World Economic Forum, Davos, Switzerland

DR. LUCY PÉREZ: Good afternoon everyone. I am Lucy Pérez, a senior partner with McKinsey and Company, and a co-leader of McKinsey’s Health Institute, and it gives me great pleasure to be here with all of you to moderate this important conversation. Lead, with its pervasive presence poses serious threats to our people and the environment and to our collective well-being. I’m looking forward to the conversation today with these three wonderful speakers. Please join me in welcoming His Excellency Prime Minister Irakli Garibashvili of Georgia, The Honorable Mudrick Soragha, Minister of Labor, Economic Affairs, and Investment of Tanzania, and Administrator Samantha Power of the U.S. Agency for International Development. 

We will hear some opening remarks first from Administrator Power before we start a conversation with the panelists. I would encourage you to think through what questions you have for this group. Let me with that now, turn the floor over to Administrator Power. 

ADMINISTRATOR SAMANTHA POWER: Thank you, Lucy [Pérez] for that introduction, and really a special thanks to Prime Minister [Irakli] Garibashvili of Georgia, whose efforts to treat and prevent lead exposure have cut blood lead levels in the country’s hardest-hit regions by two-thirds in just five years. Really looking forward, Mr. Prime Minister, to hearing your account of how you achieved that measurable success. And Minister [Mudrick] Soragha from Tanzania, whose country was the first in East Africa to regulate lead paint, and with whom we are looking forward to working on the ground to expand the impacts of those regulatory efforts. 

First, just maybe a personal reflection on this panel. I have spent my career – first as a journalist, and as a human rights activist, and as a government official, and as a diplomat – looking for ways to promote and protect human rights, and to try, especially while at USAID, to improve and even if we can save lives around the world. I can say right here, that never in my career have I seen an opportunity like the one we are about to discuss – to deliver such a powerful blow to such an invisible killer for such a relatively small amount of funding. 

And I’m speaking, of course, we are speaking about lead poisoning. The world can make a really substantial dent in lead exposure for less than it costs to make the last movie you saw. 

Lead poisoning claims a staggering 1.6 million lives each year. That’s more than the deaths caused by malaria and HIV/AIDS combined. 

One would expect that such a staggering human cost would garner major international attention and resources. Yet the total investment each year from international donors in taking on this crisis is just $15 million. That is million with an M, million.

If all we do coming out of today, and I really want to send a special welcome and thanks to all the people who are watching online, if all we do together is begin the final push for example to eliminate lead in consumer goods – if all we do is begin to harness the power of our networks and commit just a fraction of our annual budgets to this cause – we have the chance to prevent brain damage for hundreds of millions of children and every year, potentially, to save hundreds of thousands of lives.

Perhaps no one can better understand the urgency of addressing the lead crisis than parents. For decades, lead has poisoned kids in their classrooms, their bedrooms, their playgrounds. Lead lurks in the food that kids eat, the water they drink, the medicines they take, and of course the paint brightening their bedroom walls, and the toys that are helping them learn and grow. Until very recently, lead laced the gasoline powering their family cars, and it spewed out of exhaust pipes into the air that they breathed.

Lead is particularly harmful to children, but there is no safe amount of lead for anyone. Imagine if a single sugar packet filled with lead dust was sprinkled across an American football field – so think of the scale of the football field and the tiny little packet of sugar, what comes out of that packet would be enough to poison a child playing there. 

And once in the body, lead can threaten almost every major organ – wreaking special havoc on the heart and the brain. Signs of exposure are often difficult to attribute; cognitive deficits might be ascribed to poor education, and even deaths are attributed to heart attacks or strokes, rather than the lead poisoning that caused them.

Yet for a problem so omnipresent, so invisible, so deadly, the key policy response is actually straightforward: eliminate lead at its source, before it reaches communities. 

That, of course, as we all know, is what happened before. In the 1970s, when government officials and activists tackled one of the largest sources of lead: gasoline. By the turn of the century, industrialized countries from Japan to the United States had implemented total bans on lead additives. Over the following two decades, a UN-led campaign helped achieve that same result throughout the rest of the world – it’s an incredible, insufficiently told success story. They spent just $6 million in ten years, and that period covered the phase-out of leaded gasoline in all of sub-Saharan Africa and every remaining holdout except for four countries.

