Announcing the Lead Exposure Action Fund

By Alexander_Berger, Emily Oehlsen @ 2024-09-23T19:04 (+259)

This is a linkpost to https://www.openphilanthropy.org/research/announcing-the-lead-exposure-action-fund

One of Open Philanthropy’s goals for this year is to experiment with collaborating with other funders. Today, we’re excited to announce our biggest collaboration to date: the Lead Exposure Action Fund (LEAF). 

Lead exposure in low- and middle-income countries is a devastating but highly neglected issue. The Global Burden of Disease study estimates 1.5 million deaths per year attributable to lead poisoning. Despite this burden, lead poisoning has only received roughly $15 million per year in philanthropic funding until recently. That is less than 1% of the funding that goes towards diseases like tuberculosis or malaria, which are themselves considered neglected. The goal of LEAF is to accelerate progress toward a world free of lead exposure by making grants to support measurement, mitigation, and mainstreaming awareness of the problem.

Our partners have already committed $104 million, and we plan for LEAF to allocate that funding between now and the end of 2027. We’re very grateful for the trust that Alpha Epsilon Fund, the Bill and Melinda Gates Foundation, the ELMA Foundation, the Livelihood Impact Fund, Lucy Southworth, the 10x Better Foundation, Good Ventures, and other supporters are putting in us, and excited for the progress we will be able to make together against lead poisoning. We especially want to acknowledge Lucy’s formative contribution: her idea to establish a pooled fund focused on global lead removal inspired us to launch this initiative.

LEAF has already committed more than $20 million in grants, and we expect to allocate the remainder by the end of 2027. We estimate that this will roughly double total philanthropic spending toward lead exposure reduction in low-income countries.

Why we chose to work on lead

We seek out focus areas that are some combination of important, neglected, and tractable. Lead exposure in low-income countries is all three.

Importance

Exposure to lead can cause long-term harm to human health, even at low levels. In children, exposure adversely affects the developing brain, causing reduced cognitive development, lower educational attainment, learning disabilities, reduced attention span, and behavioral disorders. Adults are also susceptible to the effects; exposure can cause problems with kidney function, the nervous system, and the cardiovascular system. Lead exposure causes an estimated 1.5 million deaths each year.

In Flint, Michigan—the center of a major scandal on child lead exposure in the United States—it was estimated that one in 20 children had blood lead levels above the Centers for Disease Control and Prevention’s previously recommended threshold for action (5µg/dL) at the peak of the crisis.^[1] At present, one in two children in LMICs is estimated to be above that same threshold.

Neglectedness

Despite its severe impact on cognitive and physical health, lead exposure receives little philanthropic attention, even compared to other neglected health challenges like tuberculosis (TB) and malaria. Both of those issues receive billions of dollars in philanthropic support each year. Despite a comparable estimated global burden,^[2] lead exposure received only around $15 million annually until recently (much of it from Open Philanthropy and GiveWell).

Tractability

Fortunately, lead exposure is a tractable issue – we have evidence that it can be addressed effectively at scale:

• Between the late 1970s and the 2010s, average blood lead levels in the US declined by 94%, largely due to regulations that limited exposure from sources like gasoline and paint.
• In Bangladesh, after a 2019 study found high levels of lead in turmeric, the country’s Food Safety Authority instituted a program of fines, monitoring, and education. A follow-up study suggests that blood lead levels fell by roughly 30%. 
• In Malawi, the market share for consumer paint that contains lead dropped from 67% to 24% between 2021 and 2023 after the Lead Exposure Elimination Project (LEEP), one of our grantees, worked with the Malawi Bureau of Standards to improve testing capacity and strengthen auditing processes.

We launched a program on lead exposure in October 2023, building on a portfolio of grants recommended to Open Philanthropy by GiveWell (which incubated Open Philanthropy and still works closely with us). GiveWell’s work in this area, starting in 2019, directly inspired our own, and we’re grateful to them for helping us reach this point.

What LEAF hopes to achieve

Our work on lead exposure is focused on three broad buckets:

• Measurement: Collecting data on the prevalence of lead exposure, and working to understand the sources of exposure.
• Mitigation: Directly targeting the most urgent and addressable sources (with a particular focus on paint and spices).
• Mainstreaming: Advocating for countries to prioritize lead exposure when setting health policy, and for funders to commit to higher levels of support for this work.

The LEAF team

The LEAF team includes James Snowden, Santosh Harish, Chris Smith, and Emily Oehlsen. James oversaw GiveWell’s early work on lead before joining Open Philanthropy. Santosh leads Open Philanthropy’s work on improving air quality in South Asia, bringing expertise in environmental health from an analogous and more developed field. We’re also in the final stages of hiring additional grantmakers to help manage the program going forward.

An experiment for Open Philanthropy

As we wrote in March, we are exploring working more with other donors who are dedicated to optimizing the impact of their charitable giving at scale. LEAF is our biggest such experiment yet.

The problems that Open Philanthropy tackles – from lead exposure and air pollution to factory farming and risks from advanced AI – are too large and complex for any donor to address alone. By establishing LEAF, our first collaborative fund, we’re trying out a new style of giving in partnership. We are deeply grateful for the generous support of, and trust placed in us by, the philanthropists who’ve joined LEAF.

We are excited to see how much progress we can make towards lead removal globally, and to see how this model of giving works for us. 

Grantmaking so far

LEAF has already committed more than $20 million in grants, including support for:  

• The Center for Global Development, to highlight lead exposure as a core development issue within the global aid community.
• Pure Earth, to work on a range of activities – from improving lead-acid battery recycling in Indonesia to piloting an intervention for lead exposure from cookware in India. 
• A collaboration between the Lead Exposure Elimination Project and professors from Stanford and Mercer University, to develop a new method for testing lead levels in paint using portable XRF devices.
• Pahle India, to run a working group on lead exposure in India. The group was first convened in August 2024, and was attended by over 60 experts from India and other countries.

We are also co-founding (and have pledged to co-fund) the Partnership for a Lead-Free Future, a global initiative with the goal of bringing together UN institutions, aid agencies, funders, and country governments to make progress on lead exposure. Such global partnerships have been instrumental in previous successful efforts.^[3] The partnership was announced today on the sidelines of the UN General Assembly at an event featuring the leadership of USAID, UNICEF, WHO, UNEP, and the World Bank. You can learn more about this effort in a joint op-ed published in the Washington Post with USAID Administrator Samantha Power.

The world has already succeeded in massively reducing the burden of lead exposure for hundreds of millions of people. We’re excited to be taking the next crucial steps toward eliminating lead exposure globally, ensuring that everyone—regardless of where they live—has the opportunity to lead a healthy life in a lead-free environment.

1. ^{^}

   The CDC revised its threshold for action downwards to 3.5ug/dl in 2021.

2. ^{^}

   Lead exposure is estimated to kill more people (1.5 million) than either TB (1.2 million) or malaria (750,000), but to cause fewer disability adjusted life years (34 million) than either TB (47 million) or malaria (55 million).

3. ^{^}

   For example, see this case study of the Partnership for Clean Fuel and Vehicles, which appears to have been instrumental in eliminating leaded gasoline.