The number of countries with national suicide prevention strategies has increased in the five years since the publication of WHO’s first global report on suicide, said the World Health Organization in the lead-up to World Suicide Prevention Day on 10 September. But the total number of countries with strategies, at just 38, is still far too few and governments need to commit to establishing them. The intervention that has the most imminent potential to bring down the number of suicides is restricting access to pesticides that are used for self-poisoning. The high toxicity of many pesticides means that such suicide attempts often lead to death, particularly in situations where there is no antidote or where there are no medical facilities nearby. As indicated in the WHO publication released, Preventing suicide: a resource for pesticide registrars and regulators, there is now a growing body of international evidence indicating that regulations to prohibit the use of highly hazardous pesticides can lead to reductions in national suicide rates. The best-studied country is Sri Lanka, where a series of bans led to a 70% fall in suicides and an estimated 93 000 lives saved between 1995 and 2015. In the Republic of Korea – where the herbicide paraquat accounted for the majority of pesticide suicide deaths in the 2000s – a ban on paraquat in 2011-2012 was followed by a halving of suicide deaths from pesticide poisoning between 2011 and 2013.
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