Leaded gasoline was one of those rare public health threats – wide-ranging and deadly, yes, but also eminently solvable. And the impact has been tremendous. Every year, the ban on leaded gasoline saves roughly 1.2 million lives.

Higher-income countries like the U.S. went on to ban lead additives in other products like house paint and water pipes. Starting in 1978, blood lead levels throughout the U.S. dropped 60 percent within 10 years, and 95 percent within 25 years. Today, President Biden is making historic additional investments, this time, in the replacement of lead water lines, the removal of lead-based paint in older buildings, and the clean-up of lead deposits in soil.  

But in many low- and middle-income countries, there is still very little regulation of lead in products beyond gas, and often no enforcement, or too little enforcement, to ensure that regulations are being followed. 

Today, one in two children in these countries has elevated levels of lead in their blood. That is every other student in a classroom, every other child kicking a soccer ball on a field. 

Lead causes learning disabilities and educational performance gaps estimated to cost the global economy at least a trillion dollars every year.

Fortunately, and again looking ahead there is a lot of good news for us to seize upon, the successful phase-out of gasoline and other products has given us a straightforward, proven playbook to take on this crisis.

First, conduct regular blood and market testing, and ideally blood lead level testing, to identify exposures and trace exposure back to the source.

Second, pass binding controls to phase out lead in specific products and industries.

Third, where needed, support the private sector to transition to lead free and often – and this is key – cost-comparable alternatives. Those cost-comparable alternatives are out there and accessible, they just have to be seized upon.

And finally, enforce and ensure that regulations are being followed.

This playbook is broadly applicable, but it is especially efficient and affordable to implement one slice of this problem, and that is that which relates to consumer products – paint, spices, and cosmetics. So, we are also supporting the advocacy needed to pass and enforce new regulations to phase out lead in these products.

That is why I’m delighted, here today at the World Economic Forum, to announce that USAID is the world’s first bilateral donor agency to join the Global Alliance to Eliminate Lead Paint. The Alliance has helped ban leaded paint in almost 40 countries – more than a third of all nations that have bans. Joining the Alliance can give our teams on the ground the support they need to assist our government partners in passing similar policies.

The process to phase out lead from consumer products is often incredibly cheap. In 2019, for example, Bangladeshi researchers discovered that turmeric was a primary cause of high blood lead levels. Government officials launched an aggressive media campaign to inform communities about the dangers of lead and followed up with impromptu testing of turmeric to identify which shops were selling leaded products. Within two years, just two years, the percent of turmeric samples containing lead dropped from 47 percent to zero. And the cost of the entire effort, from start to finish, was in the low millions.

Now, not all efforts to prevent the release of lead into the environment will be so cost effective. Preventing lead pollution in industries like mining and manufacturing, replacing infrastructure like old lead pipes, and cleaning up contaminated soil and water, that’s of course require more resources. But that’s why it’s so important to give countries the tools and support they need to identify, what for them, are the biggest sources of lead exposure – so that they know where they need to concentrate resources to eliminate lead.

I’m pleased to announce here today that USAID is committing an initial $4 million toward identifying and addressing common sources of lead exposure in low- and middle-income countries, including blood testing and sampling initiatives. That money is going to fund pilot programs in India and South Africa focused on lead mitigation, while also supporting UNICEF as they work to expand blood testing nationwide to Bangladeshi children.

Today though, the reason we are here and doing this at the World Economic Forum, is to make an appeal, to donors of all kind – governmental donors, other international funders, diaspora doors, high net worth individuals – to join us. 

Join us in building up testing capacity, join us in helping countries identify the source of the problem, best apply their resources to take it on or reinforce those resources where we need to, and see that those efforts are making a measurable difference – finding ways to see the impact of specific interventions.

