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…the suicide rate in Sri Lanka has dropped significantly. So, from 57 deaths per 100,000 population in ’95, it has dropped now to 17. This is a 70% reduction. So, it’s a very significant success, in fact the greatest decrease in suicide rate ever seen.

Dr Leah Utyasheva

How people kill themselves varies enormously depending on which means are most easily available. In the United States, suicide by firearm stands out. In Hong Kong, where most people live in high rise buildings, jumping from a height is more common. And in some countries in Asia and Africa with many poor agricultural communities, the leading means is drinking pesticide.

There’s a good chance you’ve never heard of this issue before. And yet, of the 800,000 people who kill themselves globally each year 20% die from pesticide self-poisoning.

Research suggests most people who try to kill themselves with pesticides reflect on the decision for less than 30 minutes, and that less than 10% of those who don’t die the first time around will try again.

Unfortunately, the fatality rate from pesticide ingestion is 40% to 70%.

Having such dangerous chemicals near people’s homes is therefore an enormous public health issue not only for the direct victims, but also the partners and children they leave behind.

Fortunately researchers like Dr Leah Utyasheva have figured out a very cheap way to massively reduce pesticide suicide rates.

In 2016, Leah co-founded the first organisation focused on this problem – The Centre for Pesticide Suicide Prevention – which recently received an incubation grant from GiveWell. She’s a human rights expert and law reform specialist, and has participated in drafting legal aid, human rights, gender equality, and anti-discrimination legislation in various countries across Europe and Canada.

In this episode, Leah and I discuss:

  • How do you prevent pesticide suicide and what’s the evidence it works?
  • How do you know that most people attempting suicide don’t want to die?
  • What types of events are causing people to have the crises that lead to attempted suicide?
  • How much money does it cost to save a life in this way?
  • How do you estimate the probability of getting law reform passed in a particular country?
  • Have you generally found politicians to be sympathetic to the idea of banning these pesticides? What are their greatest reservations?
  • The comparison of getting policy change rather than helping person-by-person
  • The importance of working with locals in places like India and Nepal, rather than coming in exclusively as outsiders
  • What are the benefits of starting your own nonprofit versus joining an existing org and persuading them of the merits of the cause?
  • Would Leah in general recommend starting a new charity? Is it more exciting than it is scary?
  • Is it important to have an academic leading this kind of work?
  • How did The Centre for Pesticide Suicide Prevention get seed funding?
  • How does the value of saving a life from suicide compare to savings someone from malaria
  • Leah’s political campaigning for the rights of vulnerable groups in Eastern Europe
  • What are the biggest downsides of human rights work?

Keiran Harris helped produce today’s episode.


In Sri Lanka the situation was as such that the suicide rate had increased dramatically after the introduction of highly hazardous pesticides into the agriculture — as the result of the green revolution in 1960s. The suicide rate increased from five per 100,000 people to 24 per 100,000 people in 1976, and then peaked at 57 incidences for 100,000 people in 1995.

So, this is a staggering increase in suicide rates. And you can see a direct correlation with the increase in the pesticide use. So, when my colleague Prof. Michael Eddleston and the pesticide registrar at that time noticed this trend, they thought ‘what kind of intervention could help?’ So, from 1984 to 2011, there was a lot of pesticides that were banned in Sri Lanka. So, in ’94, the most toxic insecticides Parathion and Methyl Parathion were banned, and then unfortunately this became substituted by less toxic one, but still people died from further highly hazardous pesticides that they started using as a substitute.

When those five other highly hazardous pesticides were banned, the rapid increase in suicide has stopped, but also another, Endosulfan, another very toxic pesticide was substituted as means of suicide. However, when this was banned in ’98, and further class two pesticides were banned in 2008 to 2011, the suicide rate in Sri Lanka has dropped significantly. So, from 57 instances to a 100,000 population in ’95, it has dropped now to 17. And this is a 70% reduction in suicide rate. So, this is a very significant success, and this is the greatest decrease in suicide rate ever seen.

The strategy that we are employing is harm reduction or harm minimization. So, what this means is that instead of trying to tell people, “don’t commit suicide,” which is also, of course, a fair statement, we want to reduce the harm when people still go and try to kill themselves. So, this harm minimization, harm reduction strategy was developed by William Haddon, who was a U.S traffic administrator, the head of the U.S traffic administration authority, who realized in the 60s that the traffic accidents in the United States have gone up, and the fatality of this traffic accidents have gone up significantly as well.

So, what he suggested is that radically new approach to the problem. He says instead of telling people to stop having accidents, and become better drivers, he suggested that, “Let’s accept that traffic accidents, road accidents will happen, but let’s minimize the harm from them.” So, the inside of the car — that was a death-trap previously — he decided to redesign the inside of the car. So, when the traffic accident happened, it would not be deadly to a person.

So, he designed the steering wheel so that it would not pierce a person to death, but would just collapse and not inflict much harm to the driver. And the same happened to the car hood, which became collapsible, and would not just cut the driver in half. So, this is the harm minimization approach which we’re also advocating for.

I see saving someone from suicide very similarly to saving someone from a different disease or from a different … from a road traffic accident for example. I don’t think that’s that different — we’re preventing harm to health and to life of a human being. And the fact that many people decide not to kill themselves if they are prevented from suicide is very telling. These are just vulnerable people, who at the moment of suicidal crisis happen to have this horrible substance next to them. That’s why this horrible substance should be removed from close availability. Some people take a drink, but some people who maybe have many more stresses in the moment of crisis, decide to go for the ultimate means.

So, I think this is not that different than any other intervention that saves lives and saves health. For example, saving someone, or helping someone in the case of non-communicable disease will take years and years. Better habits, more exercise, less alcohol, or less harmful use of alcohol and such. This is extremely cost effective, because you just remove the substance, and the person may live a healthy life ever after, and not attempt this again.

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About the show

The 80,000 Hours Podcast features unusually in-depth conversations about the world's most pressing problems and how you can use your career to solve them. We invite guests pursuing a wide range of career paths — from academics and activists to entrepreneurs and policymakers — to analyse the case for and against working on different issues and which approaches are best for solving them.

The 80,000 Hours Podcast is produced and edited by Keiran Harris. Get in touch with feedback or guest suggestions by emailing [email protected].

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