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An illustration of a man and a woman, Jack Rafferty and Lucia Coulter. Rebecca Clarke for Vox

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Lucia Coulter and Jack Rafferty want to strip the world of lead-based paint

The Lead Exposure Elimination Project is already getting results in countries where lead-based paint is still used.

Dylan Matthews is a senior correspondent and head writer for Vox's Future Perfect section and has worked at Vox since 2014. He is particularly interested in global health and pandemic prevention, anti-poverty efforts, economic policy and theory, and conflicts about the right way to do philanthropy.

The United States, famously, has not fully dealt with its lead poisoning problem, a legacy largely due to decades’ worth of cars spewing exhaust from leaded gasoline onto local populations and into local soil, where it can linger for a shockingly long time. The continued presence of leaded paint in old houses and lead pipes in old water lines, of course, does not help. In some situations, as in Flint, Michigan, in the mid-2010s, corrosive water sources can cause those pipes to leach lead into the water that reaches ordinary people, leading to spiking levels of poisoning.

But the US is an outlier by global standards, in that our lead problem is milder than those in countries where most of the world’s people live. A systematic evidence review in 2021 pooled lead screenings from 34 countries representing two-thirds of the world’s population, and estimated that 48.5 percent of children in those countries had high blood lead levels.

The most recent Global Burden of Disease study published in the Lancet, in 2019, estimated that about 900,000 people die due to lead annually, representing 21.7 million years of healthy life lost. One attempt to quantify the economic costs of lead in low- and middle-income countries estimated that in 2011, the burden was around $977 billion annually, or 1.2 percent of global GDP.

Despite the dramatic extent of the problem, lead poisoning has not been a major focus of global health efforts in recent decades. The organization Pure Earth (formerly the Blacksmith Institute) and its founder Richard Fuller have been an admirable exception, and remain the dominant group doing direct work on the problem. But recently they’ve been gaining much-needed allies in the fight.

The Lead Exposure Elimination Project (LEEP), founded by physician Lucia Coulter and nonprofit veteran Jack Rafferty in 2020, has quickly become a leading group working specifically on lead paint, which remains remarkably common in the Global South. A LEEP study in Malawi has already spurred that country to begin regular inspections to test for lead levels in paint, and the organization is making progress in Liberia and Pakistan.

It’s a great example of how newcomers can complement established players in a field, and make tangible progress.

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