Lead Exposure Affects One in Three Children Worldwide
Pure Earth’s Drew McCartor argues that lead poisoning remains a global public-health crisis, exposing more than a billion children and causing damage that cannot be reversed once it reaches a developing brain. His proposed response is straightforward: governments should measure children’s exposure, identify the main local sources, then regulate, enforce and clean them up. He points to Georgia, where action on lead-contaminated spices cut levels in the hardest-hit regions by 75 percent, as evidence that the model can work.
Lead exposure is a present-tense global loss
Drew McCartor says lead poisoning is routinely treated as a problem already solved, even as it imposes an enormous and ongoing toll. By the end of a single day, he says, lead will have permanently robbed the world’s youngest children of more than two million IQ points. The same loss recurs each day until exposure is reduced.
The harm is not confined to childhood cognitive development. Lead also contributes to cardiovascular disease, heart attacks and strokes, McCartor says. In 2023, the latest year for which he cites estimates, lead caused more deaths than active wars, natural disasters, road accidents, HIV and malaria combined.
More than one billion children and teenagers—roughly one in three—have blood-lead concentrations above the World Health Organization threshold at which intervention in a child’s life is warranted, according to McCartor. Nearly all live in low- and middle-income countries. There, he says, the average child’s exposure is high enough to cost an estimated four to five IQ points.
His population-level argument is that this is not a marginal loss distributed evenly across an abstract average. A four-to-five-point shift moves the entire IQ distribution downward: it cuts in half the number of children with IQs above 130 and increases by half the number below 70, who face intellectual disability.
To do it to a billion kids, that changes the trajectory of humanity.
The response is practical: measure, locate, remove
McCartor argues that lead poisoning does not require a new technology or an unusually favorable political moment to address. After 25 years of testing prevention strategies, he says, Pure Earth has found that governments can dramatically reduce exposure through three linked actions.
First, they need nationally representative data on children’s exposure. This usually means blood-testing a few thousand children to establish a baseline: how many children are affected and where they live. The survey is not only diagnostic. It gives a government its own evidence of the problem, McCartor says, and that evidence can create the basis for a response when the findings are severe.
Second, authorities need to identify the leading sources of exposure in their own setting. Old paint and pipes receive substantial attention in Western discussions, but the sources differ widely by country. They can include food and spices, traditional cosmetics and medicines, ceramic glazes, cheap aluminum cookware, and industrial pollution. The practical task is to identify the priority sources rather than treating every possible source as equally urgent.
Third, governments must regulate and remove lead from the economy and environment. In McCartor’s formulation, that means tightening standards, improving enforcement capacity and cleaning up contaminated sites. He does not describe this work as easy, but rejects the idea that it is technically mysterious. The model depends on converting measurement into a country-specific regulatory agenda: data establishes the scale, source identification establishes what to target, and enforcement removes the routes through which children are exposed.
Georgia shows what the model can achieve
Drew McCartor offers Georgia as the central example of the sequence working in practice. In 2018, the country conducted a national survey with UNICEF and found that 41 percent of Georgian children exceeded the WHO intervention threshold. The government brought in Pure Earth to identify the major driver: contaminated spices.
Lead-based pigments were being added to spices to make their orange and red colors brighter. Georgia then tightened regulations and improved enforcement capacity. McCartor says lead levels in the country’s hardest-hit regions have since fallen by 75 percent.
The point is not that spices are the universal problem. Georgia’s result supports the opposite conclusion: countries need to establish their own exposure profile, identify their own main sources, and then act on them. McCartor says Pure Earth has also helped the Philippines conduct its first large survey, Ghana identify exposure sources, and Mexico reduce the use of lead-based glazes.
In Georgia, McCartor says, the government owns the agenda and the next generation is well protected. Outside groups can help generate evidence and identify hazards, but the country’s response centered on its own survey findings, regulations and enforcement capacity.
Saim’s exposure shows why prevention cannot wait
In a Bangladeshi village where Pure Earth was cleaning up lead pollution, Saim was in a community affected by men recycling old car batteries. They removed lead plates from the batteries and melted them over open fires, spreading toxic dust through the village.
Saim’s mother told Pure Earth that he had been doing well in school and could remember things before the recycling operation arrived. Gradually, she said, he began forgetting. During an interview, he first identified himself as being in Grade 2, then said that he and a friend were both in Grade 3. When asked about the contradiction, he answered:
I can’t remember!
Drew McCartor stresses that lead poisoning cannot be recognized simply by looking at a child. He describes the developing brain as a city under construction, with calcium directing the formation of synaptic connections needed for learning, memory and impulse control. Lead can masquerade as calcium, so the brain uses it in calcium’s place. But instead of organizing functional connections, he says, it produces “dead-end streets and bridges to nowhere.”
Once that chaotic network is built, McCartor says, the damage is permanent. Pure Earth cannot give Saim back what lead took from him. Prevention therefore has to reach children whose brains are still developing before exposure does.
An eight-year effort aimed at 500 million children
Drew McCartor says Pure Earth is rolling out its survey-source-regulation model in more than 20 countries with support from the Audacious Project donor community. Those countries are home to 500 million lead-poisoned children.
The planned effort has an eight-year horizon. McCartor says it is intended to improve intellectual capacity, health and longevity not only for those half-billion children, but for the generations behind them that would otherwise encounter the same contaminated products, industrial practices and polluted sites.
Georgia is his evidence that the approach can produce large reductions once a government has identified and acted on a principal exposure source. The scale-up is a different proposition: applying that sequence across countries whose hazards may range from spices and ceramics to cookware, medicines and industrial recycling.
The central obstacle, McCartor says, is visibility. Lead remains widely understood as a historical problem despite its current reach. His prescription is correspondingly concrete: make the burden measurable, identify where exposure originates, and use regulation, enforcement and cleanup to remove it before more children are harmed.