Venomous Snakes Represent a Serious Public Health Problem. Scientists Are Biting Back With a Groundbreaking Antidote

Researchers around the world are attempting to create a safer and more effective treatment in hopes of saving hundreds of thousands of lives

Ari Daniel

– Host, “There’s More to That”

March 12, 2026 9:27 a.m.

Snakes bite five million people each year, killing some 125,000 and disfiguring or blinding three times as many. Antivenoms aren’t always readily available where the problematic snakes live. They also can be deadly themselves, as they could induce life-threatening allergic reactions.

Within the last couple years, however, researchers have made substantial progress toward creating safer antivenoms, reducing the chance of anaphylaxis. Some dream of a universal remedy, but venom is a complex brew, and many of its most dangerous components remain unknown to science.

In this episode, host Ari Daniel speaks with journalist Victoria Malloy, who wrote a story for Smithsonian magazine about antivenoms, and researcher Irene Khalek. They discuss the danger of snakebites globally, the history of antivenoms and their traditional manufacture, and the various efforts underway to create safer versions.

A transcript is below. To subscribe to “There’s More to That,” and to listen to past episodes about the teeming world of migrating birds, bats and bugs above our heads; a prehistoric cave that entombed animals for millennia; and the army of experts and citizen scientists devoted to protecting native bees, find us on Apple Podcasts, Spotify, iHeartRadio or wherever you get your podcasts.

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Ari Daniel: Neville Wolmarans has been bitten more than 20 times by some of the deadliest snakes on earth.

Victoria Malloy: Mambas, cobras, puff adders—a full range of snake species that you could expect in the area where he’s based, in South Africa.

Daniel: That’s environmental journalist Victoria Malloy. She wrote about Neville and the emerging new science around antivenoms in a recent piece for Smithsonian magazine.

Malloy: In his line of work, he rescues and relocates snakes. So, he’ll actually get calls out from people in his area, who maybe have found them in their home, in their office, that kind of thing. And so just being in close proximity, he’s very much frontline engaging with them.

Daniel: Neville runs an educational reptile park containing the snakes and other creatures he rescues. His first real bite was back in 1971—a black mamba got him right through the cloth of the capture bag.

Malloy: The fangs came out through the bag and got him on the hand, in the finger.

Daniel: Though painful, that one turned out to be what’s called a “dry bite.”

Malloy: Not enough venom got into his system for him to suffer the potentially fatal effects from it.

Daniel: Yeah.

Malloy: But of course, not every bite is going to be like that, right?

Daniel: Sure enough, three years later, in 1974, Neville was bitten again by a black mamba, and this time the outcome was way more intense.

Malloy: A mamba bite can be fatal in under an hour.

Daniel: So he sped to the nearby hospital for treatment. He was in such severe respiratory distress that he was injected with 22 vials of antivenom.

Malloy: That’s when he discovered he was allergic to antivenom. It was administered to him, and his body almost immediately went into an anaphylactic shock response.

Daniel: He pulled through and recovered. But then many decades later, in 2019, he was bitten and again had a reaction to the antivenom.

Malloy: After sustaining multiple green mamba bites, doctors made the risky decision to use antivenom again, despite knowing his allergy. And it triggered anaphylaxis almost immediately. His airway closed, his temperature spiked, and he went into cardiac arrest, subsequently spending 18 hours in the ICU.

Daniel: Oh my goodness. From the remedy!

Malloy: From the remedy, yes. In his words, the thing that’s supposed to save you becomes the thing that can kill you. People are under the impression that it is a lifesaving treatment, and in many cases it is, but it also has inherent risks of its own.

Daniel: Why was the antivenom such an issue for him? Why did he have this anaphylactic reaction?

Malloy: Basically, it’s derived from horse serum. And that’s the reason for the allergy—it’s animal proteins that the body recognizes as foreign. So that generates that allergic response. And the process of immunizing horses to produce the antibodies, that really hasn’t changed in over 120 years. That’s still the way that it’s made.

Daniel: Wow.

Malloy: But as you can imagine, when fighting a toxin like venom, you need the neutralizing antibodies, and those antibodies have to come from somewhere. And so horses have robust immune systems capable of producing large quantities of antibodies. Their size also allows for repeated blood draws, and they generally tolerate the immunization process well. But it’s also the reason why severe reactions tend to be prominent.

