By Nicole Tau
For years, the claim that Lesotho, a small country entirely surrounded by South Africa, has “the highest suicide rate in the world” has circulated widely.
Among those reporting it are:
- Health thinktank the African Population and Health Research Center, who in October 2025 said that Africa is home to “six of the top ten countries with the highest suicide rates globally, with Lesotho leading with the world’s highest suicide rate”.
- The BBC, who in August 2024 reported that 87.5 suicides per 100,000 people occur in Lesotho, under the headline “The small African country with the world’s highest suicide rate”.
- The UK’s Telegraph, who in February 2024 similarly reported that Lesotho “has the highest suicide rate in the world, with 87.5 suicides per 100,000 people”.
Many other news outlets and organisations have repeated the claim.
Much of this reporting has cited the World Health Organization. The BBC’s statistic is from a 2019 WHO report, which listed an age-standardised suicide rate of 87.5 per 100,000 for Lesotho.
Age-standardised rates adjust for differences in population age structures, making comparisons appear straightforward. But the WHO warns that for many countries, these rates are not based on complete or reliable data.
Of the WHO’s 183 member states, just over 60 had “high-quality vital registration data”, it said. For the rest, mostly low- and middle-income countries such as Lesotho, the health agency had to model suicide estimates due to missing or poor quality data.
The WHO said: “Where data are available and of high quality, estimates from different institutions are usually in agreement. Discrepancies are more likely to arise for countries where data quality is low and when data are sparse and potentially biased. These discrepancies are best addressed by improving the primary data.”
Data ‘unavailable and unusable’
The 2019 WHO report gave Lesotho the lowest possible data quality rating, a score of four, meaning that its “death registration data are unavailable or unusable due to quality issues”.
The WHO emphasised: “Estimates of mortality by cause should be interpreted with caution … they are not likely to be informative for policy evaluation or comparisons among countries.”
Africa Check has previously reported on this warning against using the data to rank countries. However, the organisation has not always consistently applied this caution in its own work.
New WHO study revises Lesotho’s suicide rate, but keeps same caution
In 2025, the WHO released updated global suicide estimates using substantially revised methods. This study used 2021 data from the global burden of disease, run by the WHO and the Institute for Health Metrics and Evaluation at the University of Washington in the US.
The study put Lesotho’s age-standardised suicide rate at 36.7 per 100,000 – far lower than the 87.5 estimate.
To understand the shift, we contacted the WHO Lesotho office. Communications manager Letitia Nangwale directed us to some important caveats in the study.
Because the Covid pandemic disrupted cause-of-death reporting in many countries, the WHO says its 2020 and 2021 suicide estimates are likely undercounted.
“This means they are not comparable with previously published estimates for 2000–2019 or with earlier versions published by WHO. The suicide estimates in this publication replace all those previously published by WHO, and any differences with previously published versions should not be interpreted as time trends,” it said.
A 2024 fact-check by a former Africa Check fellow also highlighted the need for caution when comparing suicide rates across countries.
Lesotho’s health ministry working on new data
Pearl Letsoela, psychotherapist and coordinator for the Lesotho’s mental health programme, said that the ministry could “neither refute nor validate” the claim that Lesotho had the world’s highest suicide rate.
“We are conducting our own suicide situational analysis with WHO support to understand the true picture,” she said.
Letsoela explained why accurately capturing suicide data was difficult.
“A complete suicide is not reported at the psychiatric hospital but certified at general hospitals, and even then, it’s often coded clinically, not as suicide. For instance, if someone ingests poison or hangs themselves, the cause may be recorded as respiratory failure or blood loss,” she said.
Letsoela confirmed that the ministry only recently developed data collection tools to “single out suicide” in hospital reporting. These cases were previously tallied under “Other Psychiatric Conditions”.
In contrast, countries such as the United Kingdom and Japan record every death with a legally verified cause, allowing a “direct count”. But Lesotho, like many low- and middle-income countries, still lacks such complete or consistent civil registration systems.
Conclusion: Popular claim oversimplifies a complex situation
Lesotho is frequently labelled as having the world’s highest suicide rate. But this is based on modelled and highly uncertain WHO estimates, not actual death counts.
The claim oversimplifies a situation shaped by weak data systems, such as in civil registration. In the absence of reliable and complete records, no definitive country ranking is possible.
Nicole Tau, a fact-checker with CheckDesk in Lesotho, is an Africa Check fellow. This report was produced during the 2025 Africa Check fellowship in Nairobi, Kenya, which was generously supported by the Konrad Adenauer Stiftung, a German foundation promoting democracy and media development. The fellowship works to strengthen information integrity and resilience across Africa.
