:16 Every year, there are an estimated 58,000 snake bite deaths in India alone.
09:22 The Irulod Cooperative collects most of India's venom.
09:25 It pays its members to catch snakes, nearly $30 for a spectacled cobra, or about $3.50
09:32 for a soft-scaled viper, seen here.
09:36 The cooperative collects venom from India's four most dangerous snakes, which is blended
09:40 together to make one antivenom.
09:43 But roughly 65% of India's population lives in rural areas, far from city hospitals, making
09:51 it hard to get antivenom to victims in time.
09:58 The same problem exists in sub-Saharan Africa, where as many as 30,000 people die a year
10:03 from snake bites.
10:05 Many victims don't go to hospitals, so the data is hard to track.
10:09 Because the world doesn't look at this problem, it is the poor person at the end of the line
10:13 in the community that cannot afford it that's the person that's bitten.
10:18 Before his death in 2019, Royan Taylor dedicated his life to improving antivenom access for
10:24 poor rural communities in Kenya.
10:27 There is a need for antivenom because we don't have enough antivenom now.
10:35 Alvion Ndunge's child was bitten in Kituwi County, Kenya, about 100 miles east of Nairobi.
10:40 It was black and it started to bleed.
10:44 The doctor said that the baby had to be removed so that it wouldn't harm his hands.
10:59 The county has to use a motorcycle ambulance to get some victims to hospitals.
11:04 But not everyone gets medical help in time.
11:09 Wende Kilonzo's child died after a snake bit her in the middle of the night.
11:14 I woke up in the morning, went to the toilet, and I washed my hands.
11:23 I met my daughter when I got home.
11:39 The Kenya Snake Bite Research and Intervention Center hopes to develop the first antivenom
11:44 in East Africa.
11:45 No one has produced any kind of antivenom in Kenya.
11:50 We call it African Paphira.
11:52 This is the most common snake we come across in Africa.
11:56 It seems to bite many people.
11:59 It's also one of the most deadly on the continent.
12:03 In Sub-Saharan Africa, the most effective treatment for a snake bite can cost more than
12:07 $100 a vial.
12:09 And victims sometimes need more than 10 of them.
12:14 Many of the people who get bitten are breadwinners.
12:16 So if they're in a hospital bed, their family's going hungry.
12:20 Many victims couldn't afford treatments, so some manufacturers stopped producing antivenom
12:24 for Sub-Saharan Africa altogether.
12:27 Today there's a dire shortage of quality antivenom.
12:32 The Kenya Intervention Center has a database of venom from local snakes, but hasn't been
12:36 able to set up a horse farm or antivenom lab yet.
12:40 You need to have the land.
12:41 You need to maintain the land, the pastures, do all the maintenance.
12:46 To set up an antivenom manufacturing facility to the right specifications is going to cost
12:51 somewhere between $10 and $30 million.
12:56 A few countries have greatly reduced their death rates, thanks in part to government
13:00 investment.
13:01 In Costa Rica, just one to two people die each year from snake bites.
13:06 Australia's death count is just as low.
13:09 Both countries have free antivenom treatment.
13:12 But places worldwide, you have to pay for antivenom and it is unbelievably expensive.
13:18 So here in Australia, we are unbelievably lucky that the government looks after us in
13:23 that way.
13:24 These are some interesting ones, yeah.
13:32 Researchers like Matthias Bittenbinder are trying to make antivenom cheaper and more
13:36 accessible.
13:38 His work is partly funded by the Naturalis Museum, which preserves 30,000 snakes for
13:43 research.
13:44 Some of the jars are over 100, 150 years old.
13:49 This is a really interesting species.
13:51 This is the Russell's viper.
13:54 And this is one of the species that is most heavily feared in India.
13:59 And also one of the species that we're studying in our lab.
14:06 Matthias is researching ways to produce antibodies in a lab, which would eliminate horses from
14:11 the process and require less venom from live snakes.
14:14 If you're not using the animals as the factories to produce the antibodies, you could produce
14:21 them in bulk in the lab.
14:25 So we're standing now in front of our, basically our chamber of secrets.
14:31 And in here, this is where we keep our snake venoms.
14:40 He's studying how venom affects the human cells in this well plate.
14:44 We have a venom of a rattlesnake, which we know is capable of destroying the cells.
14:53 We can see these, like, very prominent holes.
14:57 So you can imagine that when you get bitten by a rattlesnake and then the venom's caused
15:01 to punch holes in your blood vessels, then you will bleed out from the inside.
15:07 Matthias hopes his research will help scientists develop an oral tablet that would work on
15:12 all snake bites.
15:14 It could be the Holy Grail, which makes it possible to neutralize the effects of all
15:19 the different snake species.
15:21 That would make it easier to get treatment to victims in rural communities hit hardest.
15:26 This is my hope, and to be able to study these magnificent creatures and their effects, but
15:34 also to help the people that need it the most.
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