Inside MSF’s Global Centre of Excellence for Snakebite Treatment

In the remote town of Midre Genet, in Ethiopia’s Amhara region, Médecins Sans Frontières/Doctors Without Borders (MSF) runs the organisation’s largest snakebite treatment programme worldwide, the Abdurafi/Midre Genet Treatment Centre.MSF has been working in the Amhara region since 2003, supporting patients affected by diseases that often remain overlooked despite their devastating impact on vulnerable people. 

In 2025, MSF teams treated close to 2,000 snakebite patients in the Abdurafi/Midre Genet Treatment Centre — the highest number recorded at the project in the past 17 years — and more than any other MSF project globally. Over the years, the hospital has become recognised as a centre of excellence for snakebite care in MSF, thanks to its exceptionally low mortality rates for high-fatality diseases.   MSF’s Abdurafi/Midre Genet Treatment Centre recorded a snakebite mortality rate of just 0.05 per cent in 2025.

For comparison, the average snakebite mortality rate across Sub-Saharan African countries is estimated at around 7.6 per cent according to PLOS (Public Library of Science) reports. “Snakebite is a medical emergency that requires rapid treatment,” says Anthony  Pedzisai, MSF medical team leader at the Abdurafi/Midre Genet Treatment Centre. “Without timely care, patients can face severe complications, including disability or death.”

Access to timely treatment remains a major challenge for patients suffering from time-sensitive diseases such as snakebite. Although antivenom is available in a few health facilities, it is often too expensive for people in vulnerable situations. A single vial can cost around 3,000 Ethiopian Birr (20 USD), and an average patient may require up to seven vials during treatment. For migrant farm workers, who are among groups the most exposed to snakebites due to sleeping and working outdoors during harvesting seasons, these costs are often unaffordable. 

Delays in reaching care further increase the risks for patients. Insecurity, transportation barriers, and limited awareness about the importance of seeking immediate medical attention continue to prevent many people from accessing treatment on time. The security situation in parts of Amhara has restricted movement, especially at night, which has driven up transportation costs. These costs have also been severely impacted by the current global fuel crisis, making access to healthcare even more difficult for vulnerable communities. Delayed treatment can lead to severe complications, preventable amputations, and death. “We paid more than 8,000 birr (50 USD) to come here,” says Gosaye Muluken, a caretaker of a snakebite patient at the MSF facility of Abdurafi/Midre Genet. “In the past it used to be much cheaper.” 

Insecurity has also affected MSF teams, limiting outreach activities aimed at raising awareness about the symptoms, prevention, and treatment of snakebite and kala-azar, a severe parasitic disease (visceral leishmaniasis) spread by sandfly bites. 

Another major factor contributing to delayed access to healthcare is the widespread use of traditional medicine as a first response to snakebites. While MSF recognises the important role traditional healers play within communities, we strongly encourage patients to seek primary medical care as early as possible. “Traditional medicine and medical care can coexist,” says Pedzisai. “But for life-threatening conditions such as snakebite and kala-azar, patients should first seek treatment from qualified health professionals. Too often, patients arrive with advanced stages of envenomation (the consequences of venom being injected into a person) after first seeking traditional remedies.”

To improve access to treatment in remote and resource-limited settings, MSF introduced the PANAF antivenom in June 2025 in consultation with health authorities. PANAF is a WHO pre-approved antivenom that does not require cold-chain storage, making transportation and storage significantly easier in isolated areas where electricity and refrigeration are limited.  

Access to antivenom remains a major challenge across many parts of Ethiopia and Sub-Saharan Africa. Treatments are often expensive, difficult to transport, and unavailable in many health facilities, leaving vulnerable communities without timely care. 

PANAF is also cheaper than other antivenoms as it covers any envenomation from African snakes. By the end of June 2026, MSF teams expect to present the results of this clinical research at MSF Scientific Days and will share broadly with other snakebite actors in Ethiopia to advocate for its wider use. 

Alongside snakebite treatment, MSF’s Abdurafi/Midre Genet Treatment Centre also provides care for kala-azar, also known as visceral leishmaniasis, a potentially fatal parasitic disease transmitted by sandflies. 

In 2025, MSF treated 113 kala-azar patients in Abdurafi Clinic. While the number of cases has significantly decreased in recent years, MSF teams are continuing research activities, including monitoring sandfly populations, to better understand the reasons behind the decline. “Kala-a” says Pedzisai. “At MSF’s, however, the mortality rate among treated patients has remained at 2.6 per cent.”  

For MSF teams in Midre Genet the goal remains clear: ensure that people affected by neglected tropical diseases can access timely, effective, and lifesaving care, despite access constraints, insecurity, remoteness, and the many other barriers standing in their way.