Lead is one of the most poisonous things going. A single sugar sachet of lead, spread over a park the size of an American football field, is enough to give a child that regularly plays there lead poisoning. For life they’ll be condemned to a ~3-point-lower IQ; a 50% higher risk of heart attacks; and elevated risk of kidney disease, anaemia, and ADHD, among other effects.

We’ve known lead is a health nightmare for at least 50 years, and that got lead out of car fuel everywhere. So is the situation under control? Not even close.

Around half the kids in poor and middle-income countries have blood lead levels above 5 micrograms per decilitre; the US declared a national emergency when just 5% of the children in Flint, Michigan exceeded that level. The collective damage this is doing to children’s intellectual potential, health, and life expectancy is vast — the health damage involved is around that caused by malaria, tuberculosis, and HIV combined.

This week’s guest, Lucia Coulter — cofounder of the incredibly successful Lead Exposure Elimination Project (LEEP) — speaks about how LEEP has been reducing childhood lead exposure in poor countries by getting bans on lead in paint enforced.

Links to learn more, summary, and full transcript.

Various estimates suggest the work is absurdly cost effective. LEEP is in expectation preventing kids from getting lead poisoning for under $2 per child (explore the analysis here). Or, looking at it differently, LEEP is saving a year of healthy life for $14, and in the long run is increasing people’s lifetime income anywhere from $300–1,200 for each $1 it spends, by preventing intellectual stunting.

Which raises the question: why hasn’t this happened already? How is lead still in paint in most poor countries, even when that’s oftentimes already illegal? And how is LEEP able to get bans on leaded paint enforced in a country while spending barely tens of thousands of dollars? When leaded paint is gone, what should they target next?

With host Robert Wiblin, Lucia answers all those questions and more:

• Why LEEP isn’t fully funded, and what it would do with extra money (you can donate here).
• How bad lead poisoning is in rich countries.
• Why lead is still in aeroplane fuel.
• How lead got put straight in food in Bangladesh, and a handful of people got it removed.
• Why the enormous damage done by lead mostly goes unnoticed.
• The other major sources of lead exposure aside from paint.
• Lucia’s story of founding a highly effective nonprofit, despite having no prior entrepreneurship experience, through Charity Entrepreneurship’s Incubation Program.
• Why Lucia pledges 10% of her income to cost-effective charities.
• Lucia’s take on why GiveWell didn’t support LEEP earlier on.
• How the invention of cheap, accessible lead testing for blood and consumer products would be a game changer.
• Generalisable lessons LEEP has learned from coordinating with governments in poor countries.
• And plenty more.

Producer and editor: Keiran Harris
Audio Engineering Lead: Ben Cordell
Technical editing: Milo McGuire and Dominic Armstrong
Transcriptions: Katy Moore