Well, good afternoon everyone. I'm Mike Bloomberg and I wanted to welcome you on behalf of the 26,000 employees of Bloomberg who are scattered around the world. It's an honor for us to be working with Dr. Tedros and others. And the way we look at the world is if we don't make it a better place, our children won't have a good life. And so, we've got to work as hard as we can. I am 84 years old, probably the oldest one in the room. So, it's up to you rather than me. But I've been lucky enough and able to be included and to help. What I can do is bring introductions and bring cash. Two things that are really important. If you go back and look at my academic record, I don't think you'll say you want to put me in charge of anything, but that's another thing.
Anyways, it's great to have so many people from around the world here in New York this week, the UN General Assembly week, and everyone in the world's decided to come, too. If you had a traffic jam while you're here, all I can tell you is it was never a problem when I was mayor.
Seriously, thanks for joining us and helping us to prevent lead poisoning and improve public health around the world. And a special thanks to Coefficient Giving and the Partnership for a Lead-Free Future, our co-host today, gathering with us at Bloomberg Philanthropies. Our team has always had a passion for public health, especially the big challenges that too often go unrecognized, and lead poisoning is certainly one of them. More than one in three children globally are affected with lead poisoning. Just think about that, how many people there are. Exposure can cause lasting damage to their brains and contribute to cardiovascular disease later in life. And this has been a threat to public health for generations. But the good news is it is preventable and we really do have the knowledge and tools to make an enormous difference. That's the good news. We know what works and we've learned that firsthand in New York.
During our years in City Hall, our administration published the city's first comprehensive report tracking lead levels in children. In fact, one of today's panelists, Tom Frieden, led that charge as the city's health commissioner, which he can tell you about later on. We strengthened our lead paint laws. We've sent inspectors into homes, and we used the data to target our efforts where they are needed most. And as a result, the number of children testing positive for lead poisoning in these neighborhoods fell by two-thirds. As we like to say around here, if you can't measure it, you can't manage it. And now we're taking the same data-driven approach around the world. We've committed $250 million to reduce lead poisoning in some of the places that need it most. We support partners who have helped government pass and enforce strong policies. And we support the work of identifying and removing sources of lead and improving testing and data collection so leaders can target their resources effectively and manage their progress.
I'm glad to say that we're already seeing encouraging signs across Africa. 21 countries have adopted or are moving towards adopting stronger lead paint regulations. In South Africa, with testing support by our partners, we've helped trigger the country's first-ever paint recall. In Ethiopia, the government is laying the groundwork for a national survey of lead levels. And in Brazil, the government strengthened its lead poisoning regulations, which will help protect about 1 million children in the decades ahead. Our goal is ambitious — to eliminate lead poisoning around the world — but none of that can happen without strong partnership and strong leadership from governments. And so we're trying to make sure that they get that. We're fortunate to be working with outstanding partners, including many represented here today. If you're not a partner yet, well, what are you waiting for? We'd love to have you. This group brings the expertise and the experience that turn good ideas into progress. And our job here is to help you do even more. One of those outstanding partners is my friend Dr. Tedros, Director-General of the World Health Organization. For many years now, Bloomberg Philanthropies has been fortunate to work closely with his team on this issue and many others. He's done an incredible job and we look forward to working with him and everyone else in this group to build on this progress. So, Dr. Tedros, the floor is yours.
The printing was late so I had to bring my effort. I prefer papers.
Tedros Adhanom Ghebreyesus
5:26 ↗
Ambassador Mike Bloomberg. By the way, this is his 10th anniversary as goodwill ambassador for WHO. And thank you so much.
Honorable ministers, excellencies, dear colleagues and friends, let me begin by thanking Mike for his leadership through Bloomberg Philanthropies and for bringing us all here today. My thanks also to Coefficient Giving, the Partnership for a Lead-Free Future, and all partners, and to my friend Tom Frieden of Resolve to Save Lives, who will show that lead poisoning is one of the world's most serious and most preventable environmental health threats. There is no known safe level of exposure to lead for young children. The consequences can last a lifetime and lead can permanently damage the developing brain, affecting a child's ability to learn, to thrive, and to reach their full potential. The burden is enormous. The exposure is associated with more than 3.5 million deaths every year.