Daniel: Again, because of those foreign proteins from the horse blood. And how common is this kind of severe reaction?

Malloy: One study of antivenom use in South Africa found that 47 percent of patients suffered anaphylaxis. And of those, 29 percent needed a breathing tube inserted.

Daniel: So this clearly suggests that there’s a problem with the current antidote to snakebites.

Malloy: Indeed.

Daniel: From Smithsonian magazine and PRX productions, this is, “There’s More To That,” the show that considers the dangers of the natural world and bites back. I’m Ari Daniel. In this episode, we slither into the science of snake venom, the global health concern around fatal snakebites and what’s being done to create more effective remedies. Stay tuned.

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Daniel: So what do these severe reactions mean, Victoria, for the way that antivenoms can be distributed?

Malloy: So because of those risks, antivenom is generally only administered in larger hospitals that are equipped to be able to intubate and resuscitate people if needed. And if you think about where venomous snakes inhabit, we’re talking vast rural areas in places like sub-Saharan Africa, South and Southeast Asia, Australia, parts of the Americas; particularly communities that live in rural areas that could easily be two- to three-hour drive from the nearest hospital.

Daniel: Boy.

Malloy: And when we’re talking about something like a mamba that we know can be fatal in under an hour, that poses a serious issue.

Daniel: Hospital access and severe allergic reactions aren’t the only potential pitfalls to caring for people with snakebites.

Malloy: Antivenom mismatches can be an issue as well, because they’re not a universal, broad spectrum. It’s based on being able to match the antivenom that’s been targeted to a specific species.

Daniel: Most of the time, that is.

Malloy: And in some cases, diagnostic tools in hospitals are limiting as well, in the sense that they might not be able to identify what species the snakebite is from, in which case, if you’re using an antivenom that’s targeting one species, and the snakebite is from another, then that’s going to reduce effectiveness.

Daniel: And I’m sure some of these snakebites, they happen so fast and people aren’t experienced in taxonomic differentiation of the snakes to know what they’ve been bitten by.

Malloy: That’s right.

Daniel: So what tends to happen to snakebite victims in these areas that may be located too far from a hospital or that have limited supply?

Malloy: People are, unfortunately, just dying. I read this one report of a woman who I guess was walking home from somewhere and needed to stop and relieve herself. And so she walked into the brush and then got bit and she ended up dying. Another woman who was getting out of her shower discovered a cobra that was in her bathroom—she got bit and unfortunately died.

Daniel: No!

Malloy: That’s the sad reality for a lot of people, I’m afraid.

Daniel: How big of an issue are snakebites currently worldwide?

Malloy: According to the World Health Organization, an estimated five million people are bitten by snakes worldwide each year.

Daniel: More than 125,000 of those people die.

Malloy: And three times as many survivors are left with permanent disabilities, like disfiguring loss of limbs, to the point where snakebite envenoming has been classified as a high priority neglected tropical disease by the WHO.

Daniel: But there are scientists out there working hard to develop safer, cheaper, broader spectrum and more widely available treatments—like Irene Khalek.

Khalek: I remember the description of the job, and it was for snakebite toxins, finding antibodies against them. And that immediately drew me in.

Daniel: That was around six years ago when she started working with the snake bite project at Scripps Research in Southern California.

Khalek: There hasn’t been a lot of change in that technology, whereas there’s been a ton of change in how we discover antibodies, how we engineer them. And so it was a unique opportunity for that.

Daniel: The big thing she says is being able to identify the antibody for each toxin in a snake’s venom. And that’s something we don’t actually know with today’s horse blood antivenoms.

Khalek: We know that there’s antibodies in there that neutralize the snake toxins. But we don’t know anything about their sequences, we don’t know how to make them. And they’re always going to be a different set of antibodies. One horse will make its own version of antibodies against the toxins, and that may change over the horse’s lifetime as well.

Daniel: So Irene and her colleagues are making synthetic antibodies in the lab instead.

Khalek: It’s a much more consistent product, Then you can trim down the number of antibodies that are actually needed in the formulation.

Daniel: It also has the potential to be cheaper. The way antivenoms are made and distributed today isn’t exactly cost-effective.

