Lucia Coulter is a co-founder and co-director of the Lead Exposure Elimination Project (LEEP), a non-profit working to reduce lead exposure via lead-based paint. Lucia was kind enough to answer some questions of mine about lead exposure generally and LEEP's work specifically. Here are some extracts:

ERICH: Given the outrage that followed the Flint water crisis some years ago, it might be surprising to some that, as you write in your introductory post on the Effective Altruism forum, "815 million children have blood lead levels [at] a sufficient level for neurodevelopmental effects and reduced IQ [and] one in three children are currently affected by lead poisoning to some degree". Why has lead exposure been so neglected?

LUCIA: I think there are a few reasons for this but probably one of the most important is that this widespread chronic lead poisoning affecting one in three kids is relatively invisible. The effects include neurodevelopmental problems like reduced intelligence, behavioural problems, reduced educational attainment, reduced income, and cardiovascular disease later in life. Anyone experiencing these problems or seeing children experience these problems isn't going to know that they are the result of lead exposure. And as a result, lead exposure is not going to seem like a priority problem to research or address.

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ERICH: Could you expand a little on how Charity Entrepreneurship helped you prepare? Did they offer trainings and mentorships, that sort of thing?

LUCIA: Firstly they provided a two-month full-time incubation program, which I went through (remotely) in the summer 2020. This was where I decided to work on lead exposure (which was an idea researched and recommended by Charity Entrepreneurship), where I paired up with my co-founder Jack, and from where we received our initial seed grant. During the program we learnt a huge amount of extremely relevant and practical material – for example, how to make a cost-effectiveness analysis, how to make a six-month plan, how to develop a monitoring and evaluation strategy, how to hire, and a lot more. Since then Charity Entrepreneurship has provided LEEP with weekly mentoring and wider support through the community of staff, previous incubatees, and advisors. I highly recommend checking out the Charity Entrepreneurship incubation program if anyone is interested!

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ERICH: David Bernard and Jason Schukraft discuss, as one area of uncertainty here, that there already seems to be "global momentum toward restrictions on the amount of lead that can be included in residential paint". Does that seem true to you? and if so, what does that mean for LEEP?

LUCIA: It is true that there is a global trend towards lead paint regulation, but this does seem to be due to active efforts to promote the change. In our cost-effectiveness analysis we assume that lead paint regulation would be implemented even without our input, but we would expect this to happen some time in the future (perhaps around eight years in Malawi). So our impact is a result of bringing the change forward in time. In the case of Malawi it would probably have taken someone else to carry out a paint study and bring the data to the attention of the government to cause any change. There hasn't been any other activity in this area so we don't think this would have happened in the near future without our input. Similarly, in Zimbabwe before our involvement there was no research into the problem of lead in paint and to our knowledge no efforts to advocate for regulation.