So many of the challenges we face, that are being discussed in other rooms, that are being discussed all around the world, that are searing our consciences as we are here today are entrenched, they are complicated, they are hard to solve. Lead is different. According to the Center for Global Development, we can eliminate lead from two critical consumer sources, paint and spices, for just $30 million. That is the cost of a private jet. To be clear, there are other consumer goods that we absolutely have to tackle together, but the cost there too will be comparable.

For a small price we can spare parents of living the nightmare of seeing their kids poisoned in the places where they’re supposed to be safe. We can help prevent cardiac deaths in men and women who are too young to die. And we can help kids under five safely learn and grow to their fullest potential – if we simply choose to.

Thank you so much.

DR. PÉREZ: Thank you, Administrator Power. Those are powerful words. It is clear that lead poisoning is a health crisis, is an economic productivity and attainment crisis, it’s also an education crisis. It is helpful to hear of the playbook and the tools that are available and can drive change. Administrator Power referenced the success of Georgia. And so Prime Minister [Garibashvili], would love to hear you elaborate on what was Georgia’s journey and how you made that change happen.

GEORGIAN PRIME MINISTER IRAKLI GARIBASHVILI: Thank you very much. Well, first of all, thank you very much. I want to express my gratitude to USAID Administrator, Madam Power, and your friends and colleagues. Thank you very much for inviting us to highlight Georgia’s success story. I also want to mention that lead poisoning stands out as one of the most pressing public health challenges in the world. It is also crucial to recognize that this challenge extends beyond Georgia and other countries – it is a global issue. Recent reports highlight that an estimated one in three children worldwide suffers from lead poisoning due to exposure to common sources like paints, in form of batteries, recycling centers, cookware, cosmetics, and in some instances spices as was mentioned. 

Also, it is crucial to understand that lead poisoning contributes to nearly 1.5 percent of annual global deaths and poses severe risks, especially to children and pregnant women in low- and middle- income countries. As for Georgia’s success story, first of all, multiple indicator cluster surveys conducted in our country in 2018 by UNICEF, with support from USAID, revealed that 41 percent of children aged between two and seven years had blood lead levels above an acceptable thresholds. This data triggered immediate action by the government. We swiftly initiated relevant steps aimed at mitigating and preventing lead poisoning in the country. 

The national response package launched in 2019, with support from UNICEF and USAID, including the wide-scale awareness campaign, led by a monitoring among children and pregnant women, establishment of the chemical risk factor laboratory, and development of a lead surveillance system to monitor blood lead levels and identify sources of exposure. In order to identify the sources of exposure, we have started the assessment of environmental conditions within the same program. These interventions result in speed improvements indicating the effectiveness of the response package, at the fourth year of the lead response surveillance program’s implementation, we have observed at remarkable 75 percent decrease in the prevalence of blood lead levels among children in the region, with the highest initial prevalence. In order to sustain these achievements, Georgia has bolstered the regulatory framework concerning the lead containing products aligned with EU association agreements. Since July 2023, we have implemented stricter technical regulations that controlling the manufacture, sale and import of construction paints; legal limits have been set to govern the production, sale, and import of paint with higher lead concentrations. 

Additionally, to address potential risks, Georgia has enhanced its regulatory framework concerning lead migration in toys. Relevant regulation enforced since 2021, focuses on ensuring the safety of choice incorporating legal limits to govern the production, sale, and import of toys with high lead migration. We are also actively working on establishing government regulations to ensure the safety of these products, aligning with EU legislation following WHO recommendations. In order to improve the ambient air quality monitoring in the country, we have started continuous 24/7 sampling and analysis of heavy metals, including the content of lead in major cities. The current results show that ambient air pollution may not be considered as a source of lead exposure. 

We also recognize that while the primary responsibility for combating lead poisoning rests with our government, international organizations play a pivotal role in this global effort. Georgia has been fortunate to receive substantial support from international entities, partners, friends, such as USAID, UNICEF, WHO, Germany, and the Arctic University of Norway. This support is directed towards strengthening chemical biomonitoring, building laboratory capacity, establishing surveillance models, developing communication campaigns, and training human resources. 