Khalek: Maintaining those large animal farms—they are very, very expensive, routinely having to bleed the horses. And in the case of venom, the horses need to be what they call hyperimmunized, so routinely injected with venom samples over a long course of time. So the blood is collected, it’s separated out into the plasma versus the cells, and the antibodies are essentially there in the plasma. And the amount of product you’re getting from that can be very, very small. They require very high doses. In the United States, sometimes people can end up with $80,000 worth of antivenom, $100,000, depending on how many vials they needed to have administered. Who is paying for that is, again, another question.

Daniel: And it’s so expensive because it’s this very elaborate, labor-intensive, horse-involving process?

Khalek: Yeah. Maintaining those farms is one thing, it’s also a drug that isn’t that commonly used, doesn’t have a huge market for it. It’s not a lucrative thing for a lot of companies to develop further on. The price of those farms is also something that’s difficult to drive down further, with typical market dynamics. But if we were able to switch over to a synthetic means of producing the antibodies, which is what our lab is working on, and other labs around the world as well, that is something that could come down in price as technologies develop to make the cells more efficient in producing those antibodies to make the media cheaper, potentially. There is potential to bring the cost of that down further.

Daniel: Irene’s lab is trying to do just that. They’re using simple yeast as the medium to search for specific antibodies to combat each snake venom toxin.

Khalek: We’re able to screen through billions of different antibody clones in a huge library of these yeast cells that are displaying a different antibody type. And we can expose them, then, to a certain toxin from a snake or anything we’re looking to target, and then continually sort down which ones are actually working, and then have some lead candidates that we can then synthesize, study more rigorously. So the yeast is a really useful system for that.

Daniel: A little more wieldy than a horse.

Khalek: Yeah, the yeasts are very pleasant to work with. You can essentially pour the media down the drain. It’s just like all the other breweries that are here in San Diego. It’s a nontoxic, nonhazardous species. It’s the same species used in brewing beer and making bread. So, yeah, they smell like beer and bread.

Daniel: What a lovely microscopic collaborator.

Khalek: Yeah.

Daniel: This approach arose, at least in part, from the way that research on AIDS treatment has been conducted.

Khalek: It seems like it’s very different than HIV, but there were actually a lot of parallels that the founders of the project saw in looking for antibodies that are what we call broadly neutralizing, so they can hit multiple variants. So of course with the HIV virus, it’s always coming up with new variants at its pace of evolution. But studying the antibodies that are the most effective by the very, very few people that make them, that neutralize that virus, we saw parallels in that to the case of snakebite, where you also have many, many different variants of the same toxin found in different species of snakes around the world.

Daniel: And they have made some progress. Irene’s team has targeted one type of protein in particular called the three-finger toxin. That’s one of the worst toxin types, because it can cause full paralysis in a bite victim, including closure of the airways.

Khalek: We did develop an antibody that was very broad across that toxin type found in all sorts of elapids in Australia, Asia, Africa. But of course we have to do that for multiple of the other toxin types.

Daniel: A quick note on snakes here. There are thousands of identified toxins lurking among the hundreds of different venomous snakes around the world, but essentially these snakes are divided into two main families.

Khalek: There’s the elapids, which include the cobras, the kraits, the mambas, coral snakes, sea snakes; and then the other family is the vipers, which includes your rattlesnakes, puff adders, saw-scaled vipers. And both of them contribute to a lot of the snakebite deaths, but they have very different venoms. The snakes are usually identified based on their fangs. So, the elapids have these short, fixed fangs, and the vipers have these longer, retractable fangs.

Daniel: The holy grail is to ultimately find a truly universal antivenom across both families, but—

Khalek: Since the toxin profiles are so different between vipers and elapids, it does make sense to have two separate antivenoms for that.

Daniel: So you’re saying you would need a universal elapid antivenom and a universal viper antivenom?

Khalek: Yeah. And again, how universal that can be is still a question. It is a problem as well with snakebites that people don’t often know what type of snake bit them, and what type of antivenom that they’re going to need. But it is at least a bit easier to identify whether the snake was an elapid or a viper. They do look different, but also they’re going to leave a different type of mark behind at the bite site based on those different type of fangs that they have. Also, from a development standpoint, limiting the number of antibodies that you actually need in that cocktail formulation is an advantage more simple to manufacture, but also pushing through the clinic to get regulatory approval.

Daniel: Irene’s lab is focused for now on the elapids. The proteins in elapid venom, those three-finger toxins, are smaller and more stable, which makes them easier to work with.

