NEW DELHI — The ban on highly hazardous pesticides (HHPs) currently being debated in India will not only protect the environment and improve the public health but will also achieve another rarely acknowledged goal: a rapid and major reduction in the number of Indians dying from suicide.
The Supreme Court, which is currently deliberating the case challenging the government's delay in banning HHPs identified by the Anupam Verma Committee, has a major role to play. The case emerged following a public interest litigation by Kavitha Kuruganti and others filed in 2017.
Statistics on suicide are notoriously unreliable due to stigma and the family's fear of negative consequences. Official data estimate 131,623 people committed suicide in 2015 — that is 15 suicides every hour. A nationally representative survey estimated that 92,000 (49.2%) of 187,000 Indian suicides in 2010 resulted from poisoning, with the great majority following pesticide ingestion. Pesticide poisoning was the leading method of suicide among both men and women. It is also the method that is easiest to prevent.
Indian small farmers use high strength pesticides and fertilizers to increase farm productivity. This wide availability makes HHPs an easy option for those attempting suicide. In comparison with developed countries, where agricultural strength pesticides are only available to licensed workers, and where a relatively smaller number of people now work in agriculture, HHPs are freely sold in shops and dangerously stored in many homes in rural Indian communities. Unlike relatively low toxicity medicines commonly used for self-poisoning in the West, HHPs are almost always deadly if ingested. This means that the number of people who die after self-poisoning is much higher in Indian agricultural communities than in industrialized countries, producing high rates of suicide.
Many pesticide suicides are highly impulsive, with a person contemplating suicide for just a few minutes. Most who engage in suicidal behavior do not want to die, with suicide serving as a response to psychosocial stressors. If a person is prevented from using a dangerous method, they may use a method with lower lethality, with an increased chance of survival, or the suicidal impulse may pass.
Farmer suicides are just one aspect of pesticide suicides in India. In comparison to the 15,000 farmer suicides that occur each year, many by hanging, more than 80,000 pesticide suicides occur among non-farmers, according to national statistics. Many more women and non-farmers than farmers die from pesticide poisoning each year — simply due to their wide availability in their rural communities.
It's like barriers to prevent jumping from bridges and high buildings.
The World Health Organisation estimates that at least 20% of all suicides could be prevented by restricting access to poisons. Such restrictions have proven to be highly effective in the reduction of suicide in the UK after the domestic gas supply was made less toxic. Barrier installation on bridges, high buildings and railway platforms to prevent jumping has also been shown to be effective in many countries.
Restricting access to the means of pesticide suicides in India — banning and removing HHPs from agricultural practice through legislation and importation limitations — will be the most effective way to prevent suicides. Removal of HHPs rapidly and comprehensively reduced the total number of suicides in Sri Lanka, Bangladesh and South Korea.
Importantly, in these countries equally effective, but less toxic, alternative pesticides and agricultural practices — in particular, integrated pest management — have been found. As a result, no reduction in agricultural productivity has been noted following the bans.
This approach is not meant to minimize the importance of a comprehensive effort directed at improving mental health and health systems. However, legislative restrictions on HHPs is a cost-effective approach to rapidly reducing the number of suicides. In Sri Lanka, this approach saved an estimated 93,000 lives at the remarkable direct cost to the government of less than $50 per life saved.
Reducing the suicide rate should be a government priority for a number of reasons: it will save lives, help the government to comply with international human rights obligations, reduce healthcare costs and productivity loss, and help the government to achieve its commitments to the United Nations Sustainable Development Goals.
If you know someone — friend or family member — at risk of suicide, please reach out to them. The Suicide Prevention India Foundation maintains a list of telephone numbers they can call to speak in confidence. You could also accompany them to the nearest hospital.
*Leah Utyasheva is policy director and Michael Eddleston is director, Centre for Pesticide Suicide Prevention.