Importantly, our active enrollment in the European environment and health process showcases our commitment. We were honored to be selected as a co-lead for new cooperation mechanism among member states promoting the use of human biomonitoring in the WHO European region, led by Germany, at this partnership – they are friends – launched at the Seventh Ministerial Conference on Environment and Health in 2023. So as hosting the first meeting in Tbilisi in November 2023, and this gathering brought together members of the partnership to agree on priorities and promote human biomonitoring work in the WHO European region. 

So leveraging this invaluable partnerships, Georgia is steadfast in its commitment to strengthening both human and technical capacities. We aim to further develop our lead surveying systems, conduct thorough research on sources of lead poisoning, implement effective mitigation strategies, and contribute progressively to the reduction of the burden and lead exposure. 

To conclude, the World Economic Forum provides us with a unique opportunity to reinforce and elevate our collective political commitment to a shared vision – a world free of land poisoning. Adopting rigorous monitoring, strict regulations, and fostering international collaboration is Georgia’s commitment to addressing lead poisoning comprehensively. And I believe that a united global community, we can achieve greater results ensuring a healthier, and more prosperous future for generations worldwide. Thank you very much.

DR. PÉREZ: Thank you, Prime Minister [Garibashvili] for sharing the comprehensive approach that you have taken in Georgia, all the way thinking regulation, education, surveillance, leadership commitment, and international collaboration as part of that playbook to get to the wonderful results that you have shared. Thank you. 

It is true that lead poisoning is a big and often neglected problem. One of the good news, I think, there’s more and more research to help us understand the causes and the interventions that can be put in place to address it. If I may call on you, Minister Soragha to comment on sharing your thoughts on how Tanzania has approached managing lead.

TANZANIAN MINISTER MUDRICK SORAGHA: Thank you so much, Madam Lucy, and I would like to acknowledge the presence of Madam Samantha and now Prime Minister Garibashvili – apologies if I didn’t pronounce the name right. I’m glad to be here. And I’m glad to be a part of the discussion. I won’t take too much of the time. I will limit myself to maybe two or three minutes. I think most of what has been said I’m in agreement with, and I’m very happy to note that there’s a general consensus within the global community that we need to get rid of this harmful chemical substance. And for us, it’s critically important as a country to note that we are not alone in the fight. 

Tanzania has been the champion in terms of putting the right measures of eradicating lead within the society. When we first did this back in 2016. But on that same note, we are also signatories to the Basel Convention of 1999. So we have begun this process more than three decades ago, in terms of recognizing the harmful effects of this substance and taking the right measures to remove it. And it’s important once you note, in order to solve a problem, you have to recognize that there is a problem and then try to find the right solutions of addressing that issue. So as I had stated, we have been in the forefront within the region to take measures to remove lead within our society. And I don’t have to dwell too much on the statistics, but in terms of the broader economic effect on the continent, you look at the numbers – it’s costing the continent almost 150 – $134 million each year as a result of lead poisoning. That is a significant amount of money considering the already, you know, the effects that are prevalent, but also the weaknesses within the health system. You know, so it adds or compounds the problem even further. Because now you have another crisis on top of another crisis that you have to address. 

And so we have in place our regulatory measures, and as we had discussed in our briefing, that is not entirely the issue. The issue is how to enforce, how to have the proper mechanism of enforcing those regulations, and making sure that our regulatory bodies have the capacity to be able to identify the products that have led and how to remove them or how to expose them. And on the other hand, we are facing difficulties. For example, when it comes to products, for example, without microchips where you know, we typically, when we talk about lead, we talk about paints, we talk about batteries, but you can also find lead in some of these small electronic products and some of them they do have a higher content than the regular requirement. 

And so in terms of addressing that, and the identifying it, and how to remove it, that has become a challenge. But all in all our regulatory bodies, which we have plenty, have been doing a wonderful job that first of all to make sure that in all of our border crossings, ports of entry, that we have the right frameworks to identify products have exceeded the limit that is required. And then you have the remaining challenge of the stock that is already in the country – previously used batteries or toys – and how to make follow up on that and remove what is already in there. 