Khalek: But another colleague in the lab, who started around the same time as me, was working more on the viper toxins. She had a lot of experience with enzymes, and particularly large enzymes that come out of those snakes’ venoms. And those ones definitely were more challenging. They were a little more finicky, but people have found antibodies against them.

Daniel: In either case, scientists do need actual toxins in order to analyze them and search for antibodies. One way to get those toxins is from a process called “snake milking.”

Khalek: It’s not milk that you’re getting out, it’s venom. But it’s basically—a very experienced snake handler restrains the snake, they have their hand on the head of the snake, and the snake has an inclination to bite and inject venom in that situation. And they collect it into a glass or something like that. And then the snake can routinely do that, it recharges its venom and keeps it going.

Daniel: I think I’ve seen those videos where they essentially stretch a membrane over like a jar and then they put the snake on it and the fangs go in and then the venom just drips down into the base of the jar.

Khalek: This is the process also of how antivenoms are made these days. It’s that it requires snake milking and then injecting that into a large animal.

Daniel: But just like Irene’s lab is making antibodies synthetically, they can also make synthetic toxins for their testing purposes.

Khalek: Just taking the sequence that somebody’s discovered for a particular toxin variant, ordering the DNA to make that, synthesizing it in mammalian cells, and then purifying that. So that gives us a number of advantages in knowing exactly which toxin variant it is, and to plan those out in a way that we can maximize the diversity of the different toxin sequences that we’re looking for. Also, we can make something from a really rare snake, a snake that doesn’t do as well in captivity.

Daniel: But using fully synthetic toxins in the research does have some downsides.

Khalek: You don’t always know if the synthetic version of what you’re making is fully replicating the natural, native version. So, we found it helpful, ultimately, to work with both—to both work with our synthetic versions of the toxins and the real thing taken from venoms.

Daniel: Irene’s lab is one of many around the world working to push the envelope on snakebite treatment, and she says collaboration with other scientists in this field is critical right now. So what are the various approaches that different research groups are taking?

Khalek: There’s another type of antibody called a nanobody in some cases, or also single-domain antibody. These are rather unique—they come out of camelids, so they come from camels, alpacas, llamas. And these species have basically developed an alternate means of making antibodies.

Daniel: And those camelid antibodies can be engineered, or humanized, for therapeutic use.

Khalek: So they essentially immunized alpacas and llamas with venom from the 18 medically relevant species of elapids in Africa. And basically, you’re able to do some engineering to discover what are those exact nanobodies that came out of the camel or the llama.

Daniel: And then those antibodies can be made synthetically in the lab. That eliminates the need to consistently inject four-legged mammals with venom and drain their blood to retrieve the plasma. This important study, out of a lab in Denmark, focused exclusively on elapids in Africa, but Irene says even that could be an important step forward.

Khalek: ’Cause if we were to remake the antivenom landscape and have, as we call recombinant or a synthetic antivenom made of human or humanized antibodies, it will definitely be a big advantage of having just a couple that can be made to support the snakebite cases in Africa, the snakebite cases in India, Southeast Asia, South America. And even if it’s one that targets some of the snakes in North America or Australia where there’s more money for investing into that type of project or getting a clinical trial going, that’s a potential advantage as well.

Daniel: We don’t tend to think about snakebites in North America very much, certainly deadly snakebites, and is that just because the continent just doesn’t have that many?

Malloy: Yeah. When you think about some of the world’s deadliest snakes…

Daniel: This is journalist Victoria Malloy again.

Malloy: … like cobras, mambas, those are the ones that have that reputation and they get more media attention just for how deadly they are, and those are generally restricted to certain geographies in the world, right? In the Americas, we have things like rattlesnakes and things like that. But in South Africa, there’s many, many, many species that are deadly and are a part of daily existence there.

Daniel: As she was interviewing people in South Africa, Victoria learned about another method to combat snakebites that’s being explored in the field by a somewhat small cohort. It relies on a concept called biomimicry.

Malloy: Biomimicry is essentially turning to nature to harness its capabilities. So in my story, I spoke to Donald Schultz, who is a snake expert in South Africa.

Daniel: Like Neville Wolmarans, Donald Schultz helps people remove and relocate snakes.

