Tuesday, June 13, 2023

1 in 3 Children Suffer from Lead Poisoning—so Why is Lead Reduction Such a Heavy Lift?
by Karen Mathiasen and Rachel Silverman
JUNE 13, 2023
BLOG POST


This Thursday, the Center for Global Development is hosting a half-day event—Get the Lead Out—to shine a much-needed spotlight on the far-reaching social and economic consequences of lead poisoning.


Lead is an insidious toxin. In most cases, it has no overt, easily detectable symptoms when ingested—yet it causes lasting and irreversible brain damage, especially for children under five. It is linked to poor schooling outcomes, increased crime and violence, and heart and kidney damage. In different ways, lead is also dangerous to adults; estimates suggest that lead causes 900,000 premature deaths per year from increased risk of cardiovascular disease (likely an undercount). Though heart disease primarily affects older adults, the absolute death toll is higher than the attributable burden for malaria (620,000) and close to the burden of HIV/AIDS (940,000).

Lead is not an equal opportunity poison—94 percent of the disease burden (i.e., years of healthy life lost) from lead exposure occurs in low- and middle-income countries (LMICs), with India alone accounting for 275 million out of 800 million at-risk children. By contrast, rates of lead poisoning in developed countries are low—with remaining lead exposure concentrated among the poor and disenfranchised.

Getting the Lead Out—a Call to Action

Lead has been a feature of human activity for millennia, with estimates of its first use ranging from 3,000 to 2,000 BC., and descriptions of its toxicity documented since 200 BC. This makes it all the more remarkable that data on the prevalence and impact of lead poisoning are relatively new. The Lancet Commission on pollution and health, released in 2017 (and updated in 2019), and a 2020 report by UNICEF, provide the first estimates of the global burden of health attributable to lead poisoning. The biggest take-away—that one-third of the world’s children have unsafe blood levels—should have spurred decisive action. Instead, lead pollution has been sorely neglected by the international community.

And things are getting worse, not better. The Lancet Commission also found that global lead exposure increased by an estimated 40 percent between 1990 and 2017. This alarming trend reflects both the range of lead sources and its increased use, especially in fast-growing, emerging markets. Key origin points include batteries, paint, corroded pipes, contaminated spices, cosmetics, artisanal pottery, aluminum pots, and e-waste.

Because lead poisoning is preventable but not curable, every day represents a permanent loss in human potential, as well as elevated health, social, and economic costs—and every new use of lead adds permanently to the stock of lead contamination of our shared environment, increasing the challenge of lead mitigation for future generations. The outcome of continued indifference is that the prevalence and impact of this silent killer will grow and spread.

The good news is that a significant and rapid reduction in lead poisoning is an achievable goal, especially compared to other global problems consuming international attention and funding. 
Why? Because:
Major sources of lead poisoning are well documented;
Progress is quantifiable and measurable, enabling countries to establish benchmarks and set targets;
Remediation policies used by advanced countries in lead eradication are relevant to middle-income countries and low-income countries and can be duplicated;
The highest-impact strategies to combat lead poisoning are cost-effective (e.g., leveraged public health, awareness, and regulatory interventions) and therefore do not need major new allocations of scarce Official Development Assistance funds; and
We all agree that lead is bad! Unlike other global challenges, lead poisoning is not a divisive or polarizing issue.

Getting the Lead Out—Mobilizing Action

Our collective challenge as stakeholders in the international development community is to persuade policymakers in affected countries to make the prevention of lead poisoning a priority. First and foremost, this requires effectively disseminating knowledge about the costs and risks of lead poisoning as many governments and communities are simply unaware of its toxicity.

An encouraging sign is that the G7 has recently taken up the cause—in late 2022, environmental ministers hosted a workshop to discuss options for reducing lead poisoning in LMICs. In support of their efforts, CGD issued a report, offering practical solutions for a way forward. The resulting outcomes document issued by the environmental ministers proposed actions to build awareness, strengthen institutions, and encourage decisive action by governments and other stakeholders. Unfortunately, lead did not merit a mention in subsequent statements issued by the G7 finance ministers or leaders—omissions that increase the risk of further inaction.

G7 advocacy for a lead-eradication campaign would be a major win, so ideally Italy will champion the cause as 2024 chair. But an even more promising political channel would be the G20 because success will ultimately depend on actions in the countries where lead poisoning is most prevalent, like India and China, both of whom are G20 members. A recent policy brief from CGD makes the case, noting that “G20 leadership can kickstart a virtuous cycle of policy intervention by shining a high-level light on the problem while facilitating learning, exchange, and shared accountability for progress at the national level.”

As chair of the G20, India has a truly unique opportunity to become a leader in the fight against lead poisoning by launching a process to eradicate it. India should be highly motivated by the fact that lead poisoning is a major public health crisis—no country has more to gain from a successful course of action. But the window is short; the G20 Summit will be held on September 23.

Getting the lead out is a long-term commitment, requiring sustained attention. But the case is easy to make: the body of evidence on the impact of lead exposure is large and growing; designing an effective eradication strategy is eminently doable thanks to data on sources of lead, contamination sites, and populations most at risk; and cost-effective remediation practices are well established. Conversely the price of inaction would be high, erasing human potential, increasing health and social costs, and creating a bigger and more complex challenge for future generations.

Concerted international action is long overdue. The world’s children—and future generations—deserve nothing less.


Disclaimer

CGD blog posts reflect the views of the authors, drawing on prior research and experience in their areas of expertise. CGD is a nonpartisan, independent organization and does not take institutional positions.

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