Toward a lead-free future: The case for action now

Lead poisoning is one of the most neglected health issues of our time. But interventions are affordable and could save countless lives, advocates stressed on the sidelines of the 80th United Nations General Assembly, or UNGA80, in New York last month.

“Inaction will just cause generations of harm. This is a silent, long-term problem,” Jenna Forsyth, director of Project Unleaded at Stanford University’s Center for Human and Planetary Health, told attendees at an event co-hosted by Devex and Open Philanthropy on the sidelines of UNGA80.

Today, 1 in 3 children — nearly 800 million — are affected each year by lead poisoning through sources such as contaminated water and food, toxic paint, or even everyday items such as toys. No amount of lead is considered safe, and chronic exposure can cause long-term harm, including death from cardiovascular problems. In children, even modest levels can impair cognitive development and lead to learning disabilities and behavioral disorders. Those living in lower-income contexts or in informal economies where regulation may be lax in areas such as food, paint, and construction are more at risk.

But it is a relatively affordable issue to solve, as highlighted by the Partnership for a Lead-Free Future, or PLF — a coalition of players spearheaded by UNICEF that launched in 2024 to galvanize political attention, mobilize financial resources, and provide a road map to end childhood lead poisoning. Since its inception in 2024, PLF has produced a toolkit to support governments and development stakeholders with practical steps toward eradicating lead poisoning.

New data the PLF shared at UNGA80 estimated that an investment of $1.6 billion over the next 15 years could eliminate lead poisoning as a significant health issue in low- and middle-income countries, or LMICs. That equates to $2 per child in the next decade and a half – or less than 15 cents annually. The cost of inaction could be as high as $977 billion. Aside from the obvious burden on health care systems, lead poisoning can lead to lost days at school and work, ultimately impacting an individual’s contribution to the economy.

Tom Hird, head of grantmaking at Open Philanthropy’s Lead Exposure Action Fund — the first major philanthropic effort focused on lead poisoning and another partner of PLF — emphasized that “some of the highest returns you could make in global development right now exist in the elimination of lead poisoning.”

In New York, panelists discussed why the investment in the ‘hidden’ global health crisis is so critical and how that money could be used effectively to end lead poisoning as a threat quickly. These were the takeaways from the discussion.

Interventions exist — and several countries are already seeing success

Critical to ending lead poisoning and limiting its damage is first knowing where it is an issue and then tracing the sources. For Abdullah Fadil, UNICEF director of PLF, that means gathering data on the amount of lead in blood at the community level.

From there, it’s a case of governments having — and enforcing — regulations that stipulate the removal of lead from products and the environment, said Hird.

Forsyth highlighted Bangladesh as an example. By conducting blood lead surveys in a rural community in 2017, the country identified high levels of lead, particularly among pregnant women. This posed enormous threats to all, but particularly to the unborn babies. To find out how the women were being exposed, Stanford University and the International Centre for Diarrhoeal Disease Research in Dhaka conducted research, which eventually identified turmeric as the culprit. Companies were enhancing it with lead chromate, an industrial pigment, to enrich the color.

Immediately, the government launched an awareness campaign that lasted through 2021, warning consumers of the product and notifying sellers that it would be more forcefully enforcing its laws prohibiting the use of lead in food. Within a few months, turmeric samples containing lead dropped from 47% to 0%.

The country of Georgia has also seen success, said Hird, in conducting a national blood lead level survey to identify sources, which were mainly soil and paint. A 2018 survey revealed that 41% of children aged between 2 and 7 years old had high blood lead levels. In response, the government invested in laboratory and surveillance capacity while also bolstering its regulation on lead and putting in place more robust enforcement and accountability mechanisms. Within a few years, there was a 60% drop in blood lead levels among pregnant and breastfeeding women in the Adjara region.

Such examples show that lead poisoning can be swiftly and effectively addressed, preventing further harm – specifically to children. To expand success, “we need more country-specific, representative data, helping open evidence-based dialogues with a broader range of countries and widen the response,” Rachel Bonnifield, director of the global health policy program at the Center for Global Development, told Devex after the event.

There’s a clear investment case

Such data gathering and responsive action does, however, require funding. In LMICs, and particularly amid a global decline in foreign aid, that is something that can be lacking. But Hird appealed to both countries and other donors, explaining that the return on investment is high, given that lead poisoning has the potential to be eliminated as a serious threat within a generation. “Governments and donors, if you’re interested in health, education, development, and economic outputs, you can’t afford to ignore lead exposure as a development issue,” said Hird.

At a time when governments are trying to set priorities and donors are looking to maximize their impact, lead poisoning is a key issue, said Hird.

“Even without establishing lead-specific programs, there’s a lot international donors can do to integrate lead exposure reduction into their routine health and development programs,” noted Bonnifield. “Donors and development banks can start by making sure to ‘do no harm’ in their own programs, for example, by ensuring all water infrastructure programs only use lead-free pipes and fittings; by providing lead-free cookware for school feeding; and by ensuring appropriate end-of-life management for lead-acid batteries used in electric vehicles or off-grid solar systems.”

Partnerships and innovation can advance action

Addressing informal sources of lead exposure often requires not only technical solutions but also the alignment of public policy, market incentives, and social norms. After the panel, Andrew McCartor, president of nonprofit Pure Earth, told Devex that the issue also needs a coordinated response. “Solutions require sustained, collaborative partnerships with governments, industry, and communities,” he stressed.

In many countries, that is happening, he said, with governments engaging different ministries to create national lead poisoning prevention strategies. “In the years ahead, I anticipate a shift from interventions that focus on a single location or microindustry toward more comprehensive national models, where governments establish clearer rules of the game, formal industries contribute to raising the floor, and community players ensure that solutions are durable, inclusive, and locally grounded,” he shared.

McCartor also made the case for low-cost tools, such as sensors and smartphones, that can be deployed in low-resource settings. This is where private sector collaboration could come in. “If these technologies prove reliable and can be produced at scale, they could significantly expand access to testing and reduce response times,” he said.

In the meantime, machine learning and predictive analytics could help predict areas of high risk, he added, by analyzing housing, product, and environmental data. “Such tools could reduce the need for expensive and time-consuming surveys,” he said.

Concluding the panel, Fadil stressed that there are clear solutions to addressing lead poisoning and ending it as a serious health threat of our time. Action can start by building on the momentum of PLF. “[There’s] a feeling that the time is now,” he said. “Hopefully, we will not miss this chance.”