So the general outlook from our point is to make sure that we continue to engage at the community level, sensitize the community so that they understand to what extent this product has an effect on their health. I think knowing how and understanding is very critical in this aspect. And then making sure that we have a collaborative aspect of it, whether it’s the private sector, the government, PPP framework, and civil society organizations, of course, have a pivotal role as well to play in terms of sensitization and actually going in at the community level. And removing some of these harmful substances. Thank you.

DR. PÉREZ: Thank you, Minister Soragha. I want to build on this comment that you’re making around education, right, because I think one of the challenges that we see when we think of lead in consumer products. It appears to be a market failure that in some ways is exacerbated by how invisible it may be. We may not know that it is in the cooking pots that are being used to prepare a meal right, or you know, in the makeup that we may be using. And so how we think about driving that education, that understanding of the sources of materials that are in our products is essential to get to a solution. The good news is we’ve said multiple times now is that we know that there’s many interventions already available, and they present a very positive return on investment when we look at them. 

The thing is, this is a highly fragmented problem. As we think about the solutions we highlighted that it’ll vary significantly market to market. And so it is important to understand that we need to know how concentrated or fragmented a supply chain may be for a particular product in a particular geography and how easy or difficult it may be to replace it, to be substituted with another product. We know from past experience that in many instances, that substitution does not necessarily carry cost implications. Those can be some of the quick wins available. 

We heard from Administrator Power earlier, the positive story of how lead had been removed from gasoline. And that can serve as inspiration as we think about how can we apply that framework to other products. And so, Administrator Power I would like to call back on you and ask you to elaborate, how do you think about what comes next as you think about this ambitious vision focused on consumer goods? And where would you like partners to focus?

ADMINISTRATOR POWER: Thank you. Well, I’d be very interested particularly in hearing our Tanzanian colleagues’ viewpoint on that last question about, you know, where to prioritize from the standpoint of one country that’s making such a substantial effort here. I would start, I guess, as one does in the development field with the data gaps. And that can sound very antiseptic and abstract. But here, what are we talking about? We’re talking about moving from these aggregated numbers that all of us have used to what the Georgian example shows was possible the ability to generate at a community level insight into what was happening – why it was happening. 

So that starts with blood level testing, of course. Blood level testing, you know, there are people who are watching I’m sure who will forget more about lead than I will ever know – but it’s really fascinating the extent to which the testing itself can give you insight into the source of the lead poisoning. So, the science is our friend here. But testing at scale is not something that is happening in the parts of the country that are suffering the most from what you might refer to as a lead crisis. 

My colleague and I were reflecting before this session about what we’ve gone through with COVID, and the difference in COVID between the early stages, for those of us who were lucky enough to get access to testing, because many countries didn’t until far too late into the pandemic. But those early tests, you know, having to go away, taking sometimes four or five days, the damage that that would do, versus at the end of the pandemic, the rapid tests, and then the ability to act on that from a policy perspective. I’m only mentioning that because it’s fresh in our minds, because we’ve lived the pandemic so recently. But imagine if those kinds of tests – if there was a point of care tests that was available to kids, you would be able again then to know potentially what the sources of the poisoning are, develop a regulatory framework, see if those substitutions are available, but also provide care to those who have not yet suffered the developmental impacts that can be severe and can be irreversible if it has gone on too long. So I would say that. I think also you alluded earlier, and I sort of nodded to it as well, the importance of knowing which interventions work. We have a lot more than we can learn about cost effectiveness. Again, not adjudicated in the abstract but adjudicated in particular communities that may not have infinite resources to get at all aspects of this problem. 

And then last, just a couple comments. My remarks emphasize consumer products because we agree that there is substantial low hanging fruit there because those substitutions are available. We, of course, recognize that the industrial processes, the manufacturing, the mining, improper recycling, you know, scrap metal in a manner that turns up then in pots, you know, as our Tanzanian colleague described. You know where lead is already present in communities, diagnosing it, but then the cost of removal, behavior change, normative change, I mean, none of this comes easy, but I really want to come back to just how little has been invested and how quickly we collectively could see a return on investment if we concentrated, even by tripling this paltry amount of development resources, you would already start to see lives saved and negative developmental impacts avoided. 

