Warning: This article discusses suicidal behavior. If you have questions about self-harm or feel suicidal, use this link to find an international helpline.

In the lush landscapes of numerous Low and Medium-Income Countries (LMICs), a largely untold and devastating story unfolds: the dual threats of death and environmental degradation. Both can be caused by pesticides. These chemicals, once heralded as solutions during the Green Revolution, have now begun devastating communities. I spoke with Michael Eddleston, professor of Clinical Toxicology and director of the Centre for Pesticide Suicide Prevention at the University of Edinburgh. His research has focused on the under-discussed issue of pesticide-induced suicides, and over the past 20 years, he has been instrumental in lobbying for legislative and normative changes in several countries (Eddleston, 2024; Eddleston and Phillips, 2004).

"During my early days in Sri Lanka as a medical student, I was struck by the number of patients poisoned by pesticides. It was not just a medical issue; it was a profound human tragedy, largely ignored locally and globally," Michael recalls. The memory of those days has significantly marked his academic journey. It is conservatively estimated that over 14 million people have succumbed to pesticide-induced suicides since 1960 (Karunarathne et al., 2019). These estimates are likely conservative because suicides often go unreported and are illegal in some jurisdictions, leading to underreporting.

"These patients were not intent on dying. They sought to express profound emotional pain or anger. The tragedy is that the high toxicity of these pesticides means there is often no second chance," Michael explains. With the expansion of industrial agriculture, the availability of deadly poisonous materials has triggered a silent problem of poisoning, with staggering numbers. According to Utyasheva et al. (2024), pesticides are responsible for an estimated 385 million cases of unintentional poisoning annually, with 11,000 fatalities and between 110,000 and 168,000 deaths from self-harm.

The majority of these fatalities occur in rural areas, where limited access to hospital facilities exacerbates the crisis. "Working in the hospital felt like applying a band-aid to a gaping wound. We needed to address the root of the problem, which was the accessibility and lethality of these pesticides," Michael argues. This insight led to the creation of the Centre for Pesticide Suicide Prevention to reduce access to the most harmful pesticides and educate communities about safer practices.

However, it is important to note that the number of deaths, thanks to increased regulations and bans, has decreased from 371,000 in the 1990s to between 110,000 and 168,000 (Mew et al., 2017). In particular, Sri Lanka’s experience with pesticide regulation provided a blueprint for what could be achieved globally. "Following rigorous regulations and the banning of the most toxic pesticides, we witnessed a dramatic 75% reduction in overall suicides, without harming agricultural output," Michael highlights. This success demonstrates that it is possible to ban pesticides without any yield loss. "This was not just about reducing suicides; it was about proving that sustainable practices could coexist with productive agriculture," Michael reinforces. There is growing consensus and scientific evidence for regenerative practices recognized by traditional actors like the Food and Agriculture Organization (FAO), an agency of the United Nations, and even management consultants.

Michael is clear that "there is a pervasive myth that pesticides are essential for crop survival, yet the evidence supporting this is deeply flawed.” Many studies fail to consider the full spectrum of pesticide impacts, including environmental degradation and long-term health effects on communities. Wielding substantial economic influence, the pesticide industry continues to be a formidable opponent, often prioritizing profit over public health. The industry does not recognize the impact of pesticide poisoning, terming it as “misuse,” and claims that pesticides are safe if used according to the label instructions (Utyasheva et al., 2024). This shifts the blame to the farmers, oversimplifying the issue as a mere lack of knowledge.

However, a positive shift is underway globally. "There is a growing movement towards minimizing pesticide use,” Michael says. Consumers, activists, and companies are realizing the real costs of industrial agriculture and shifting towards the principles of regenerative agriculture, which aims to sustain farming through natural processes rather than reliance on harmful chemicals.

Following Sri Lanka's successful model, countries like Bangladesh and Nepal have implemented targeted bans and regulatory changes, already observing early signs of success in reducing pesticide-related deaths. "In Bangladesh, we have worked with regulators who were initially unaware of the scale of pesticide poisoning. Now, they are proactive partners in prevention," Michael says. In Nepal, similar efforts have led to a noticeable decline in poisoning deaths, proving that change is possible with informed and concerted action.

The key action points are more research and more implementation. "Our goal is to transform how agriculture approaches pest control, moving away from toxic chemicals and towards a model that prioritizes human and environmental health," Michael points out. The challenge is to demonstrate that we can feed our world without poisoning our people. It’s a complex task, but with each step forward, we’re proving that it’s within our grasp," Michael confidently states. Mounting evidence is backing his dreams.

References

Eddleston, M., & Phillips, M. R. (2004). Self poisoning with pesticides. BMJ, 328(7430), 42-44.

Eddleston, M. (2024). Poisoning by pesticides. Medicine, 52(6), 390-393

Karunarathne, A., Gunnell, D., Konradsen, F., & Eddleston, M. (2020). How many premature deaths from pesticide suicide have occurred since the agricultural Green Revolution? Clinical Toxicology, 58(4), 227–232.

Mew, E. J., Padmanathan, P., Konradsen, F., Eddleston, M., Chang, S. S., Phillips, M. R., & Gunnell, D. (2017). The global burden of fatal self-poisoning with pesticides 2006-15: Systematic review. Journal of Affective Disorders, pp. 219, 93–104.

Utyasheva, L., Rother, H. A., London, L., & Eddleston, M. (2024). Stop blaming the farmer: Dispelling the myths of ‘misuse’ and ‘safe’ use of pesticides to protect health and human rights. Journal of Human Rights, pp. 1–22.