Suicide is a major public health concern worldwide. According to the WHO, 800.000 people die by suicide every year. Of those, at least 110,000 die from pesticide poisoning. In fact, pesticide self-poisoning accounts for 20% of suicides around the world. It “is particularly common in low-income and middle-income countries (LMICs) where small-scale farming allows easy access” to poorly regulated and highly dangerous pesticides. Banning particularly lethal pesticides could reduce pesticide self-poisoning around the world.
In Asia, this lethal practice alone makes up a huge share of all suicide deaths. In China, for instance, where almost 80% of suicides are carried out by individuals from rural regions, ingestion of lethal pesticides count for 49% of all suicide deaths across the country. This makes it the most common suicide method in rural China, suggesting that the chosen methods factor into the relatively high rate of fatality. In 2008, Sri Lanka also presents an alarmingly high percentage of 60% deaths that happened because of intentional self-poisoning. In 2018 in India, the share is about 38.8%
Banning Lethal Pesticides for Suicide Prevention
In the past, health agencies all over the world “have advocated for pesticides’ safe storage and sales restrictions to help reduce these numbers.” However, this year, the World Health Organization decided to focus its efforts on a different strategy: national bans. A new WHO-funded study published in December 2020 found that enacting “national bans on highly hazardous pesticides can be a cost-effective and affordable intervention for reducing suicide deaths in countries with a high burden of suicides attributable to pesticides.”
The study concluded that establishing such bans in 14 low to high-income countries “could result in a total of approximately 28,000 fewer suicide deaths” annually and only cost around one cent per capita. The economic analysis found bans to be “more cost-effective in countries where a high proportion of suicides are attributable to pesticide poisoning.” For these 14 countries, the decline would also equate to a 6.5% reduction in suicide deaths by 2030.
More than 75% of suicide deaths occurring in low and middle-income countries. This new prevention strategy is estimated to be more cost-effective in these areas. This new study sheds light on a relationship that has not received enough research attention so far: that between poverty and mental health in LMICs. The study’s results can help the world understand and act on the social factors that relate to poverty, such as rurality and easy access to lethal means.
Reducing the Suicide Rate
Moreover, this new WHO is backed up by David Gunnell’s 2017 review. Gunnell is a British suicide expert who found that national bans in Sri Lanka, South Korea, Jordan, Bangladesh and Taiwan led to significant reductions in suicides. For instance, In South Korea, suicides caused by pesticide self-poisoning halved in 2013 following a ban on a weed killer paraquat a year earlier. Even better, Sri Lanka saw a 70% reduction in overall suicide deaths after the country first banned hazardous pesticides in the 1990s. Moreover, there were no indications that farmers who used “less toxic formulations” saw any effect on agricultural output. This suggests that such bans would not necessarily lead to reductions in agricultural productivity.
Researcher Michael Eddleston founded the Centre for Pesticide Suicide Prevention in 2017. The organization is trying to spread the success of Sri Lanka’s policy change to India and Nepal. With funding from GiveWell, CPSP collects data on lethal pesticides commonly used in suicide attempts and then uses the data to assist India’s and Nepal’s governments in considering which pesticides to ban.
Restricting access to pesticides is a great step, but the bigger and necessary challenge is to provide better mental health care and social support to LMICs. Still, the weight of evidence has shown that banning the highly hazardous pesticides that account for most deaths it’s an effective approach for preventing suicide. If bans on just a few highly lethal pesticides in Sri Lanka, Bangladesh and South Korea led to sharp reductions in the overall suicides rate, the benefits of this extremely affordable intervention could be countless for all LMICs where this lethal practice is common.
– Alejandra del Carmen Jimeno