MEDIA10: Preventing deaths and disability from snakebites
resolved Jul 10

As part of Charity Entrepreneurship's 2023 Top Ideas contest, will we select "Preventing deaths and disability from snakebites" as a top Mass Media intervention?

Idea overview

Snakebites are estimated to cause over 100,000 deaths every year, and many more cases of disability, such as paralysis or amputations. While effective antivenoms are available in many hospitals in LMICs, medical care is often sought too late for them to be effective. This organization would use mass media to help people in rural areas understand the risk of snakebites and how to prevent them, as well as the importance of seeking professional help if they do get bitten by a snake.

Mass media interventions

By ‘mass media’ intervention we refer to social and behavior change communication campaigns delivered through mass media, aiming to improve human well-being. We intend to select 2-4 ideas out of the 10 presented to recommend to entrepreneurs who enter our incubation program. This market resolves YES if this idea is chosen; NO otherwise.

About the contest

In partnership with Charity Entrepreneurship, Manifold is sponsoring a $2000 forecasting tournament to inform which ideas end up selected

  • You can win part of a $1000 prize pool as a forecaster, for best predicting which interventions we choose.

  • You can win one of ten $100 prizes for posting an informative comment on Manifold that most influences our decision.

For contest details and all markets, see the group CE 2023 Top Ideas.

Get Ṁ200 play money

🏅 Top traders

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predicted YES

Hedge your bets here:

bought Ṁ600 of NO

This has been very interesting to look into. Looks like the WHO has some work in the media space right now. Ultimately as a neglected issue I suspect there’s more impact in scaling antivenom availability, or in the long term research on synthetics and storage, than in media campaigns. Media likely could have benefits but I just don’t see it passing the bar of more cost effectiveness than other interventions.

bought Ṁ25 of NO

I could imagine that many individuals are reluctant to seek medical care at hospitals because of financial concerns.

Additionally, I expect that the rate of actual very bad/deadly bites are very low. This feeds into some psychological intuition I have, reminding ourselves of the many psychological biases there are, that people might deceive themselves that their bite won't be the 'very bad' one.

bought Ṁ35 of NO

The number of people who are affected by snakebites is much smaller than other interventions, and this idea seems to not consider the costs involved in getting a snake bite treated, specifically in scenarios when people are far away from a clinic.

bought Ṁ100 of YES

I thought this article on snakebites (and data) by Saloni was great, both for highlighting how the problem is much more significant than the available numbers suggest, and for providing background for why so many more die from snakebites in India every year (50–60,000) versus Australia (just 2).

Others are saying how spreading information doesn't seem relevant to the problem, but I can see ways in which communication campaigns would be very helpful here.

  1. Ask/enable people to report snakes and snakebites. A big part of the puzzle is figuring out where people are most likely to die from snakebites, and what kind of snakes they are. Encouraging people to communicate this information helps alleviate the problem of missing data.

  2. Storing and transporting antivenom might be expensive but, if you have a wide-scale mass media campaign, you could kickstart the process of making wider distribution of antivenom more cost-effective. If people know there will be a supply of antivenom in a particular town, then more people will travel there when they need it, and it'll be more worthwhile keeping that facility well-supplied.

    1. Plus, mass media campaigns can help people go to the right clinic straight away. If people know that the antivenom needed for a particular snake (or set of symptoms) then they can (for example) go straight to the clinic that has the cold-storage antivenom if they know that's what they need.

    2. Additionally, it would be good to tell people to photograph/capture/kill the snake so that it can be identified. As highlighted in Saloni's blog, species-specific monovalent antivenom is cheaper and more effective than polyvalent antivenom, so sharing this knowledge could save a bunch of people.

Thinking bigger, you can see how 1 and 2 complement each other. Gathering more information on where fatal snakebites are taking place helps authorities know where to transport and store certain kinds of antivenom; communicating its recent availability in the local area is then a critical next step.

bought Ṁ21 of NO

MEDIA 10 (snakebite): I don’t like snakes but again it’s not clear that a lack of information is the major cause of snakebite deaths. I’d assume it has more to do with practical barriers like transportation.

bought Ṁ100 of YES

- People know snakebites are dangerous and have ways of preventing them (eg, from a comment on the EA forum post: "In Uganda (which is in the tropics), there is potential to see many snakes.  in order to prevent such occurrences, there is sensitization about removing bushes and trimming all grassy areas regularly. Furthermore, there are some plants which are used to prevent snakes from getting into homesteads, farms, etc. These include what are called 'snake plants', tobacco plants, etc., which are planted around farms and homes. That is the local way of keeping snakes away.").

- Antivenom is kind of hard to transport, so rural clinics often don't have it, so people who live far away from hospitals will have a hard time accessing it. This affects lots of people in e.g. Subsaharan Africa. Also, it's expensive - eg in Bangladesh 60% of victims who got treated went into debt to do it.

- Prophylactic antivenom can be harmful for bites from certain snakes, making a false-positive diagnosis costly to the patient, which implies that better or more widely propagated diagnosis algorithms might be valuable in rural clinics even if antivenom becomes cheaper or easier to distribute.

- This, from the WHO, might be promising: "[E]mergency responders must be appropriately trained to recognize the signs and symptoms of envenoming and of associated medical issues
that may be a threat to life during transport, such as severe shock, haemorrhage, airway
obstruction or respiratory paralysis. The training of ambulance personnel who transport
cases of snakebite envenoming will be improved in order to reduce pre-hospital mortality
and complications. Pre-hospital mortality is reduced measurably if there is appropriate
transport." I don't know how snakebite-specific this is or how much it can be addressed by mass media, but there could be some value to letting people know which medical issues are more likely to occur after someone gets bitten by a snake. (Then again, if snakebite is a big problem, wouldn't they or their culture know this from experience?)

Overall, I'm leaning toward snakebite being a large and increasingly tractable problem, but against media campaigns directed at potential victims being useful. On the other hand, in some regions it can be hard to tell which snake you were bitten by, and it seems reasonably promising to disseminate good diagnosis algorithms to local clinics, if only so practitioners can confidently tell patients "you need to get to a hospital asap". Worst case, it doesn't help at all and then we know that antivenom access (in terms of price, travel cost, and travel time) is the bottleneck, and maybe some competent organizers have momentum toward doing something about snakebites even if this approach doesn't work.

The best approach is probably to try and distribute diagnostic kits more widely – apparently the distribution of antivenom suffers from market failures which in turn limit the distribution of diagnostic assays. But this strategy also entails educating clinicians in remote areas about the use of the diagnostics, so maybe it count as mass-media-related. (In general, I think mass media interventions have to be viewed with a baseline suspicion of "if this info is so valuable, why doesn't it have the memetic power to propagate on its own?")

predicted YES

(Alternative approach: according to one source, it's often hard to unambiguously describe the correct snake, so it can be helpful for victims to kill the snake and bring it along to the hospital to aid in diagnosis and later research. So perhaps a charity could, say... place a bounty on every dead cobra in India.)

bought Ṁ20 of NO

GPT-4 ranked this #8 of the 10

"This intervention could save lives and prevent disabilities, but the scale might be smaller compared to some of the other issues."

predicted NO

Doesn’t seem particularly high impact especially given the scale of affected people