Urgent action is needed to address the “staggering harm” caused by lead poisoning, mostly in low-income countries where more than half of children are exposed to dangerous levels of the pollutant.
A year-long project, led by Washington-based thinktank the Center for Global Development (CGD), has concluded that lead poisoning constitutes a global health crisis that has been “extraordinarily neglected” by donors and political leaders.
An estimated 815 million children – one in three worldwide – have lead poisoning, a condition linked to heart and kidney disorders, impaired intelligence, violent behaviour and premature death. Last month, a paper in Lancet Planetary Health estimated that, in 2019, 5.5 million people died because of cardiovascular disease caused by lead poisoning, about three times the number killed by lung cancer.
A common condition
The human toll of non-communicable diseases (NCDs) is huge and rising. These illnesses end the lives of approximately 41 million of the 56 million people who die every year – and three quarters of them are in the developing world.
NCDs are simply that; unlike, say, a virus, you can’t catch them. Instead, they are caused by a combination of genetic, physiological, environmental and behavioural factors. The main types are cancers, chronic respiratory illnesses, diabetes and cardiovascular disease – heart attacks and stroke. Approximately 80% are preventable, and all are on the rise, spreading inexorably around the world as ageing populations and lifestyles pushed by economic growth and urbanisation make being unhealthy a global phenomenon.
NCDs, once seen as illnesses of the wealthy, now have a grip on the poor. Disease, disability and death are perfectly designed to create and widen inequality – and being poor makes it less likely you will be diagnosed accurately or treated.
Investment in tackling these common and chronic conditions that kill 71% of us is incredibly low, while the cost to families, economies and communities is staggeringly high.
In low-income countries NCDs – typically slow and debilitating illnesses – are seeing a fraction of the money needed being invested or donated. Attention remains focused on the threats from communicable diseases, yet cancer death rates have long sped past the death toll from malaria, TB and HIV/Aids combined.
‘A common condition’ is a Guardian series reporting on NCDs in the developing world: their prevalence, the solutions, the causes and consequences, telling the stories of people living with these illnesses.
Tracy McVeigh, editor
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The World Bank calculates the cost of premature deaths to be equivalent to $4.6tn, or 5.3% of global GDP. The effects of lead poisoning are also a significant barrier to achieving almost all of the UN’s sustainable development goals, the report says.
Children are most vulnerable to the condition because they’re more likely to put lead items in their mouths (for instance, toys covered in lead paint), and because their bones and organs absorb more of the metal once consumed. Additionally, lead, which is a neurotoxin, can more easily cross the blood-brain barrier at younger ages, where it can severely affect mental development.
In July, a working paper published by the CGD aggregated 47 studies to show that the more lead children are exposed to, the lower their test scores in maths, reading and IQ. The CGD found that about a fifth of the total gap in test scores between children in rich and poor countries is attributable to differences in lead exposure.
Strict laws and billions of dollars in addressing the causes of poisoning prevent most children in wealthy countries from coming into contact with significant amounts of lead. That is not the case in poorer nations, where the metal continues to be used in commercial products such as paint (which can chip and create dust that people breathe in), traditional medicines and spices, as well as cookware glazed in lead, which can leach into food.
Black mountain in Kabwe, Zambia, is formed of lead slag from a former mine, which pollutes soil, water and air, causing lead poisoning in local people. Photograph: Larry C Price
The failure to create buffer zones between mining waste facilities and residential areas also contributes to soil and air contamination in poor countries, as does the absence of well-enforced safety and environmental standards for lead-acid battery recyclers.
As a result, it is estimated that more than half of all children in low-income countries have lead poisoning – the figure is just 3% in rich nations. During the height of the water crisis in Flint, in the US state of Michigan, where lead was found in drinking water, less than 4% of Flint’s children were clinically poisoned.
An estimated $350m in targeted aid from 2024 to 2030 would be enough to dramatically reduce lead exposure in lower-income countries, provided there is enough engagement from political leaders, according to the CGD. Funding requirements include donations for lead-testing equipment, support with advocacy and awareness campaigns, and technical assistance with drafting and enforcing regulations.
But the CGD identified that annual philanthropic funds to prevent and mitigate lead exposure in low- and middle-income nations amount to just $11m.
‘A wonderful accomplishment’: success for cleanup of Nigeria’s deadly lead pollutionRead more
The CGD statement says dramatic action is needed to end the “slow-moving crisis” and calls on development agencies and banks to support governments in low- and middle-income countries to produce national strategies that include regulation and increased awareness.
In the short term, reducing contamination, for example by removing products from the market, can have a significant impact.
Children wait in a line to collect safe drinking water after floods in Sylhet, Bangladesh, in 2022. Photograph: Syed Mahamudur Rahman/NurPhoto/Rex/Shutterstock
A 2019 study in Bangladesh found that turmeric was often adulterated with lead to make it brighter, and that this was the main source of lead exposure in the areas tested. In response, external donors helped sponsor an initiative with the Bangladesh Food Safety Authority and experts to educate the public about the dangers of lead. They also warned consumers to avoid bright yellow turmeric and notified suppliers about the legal penalties for lead adulteration. Health inspectors were then trained to test turmeric samples from a large wholesale market in the capital Dhaka, and offending sellers were fined.
Researchers found that in 2019, just before this campaign, almost half of the turmeric sampled from Dhaka’s main wholesale market contained detectable amounts of lead. By 2021, a year after the initiative, this had dropped to zero.