CPSP director Professor Michael Eddleston has carried out extensive research in Sri Lanka over the last two decades, together with CPSP colleagues and partners.
This work has helped Sri Lankan policy makers to identify the most dangerous pesticides, introduce new bans and monitor the impact of bans on suicide rates and agriculture.
Sri Lanka’s pesticide regulations have contributed to one of the greatest falls in suicide rates ever seen in the world, falling by more than 70% since 1995.
At the Future Policy Awards 2021, often referred to as the ‘Oscar on best policies’, Sri Lanka was awarded a special accolade in recognition of its policies to regulate highly hazardous pesticides (HHPs), following a nomination by CPSP.
CPSP is supporting a large study testing whether pesticide vendor training is an effective way to reduce pesticide self-poisoning in rural Asia.
The project involves delivering training to shopkeepers to help them identify people at risk of drinking pesticides, so that they do not sell to them. It follows a previous pilot study which suggested this to be an effective approach.
This large-scale study will take place over 4 years in 71 divisional secretariats within North Central, Eastern, Northern and Central Provinces of Sri Lanka. It will compare the effect of training on the number of patients presenting to hospital with pesticide self-poisoning in the province. It will also look for evidence of people switching to other methods of self-harm.
All pesticide vendors will be taught how to observe customer behaviour, check for intoxication, and ask questions which farmers should know the answer to. Videos are used to illustrate the key points and standardize the education. Brief follow-up training will be provided at regular intervals to reinforce the lessons learnt. There will also be an assessment of how closely the vendors followed the training.
This study is led by Dr Manjula Weerasinghe at the Rajarata University of Sri Lanka and Dr Melissa Pearson of the University of Edinburgh, with funding from the American Foundation for Suicide Prevention.
CPSP is currently analysing secondary data on suicides, collected as part of two cluster randomized controlled trials (cRCT) in the north central region of Sri Lanka (Household pesticide storage cRCT, Vendor training cRCT).
This work will identify key pesticides responsible for suicides following the 2008-2014 bans, with the aim of introducing further regulation and saving more lives.
This work has already shown the great importance of the WHO Class II carbamate insecticide, carbosulfan, for fatal self-poisoning. It has since been recommended for withdrawal from agricultural practice.
The Safe Storage Project explored whether keeping pesticides locked in containers would help prevent suicide deaths from pesticide poisoning. The study took place in Sri Lanka, with 53,000 households in 180 villages chosen to take part.
The study ultimately did not show any effect or benefit of safe storage.