The exploratory financial evaluation, one of many first to look at the cost-effectiveness of implementing a population-based, suicide prevention intervention in low- and middle-income international locations, concerned 14 international locations spanning low-income to high-income settings. The authors concluded that banning extremely hazardous pesticides throughout these 14 international locations might end in a complete of roughly 28 000 fewer suicide deaths annually at an annual price of I$ 0·0071(or lower than a cent) per capita.
This lower equates to a possible 6·5% discount in suicide deaths amongst these 14 international locations by 2030, equal to 20% progress in the direction of the goal for Sustainable Improvement Objective 3.4 – to scale back by one-third untimely mortality from noncommunicable ailments, of which the suicide mortality charge is an indicator.
Bans have been discovered to be cheaper in international locations the place a excessive proportion of suicides are attributable to pesticide poisoning, reaching a cost-effectiveness ratio of I$ 75 per wholesome life yr gained (HLYG) in two international locations wherein greater than 30% of suicides have been from pesticide poisoning. The intervention was estimated to be cheaper in low-income and lower-middle-income international locations (at I$ 94 per HLYG) than in upper-middle-income and high-income international locations (at I$ 237 per HLYG).
Nevertheless, the examine findings are restricted by imperfect knowledge and assumptions that could possibly be improved upon by future research. Extra analysis is required to quantify the assumptions made on this mannequin, together with the potential for substitution of means and the impact on agricultural yields.
Suicide is a serious international public well being concern, leading to 800 000 deaths yearly internationally. Pesticide self-poisoning accounts for 14-20% of worldwide suicides and is especially widespread in low-income and middle-income international locations the place small-scale farming permits easy accessibility to extremely hazardous pesticides.
Proscribing entry to generally used, high-lethality suicide strategies – a type of means restriction – is among the few efficient approaches to stopping suicide. Bans of just some extremely hazardous pesticides in Bangladesh, the Republic of Korea and Sri Lanka resulted in communities gaining access to much less poisonous pesticides and led to sharp reductions in general suicide charges. These pesticide bans didn’t stop folks from making an attempt suicide; they merely made subsequent suicide makes an attempt a lot much less deadly, thereby decreasing the suicide charge.
Empirical proof from these international locations additionally reveals that such bans don’t essentially result in reductions in agricultural productiveness (i.e. there have been no discernible subsequent decreases in crop yields). The Worldwide Code of Conduct on Pesticide Administration, produced by the UN Meals and Agriculture Group (FAO) and WHO, recommends that extremely hazardous pesticides needs to be faraway from agriculture in low- and middle-income international locations the place they can’t be saved or used with out unacceptable threat.
The financial mannequin developed by this examine could possibly be used to tell country-level analyses after tailoring the mannequin to account for related native components and incorporating country-specific knowledge.
1 I$ is the image used for an Worldwide greenback. An worldwide greenback would purchase within the cited nation a comparable quantity of products and companies a United States greenback would purchase in the US.
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