Did the WHO recognition of snakebite as a neglected tropical disease impact national NTD master plans in 15 African countries?

In 2018, the World Health Organization (WHO) acknowledged Snakebite Envenoming (SBE) as a Neglected Tropical Disease (NTD). The WHO set a target for 2030 to halve the number of snakebite victims and published a roadmap to assist affected countries with drafting national SBE policies. These national SBE policies define the course of action to reach country specific and global goals. In order to review the policy environment needed to reduce the burden, we studied if SBE policy was included in national NTD programmes and if it included the four WHO SBE policy aims and a vision for the integration of NTDs. National NTD masterplans were reviewed and combined with in-depth interviews focusing on stakeholders' experience with the integration of SBE in NTD programmes, and the influence of the inclusion of SBE on the NTD list. Only 18% (2 out of 11) of 2015-2020 NTD masterplans mentioned SBE whereas all twelve countries who published masterplans for 2020-2025 included SBE and the need for an integrated approach between NTD programmes. Information on the type of activities allowing integration or the organizational aspects of an integrated approach was often missing. The extent to which the core policy aims of the WHO SBE roadmap has been elaborated differs considerably from country to country. In the interviews, several stakeholders raised the importance of improving the quality of epidemiological data to convince policy makers of its importance, to base antivenom distribution and to facilitate overall policy making. The path of improvement that has been taken since the recognition of SBE as an NTD must be continued and benefits from a closer collaboration between policymakers, researchers and healthcare workers to reduce the evidence gap and, ultimately, to improve care.