Our work in Sri Lanka has shown that government action to reduce the availability of HHPs in farming communities can dramatically reduce pesticide suicides. After the wide introduction into rural communities in the 1960s, the national Sri Lankan suicide rate increased from around 8/100,000 people over 8 years old in 1960 to 57/100,000 in 1989. Pesticides were responsible for more than 80% of all suicides . More people did not suddenly want to die – simply the poisons now at hand were so toxic and dangerous that there was a massive rise in suicides. Remarkably, pesticide regulation by the Department of Agriculture – identifying the most problematic pesticides one after another and then replacing them in agriculture with alternative pesticides – resulted in a rapid fall in total (not only pesticide) suicides. The rate is now 17/100,000 and continues to fall (see the Sri Lankan case study) [1, 2]. Between 1995 and 2015, pesticide regulation saved an estimated 93,000 lives at a cost of 1.3 US dollars per disability adjusted life year (DALY – a year of good life lost to disability or death). Importantly, these pesticide bans had no apparent effect on the cost of agricultural inputs or outputs .
Pesticide self-poisoning hospitalises over 2 million people and kills at least 150,000 people every year. The vast majority of pesticide self-poisoning occurs in rural settings in South and South-East Asia where residents, farmers and agricultural workers have easy access to highly hazardous pesticides (HHPs) which are sold locally and stored in their homes. Many of 150,000 annual deaths occur in young people. Each death causes immense familial and community stress and can effect education, income, and health.
Following modernisation of agriculture during the Green Revolution in the 1960s, new pesticides were introduced for sale into small scale farming communities and many of them later proved to be toxic to human health. Smallholder farmers often purchase relatively small volumes of pesticides from local vendors and store them within their rural homes. Acts of self-poisoning with household poisons, which were previously relatively harmless, then became lethal as people gained access to these highly poisonous substances. An epidemic of pesticide suicides has resulted; over the past 50 years, pesticide self-poisoning has killed an estimated 14 to 16 million people worldwide.
Ingestion of HHPs often results in the person’s death. Other pesticides cause mild to moderate poisoning but may not result in death. The toxicity of the pesticides stored in people’s houses determines whether the act of self-harm results in death or a mild poisoning with a brief visit to the hospital.