BLOG: Professor Michael Eddleston reflects on steps taken in 2023 to reduce international use of highly hazardous pesticides and the impact this could have on global suicide rates.
*Warning: This article discusses suicidal behaviour. If you have questions on self-harm or feel suicidal, use this link to find an international helpline – www.findahelpline.com*
As a clinician, there is nothing worse than seeing a patient die, with no effective treatment one can offer to save their life. Unfortunately, this is a situation I repeatedly experienced when treating pesticide self-poisoning patients in South Asian hospitals.
The dangers of highly hazardous pesticides
Most of these deaths were a consequence of people having access to acutely toxic highly hazardous pesticides (HHPs) during a moment of crisis or emotional distress. Despite no real desire to die, these dangerous pesticides often had no effective antidote or treatment options, and only a small amount was sometimes enough to cause death.
For decades, international research – including my own – has indicated that bans on acutely toxic pesticides are the most effective way to prevent deaths from both self-poisoning and occupational use. A growing number of civil society groups have also called for an urgent phase out of HHPs to prevent harms to both human health and the environment.
However, although some individual countries have implemented successful bans on HHPs, international action has, to date, been slow.
2023 – a year of progress
This appeared to change in 2023, when the international community took some important steps towards action.
Firstly, in May, the WHO’s governing body, the World Health Assembly, passed a resolution on global chemical issues that recognised pesticide suicide as a global health problem and acknowledged the need to regulate HHPs.
Then, in July, the World Health Organization (WHO) and Food and Agriculture Organization (FAO) of the United Nations published joint guidance on use of pesticide regulation to prevent suicide. Significantly, this document legitimatised consideration of suicide prevention in pesticide regulation. Prior to this, suicide prevention was not always viewed as a legitimate consideration, instead regarded as ‘misuse’ – with blame placed on the vulnerable people who used them.
Finally, in October, delegates at the fifth meeting of the International Conference on Chemicals Management (ICCM5) agreed a target, calling on countries to take measures to phase out HHPs in agriculture by 2035. They also passed a resolution to form a Global Alliance on HHPs, which is requested to develop and implement an action plan on HHPs.
Impact on global suicide
So, what does this all mean?
This is significant progress that has the potential to have a major impact on the global suicide rate. Pesticide suicides currently account for around 20% of all suicides. By removing all acutely toxic HHPs from agricultural practice, global pesticide suicide numbers should fall rapidly from around 150,000 deaths a year to less than 20,000.
The suicide rate is also an indicator for target 3.4 of the UN Sustainable Development Goals (SDGs) – to reduce by one third premature mortality from non-communicable diseases by 2030. The WHO recognizes that banning acutely toxic pesticides is likely the most important part of the work to meet this indicator.
In order to achieve impact, we must see action from promises.
The next World Health Assembly is due to meet at the end of May. At that meeting, time will be set aside for the WHO to feedback on the progress it has made over the previous year. We hope to hear about engagement between Ministries of Health worldwide with Ministries of Agriculture and the Environment to drive forward removal of these pesticides from agriculture.
The FAO has already taken up the mantle of establishing and leading the Global Alliance on HHPs. This is good news, the FAO has long been a supporter of efforts to prevent harms from HHPs. We have been fortunate to work closely with the FAO over the last few years, supporting their efforts to remove harmful pesticides from agriculture. We believe that FAO should now be using its relations with the pesticide industry to lead it on a path away from the use of these problematic pesticides that have all been proven to harm the environment or human health. HHPs are simply not needed in modern small- or large-scale agriculture.
We also need countries to actively work towards the target set at ICCM5 – taking measures to phase out HHPs in agriculture by 2035. This includes work to identify HHPs used, identify appropriate alternatives, and implement new regulation. It is not enough to set a target, if there is no real attempt to meet it. We hope to hear at the 2024 WHA how countries are moving down this path to safeguard the human rights of their populations.
While many challenges still exist, there is no doubt that progress is being made. I remain optimistic recent developments will advance existing efforts to tackle the global burden of suicide. One day, deaths from pesticide poisoning will be a distant memory and hundreds of thousands of people will be alive who would have otherwise have died.
Director, Centre for Pesticide Suicide Prevention
Michael Eddleston is Professor of Clinical Toxicology at the University of Edinburgh. He has worked on pesticide suicides for more than twenty years.