Malloy: He’s seen firsthand the devastating challenges that people face day-to-day, not having access to the treatment. So he is taking a boots-on-the-ground approach. He clearly recognizes that antivenom needs a real rethinking. He’s seen it. He himself has also shared with me that he’s allergic to antivenom as well. So he’s using his science—he has a veterinary medicine background—and he’s using that to look at how you can leverage the innate resistance that nonvenomous snakes have, because there’s nonvenomous snakes that consume venomous snakes, and they don’t suffer the effects of the venom in their system.

Daniel: Though not all nonvenomous snakes are completely immune to the effects of venom, some do have an innate resistance to the toxins. And Donald Schultz sees that as an interesting lead.

Malloy: So, similar to how you’re drawing the blood from the horse to get antibodies, he’s drawing blood from nonvenomous snakes and spinning that into a serum. That is a different type of a treatment than what the likes of Irene is doing at Scripps and other people. But for him, he’s driven by immediacy, right? He obviously knows that it’s going to take time to rethink antivenom. But he needs another solution also just for himself, because he knows that he has an allergy to antivenom, and he operates daily in close proximity, engaging very deadly snakes. He basically refers to himself as the first possible test case for his snake-derived antivenom. He would use it on himself if it was a life-or-death situation.

Daniel: And Irene, the one you found, is it available for people to use now?

Khalek: No, no, the study we did had in vivo studies showing it was effective in mice. But of course, it would need to be taken through clinical trials and it would need to be formulated with other antibodies to recognize the full cocktail of venom toxins. It is possible that it could be used as an adjunctive treatment to an antivenom. While there are a lot of challenges within this field, one thing that is a nice feature about this particular type of disease, whether the mouse has been bitten or whether the human has been bitten, the antibody is still targeting the snake toxin itself, it’s not targeting something that’s in the human biology or in the mouse biology. So that’s at least a little bit more of an assurance that if we develop something that works in a mouse, it’s much more likely to work in a human than some other drugs.

Malloy: I would say that there’s real promise in these emerging treatments.

Daniel: This is Victoria again.

Malloy: But as experts rightly point out, that promise really only matters if they can make it into the hands of the communities that need the most. That’s going to come down, ultimately, to human trials, which can pose obstacles. As you can imagine, getting anything from a human clinical trial is going to take some time. And then that coupled with potential limiting obstacles around politics and governance of prioritization, distribution, training and even right down to community-based education, it all takes time going from a concept to then having it be made available to people.

Daniel: But Irene says getting to human clinical trials might not be as hard as it used to be.

Khalek: Before Covid, it was very difficult to do a cocktail formulation of antibodies. But some of the Covid formulations were multiple antibodies, and then it started to become a little more accepted. And one would hope for a neglected disease that’s been underserved, that at the time where somebody’s ready to take something into the clinic, that it can be accepted to study it as the full formulation and do the trials on that.

Daniel: So, with luck, the world might not have to wait another century before we have a new way to treat deadly snakebites.

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Daniel: To read Victoria’s article about the hunt for universal antivenoms, visit smithsonianmag.com. We’ll put links in our show notes. On the next episode of “There’s More To That,” we’ll travel back to 1776 and consider the role Abigail Adams and the other founding mothers played at the inception of the nation.

If you like this show, please consider leaving us a rating and review on Apple Podcasts, Spotify, the iHeartRadio app or wherever you get your podcasts. It helps new listeners find the show, and we’d be grateful.

“There’s More to That” is a production of Smithsonian magazine and PRX productions.

From the magazine, our team is me, Debra Rosenberg and Brian Wolly. From PRX, our team is Ali Budner, Cleo Levin, Genevieve Sponsler, Sandra Lopez-Monsalve and Edwin Ochoa. The executive producer of PRX Productions is Jocelyn Gonzalez.

Our episode artwork is by Emily Lankiewicz. Fact-checking by Stephanie Abramson. I’m Ari Daniel. Thanks for listening.

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Daniel: How do you feel about snakes now? Has reporting on this changed anything for you?

Malloy: I was thinking about that. And it’s funny because I’m probably one of maybe the most snakephobic people, but yet I’ve covered a lot of stories on them.

Daniel: What’s that called? Ophidiophobia?

Malloy: I think so, yeah. I don’t know if reporting on them more and learning more about them is taming that phobia or if it’s just stoking the fire. That’s up for debate. But having said that, I do also feel that knowledge is power, and if anything, I feel more prepared and armed with the information if I ever was to find myself in a situation. Who knows? Maybe in a pinch I could WhatsApp Neville and get some quick tips.