Very last comment it’s just to link, as Tanzania has, this issue to all the other development challenges and opportunities that exist out there. When USAID does a lot in the nutrition space, including with our Tanzanian colleagues and in Tanzanian communities, calcium and iron deficiencies increase lead absorption. So, you know, for those countries that are working in other sectors and haven’t yet budgeted for lead per se, there are still synergies that we can achieve together by concentrating resources across the spectrum of development interventions. And here to the debt crisis that has been falling so many countries, puts countries that would really like to tackle this challenge and have now new data made available and success stories like the Georgia example or new regulatory frameworks, the fiscal space has been shrunk significantly. So, supporting countries responsibly manage their debt, and responsible renegotiation of that debt it’ll be really important for the investments that the countries themselves want to be making, in saving lives and avoiding these developmental harms.

DR. PÉREZ: Thank you. I realize we have time now. I’ll turn it over to our audience to see if there’s any questions that they may want to share with the three of you. Any questions from the audience? I still have a few questions, so, I may actually, maybe Minister Soragha – if I’ll start with you. As you think about the changes and the investments that are required, how would you describe what additional help would be helpful to countries like Tanzania to address the live challenge?

MINISTER SORAGHA: I think from a capacity building standpoint, that’s one area where we need to focus and the use of technology. I think when you look at the regulatory bodies that are in charge of oversight, the technology is outdated. So it’s much – it’s very easy for, whether it’s manufacturers or importers, to, you know, go around the system without being recognized because of the outdated technology. 

And then on the other hand, within ourselves, we need to have a clear communication framework. Like I said before, we have too many agencies tasked to do the same task, but oftentimes they come out with different outcomes. And in terms of standardization, you know, you have the local standards, and then you have the regional standard. Let’s say the East African Community, or the SADC – where in one region, the accepted standard is this and then within the country it’s probably much lower. So we need to kind of harmonize that and come into an agreement. What is the accepted level, if it’s accepted to be able to come into the country? I think it’s very important and it’s something that we haven’t really had a broader discussion on. And you have examples where, you know, agencies are clashing and their business decisions, of course, it’s investment and it’s money that is involved. And if the regulatory agencies are not speaking the same language, what does it leave – room for corruption, people you know, going under the table and making decisions that can impact public health, in general. 

And then I think you have to have systems in place – digitization, in terms of the entire process, so that we can have a proper database of what has been done so far. What else is out there and how we can do it, so that we can have tangible measures of the progress that we’re making and successes that we are achieving. I think right now, most of the time we, you know, it’s just random sampling, you know, okay, let’s go here, let’s go there. But it’s not a coordinated aspect of this. There’s a lack of that cohesion in terms of the coordination. So, if we, if we digitize, if we build capacity, if we use technology, of course, and then we increase awareness within the community, from a public standpoint that will go much, much farther to the grassroots level, of course, because then you have public awareness of what this poison can do to the communities.

DR. PÉREZ: Thank you for sharing that it’s important to emphasize that interconnectivity that exists. Whether you’re talking about how interconnected the supply chains, the regulators, right, and the criticality of bringing all that together. 

QUESTION: [off-mic]

QUESTION: Thank you, Dr. Perez. Could you please elaborate on how the private sector can engage and maybe illustrate some stories of success that you’ll want to highlight right now?

DR. PÉREZ: I’m happy to. And I’m sure there may be some other examples from individual countries that others would like to highlight. But indeed, when we see and one can go all the way back to looking at that example, in the gasoline space, right? 

Where, for example, oil companies actually even before the mandate to eliminate lead came into being and were already taken action to remove lead, because there was that understanding of the unfortunate impacts that – outrageous impacts – on human health, one might say. And so there are stories, for example, when we look at the impact from lead in paint of companies that were educated, understood the impact that the lead in their products would have, as Administrator Power referenced. The children, they were thinking about if it were their own children living in houses, where it was that paint on the walls, what would be the difference? And actually leaned into that as a value proposition that then they use to communicate to their own customers, the importance of having products that were lead free. 

