Lead is a neurotoxin. In children it lowers IQ, raises the odds of behavioral problems and, later in life, heart disease. Rich countries mostly dealt with it decades ago by taking lead out of gasoline, paint and pipes. Much of the rest of the world did not. UNICEF and Pure Earth estimated in 2020 that about one in three children worldwide, roughly 800 million, had blood lead above the level at which action is recommended.
That is a huge problem with, in some places, an unusually cheap fix.
The paint route
The Lead Exposure Elimination Project (LEEP) works with governments in low- and middle-income countries to get lead out of house paint. The method is not glamorous: test paints on the market, publish the results, help write a regulation, then help manufacturers reformulate. Once the rule is in place, every can of paint sold afterwards is safer at no ongoing cost to the charity.
LEEP’s own cost-effectiveness analysis, published April 22, 2024, estimates that its paint programs cost about $4.49 per DALY-equivalent averted, with a 90% confidence interval of $0.78 to $12.93. A DALY, or disability-adjusted life year, is one lost year of healthy life. For comparison, the World Health Organization has historically treated interventions under a country’s per-capita income per DALY as cost-effective, which in the countries where LEEP works is hundreds to a few thousand dollars. Four or five dollars is an outlier.
Two other evaluators land in the same territory:
- Founders Pledge estimates $1.66 to prevent one child’s lead exposure through LEEP, in expectation, and lists LEEP among its most cost-effective recommendations.
- Giving What We Can describes LEEP as averting a DALY for roughly $14.
The spread between $4.49 and $14 is the kind of gap you should expect when different people model the same program with different assumptions. What matters is that all of them are far below the cost of most health interventions.
Where the value comes from
LEEP’s model attributes about 84% of the benefit to income, not health. Lead lowers cognitive ability, which lowers lifetime earnings. Across the 13 programs modeled, LEEP projects roughly 46.6 million children protected by 2100 and about $43.2 billion in earnings preserved, on total program costs near $4 million.
That framing is important for two reasons. First, if you weight health more than income, LEEP’s numbers look less extreme but still very good. Second, most of the projected benefit is in the future and rests on the assumption that regulations, once passed, are enforced and stay enforced. LEEP itself says the model is “mostly predictive, rather than based on results that have already been achieved.”
The other lead charity: Pure Earth
Pure Earth works on lead from other sources: informal battery recycling, contaminated spices, cookware, cosmetics. The Happier Lives Institute lists it as a “promising” charity at about 105 WELLBYs per $1,000, or $9 per WELLBY (a WELLBY is one point of life satisfaction on a 0-10 scale for one person for one year). That is the highest figure on HLI’s list. Pure Earth’s work is harder to model than paint regulation because cleanup is site-specific, so treat the number as an early estimate.
Is the money needed?
Yes, with a twist. LEEP reported in November 2025 that its immediate 2026 funding gap for paint programs was filled, and that it plans to scale to 50 African countries in 2026 while expanding into spices and cosmetics. A filled gap for one program line does not mean the field is funded; it means the next dollar goes to expansion and to the harder sources of exposure, where cost per outcome is likely higher than the paint figures above.
Bottom line
On the published evidence, getting lead out of paint is among the cheapest large-scale health interventions anyone has costed. The estimates are model-based and forward-looking, so a tenfold uncertainty band is honest. Even at the pessimistic end they compete with the best global health programs, and the problem is far from solved.
Method notes
All cost figures are the evaluators’ own, quoted with their dates. We did not build our own model. “Hundreds of millions of children” refers to the 2020 UNICEF and Pure Earth report The Toxic Truth.
Sources
Figures come from the cited sources as of the dates shown. Cost-effectiveness estimates change as programs and evidence change; check the source before giving. We are not financial advisers and receive nothing from any charity named here.