In this particular example that I’m thinking of, in this market, that company actually became a market leader as a result of leaning into a value proposition of lead free products that really resonated with a consumer. Because maybe to the point that I made earlier, a lot of the challenge that we have in this space is that invisibility of like not understanding what’s in the products, and also not understanding those deleterious effects that it will have on human health. Because oftentimes, as we’ve heard from the panelists, these effects take too long to manifest to make the connection between the source and the impact. 

But if I may turn it over, any particular stories of roles that you have seen the private sector play in your countries that you would like to call out? 

MINISTER SORAGHA: Okay, so we have three major manufacturers of paint in the country. And, of course, they are notorious in terms of – I won’t mention names – but they’re notorious in terms of the excess amount of lead that was in them. 

But the good thing about our case is that, you know, a dialogue, honest engagement and really just showing that, okay, the government is serious on this, and we’re not playing around. You guys, you need to review your standards, you need to review the amount of lead that is in your paints, otherwise, we’re going to come and shut you down. 

So at least in that aspect, we have been able to get that messaging across to them. And for them to understand where we’re coming from in the community – the health crisis that is prevalent. And you know, it’s not easy at times because of the lack of awareness, and the health impact of it, it’s something that it’s not visible, you know, it’s not something that you see outright, okay, this is the effect and it’s long term. 

So to get people on board to show that this is a public health crisis, it takes a lot of convincing. But we are happy to note that these companies have really been champions now for us, and they’re leading the example. The main issue now is for the traders who are importing. And so you can see this clash between manufacturers and traders, and it hasn’t been a very good success story from the trading side – from the trader side.

DR. PÉREZ: Prime Minister, anything to add from Georgia’s perspective?

PRIME MINISTER GARIBASHVILI: I think you’ve already explained the whole story.

DR. PÉREZ: Great. If there’s no other questions from the audience. I’m sorry, Administrator Power, anything else on the role of the private sector?

ADMINISTRATOR POWER: I would just underscore the point that you have made and that has come up but just, it used to be that the incentives cut the other way, you know, cut against public health.

And, this is a very broad topic and there are lots of sources of lead out there and there will be some for which this is not the case, but by and large you now see alternatives that companies can employ that offer similar properties at competitive price points. And so, I don’t know, you didn’t share the punch line, Mr. Minister, about whether those companies now have made those adjustments yet or are in train to doing so. But this is not a call to impose huge new price burdens on the providers of really important consumer products in developing countries. 

It is, I think the point that has come across is because not only there’s a double invisibility here – there’s an invisibility to how lead poisoning occurs, and invisibility – you know, people aren’t coughing as they would if they have the flu, they don’t show symptoms as they would if they had malaria. So it’s actually invisible in the people who are being afflicted, but also this issue globally – I’m pretty sure this is the first lead related event, for example, at the World Economic Forum, and thanks to the organizers for letting us do this, but the problem is invisible. And the fact that these solutions are available is far less visible than it needs to be. 

And I thought the Minister put it so well and brought us home, down to the community level. I mean, if parents knew what their kids were being exposed to, what those products were, you can bet that that example that you offered of the gas companies self regulating, that you would start to see consumer product providers themselves, you know, digging deep and not trying to bypass a regulatory system but indeed to embrace it because the cost to trust with the consumer would ultimately affect the bottom line. So more awareness, more leadership, more joining what we hope will be an ever expanding coalition, I think can really help us show results very quickly. 

DR. PÉREZ: To close and build on that note Administrator Power. This is clearly, like you very elegantly set up at the beginning, the scale of the challenge, let’s say but at the same time, the scale of the opportunity, right. I think we should celebrate, that we know so much more now. We know those interventions that are likely to work, many, like you said, come with incredibly positive returns on investment. And so really a time to take action and hopefully this global alliance is part of them, catalyzing the action to really lead to a healthier world, where lead is not causing the deleterious effects on human health that we have been seeing to date. 

On that note, let me thank all three of our panelists for sharing your lessons learned and participating in this very important conversation today

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