This is a tragedy we can prevent. That's why WHO is developing a global action plan and a technical package called PREVENT, both of which will be presented at next year's World Health Assembly. Together, they will give countries practical tools to identify and reduce exposure, strengthen regulation and enforcement, protect communities, and track progress. We know what works. As Mike said earlier, what we need now is the political commitment to put the solutions into practice. Mike, thank you for your leadership on this issue. WHO was proud to join the Bloomberg Philanthropies lead poisoning prevention initiative last year and we remain committed to working with you to address this very addressable global health threat. For a decade now, you have served as WHO global ambassador for non-communicable diseases and injuries. And this is one additional challenge you're trying to address. Over those 10 years, your leadership and commitment have helped put the prevention of non-communicable diseases and injuries much higher on the global agenda. From tobacco control and road safety to data for health and drowning, and now lead poisoning, your record speaks for itself. So I'm delighted to ask you to continue serving as WHO global ambassador for non-communicable diseases and injuries. And I hope you will agree. And we look forward to continuing our partnership and to working together to save lives, prevent avoidable disability and death, and give millions of children the healthier future they deserve. Of course, in a year's time, you will be working with a new Director-General, but I have no doubt that she or he will appreciate working with you as much as I have. It's August 2027, so still a lot of time and we will work together. Thank you once again for everything you have done and continue to do. Thank you so much. Thank you.
Please welcome to the stage the CEO of Coefficient Giving, Alexander Burgers.
Feel like I'm about to hit a grand slam. Thank you, Mike, so much for hosting us and thank you all for being here. About a decade ago, a Stanford grad student named Jenna Forsythe was collecting blood samples from pregnant women in rural Bangladesh for a study on clean water and handwashing. When her team analyzed the blood samples, they found something unexpected. About a third had elevated levels of lead. Jenna's team went looking for the source and they identified turmeric, the spice, as a major culprit. At markets, brighter turmeric sells for more money. And the cheapest way to make turmeric brighter is to add lead chromate, the same kind of industrial pigment that was previously used to make school buses yellow. Once the team published their findings, the Bangladesh Food Safety Authority moved fast. They began prosecuting adulteration, launched a public education campaign, put lead detectors in inspectors' hands, and fined sellers who didn't comply. In September 2019, before the crackdown, 47% of turmeric in the market had lead in it. By 2021, none did. We learned two things from that Bangladesh experience. The first was that we had been wrong about where lead exposure was coming from. A lot of it was from sources that no one had previously identified or that everyone had underestimated. The second lesson was that you can stop this kind of exposure and that it doesn't cost very much. Our rough estimate is that removing lead from turmeric in Bangladesh will prevent more than 4,000 deaths every year going forward at a cost of under $100 per life saved. You already heard the statistic that one in three children have elevated levels of lead. But that's more than 800 million kids around the world right now. And despite the scale of that problem, as recently as 2023, the entire world was only spending $15 million a year philanthropically on lead removal. That's roughly a thousand times less than development assistance for HIV and malaria combined, which are themselves underfunded diseases. Encountering an issue so big, so neglected, and so tractable is a rare outcome in philanthropy. So in late 2023, we made lead a priority and stood up a dedicated program. Two years ago this month, and just a few blocks away, we launched the Lead Exposure Action Fund, the first pooled fund dedicated to this problem. In its first year alone, its grantmaking more than tripled the world's annual philanthropic spending on lead. And we're happy that so many others have joined this fight. Bloomberg Philanthropies has built its own lead program across Asia, Africa, and Latin America, and helped the World Health Organization develop its first lead poisoning prevention package, which was previewed at the World Health Assembly this spring, and we're excited to see it moving forward. Through the Partnership for a Lead-Free Future, UNICEF is helping governments recognize lead poisoning as a priority and coordinate action against it. The Audacious Project, who's also here, recently committed multi-year funding to Pure Earth, also in the room, a grantee of ours since 2021, to help governments in more than 20 countries reduce childhood lead poisoning. And we've scaled up our own commitment considerably since we began. More funding means more organizations can afford to help tackle this challenge. Another grantee here, the Lead Exposure Elimination Project, started out trying to get lead out of paint. They've now expanded their work to other sources like spices and cosmetics. In the last year, they tested eyeliner sold in Morocco, Egypt, Pakistan, and India, and discovered that some of it was over 80% lead by weight, which is tens of thousands of times above the safe limit. Other grantees are driving down the cost of blood tests or taking on unsafe battery recycling, which we now think may be one of the largest sources of ongoing lead exposure in the world. There's no shortage of good work to fund. From supporting national blood level surveys that make it easier for governments to act on the problem to driving forward enforcement measures that can help make standards stick. At Coefficient Giving, we care a great deal about cost effectiveness and lead continues to stand out as one of the most cost-effective areas for further investment. The Lead Exposure Action Fund now has over $200 million in commitments and has room for a great deal more. If you're investing in health or education or economic growth, we think that reducing lead exposure is one of the best ways to make those investments go further. My main regret is that we didn't start on it sooner. But now we know that the problem is fixable. And I'm glad that looking around the room that there's more of us than ever before working on it. I hope that together we can make up for lost time. Thank you. And I'm going to turn it over to Abdallah Fadil.
Please welcome to the stage director of the Partnership for a Lead-Free Future, Abdallah Fadil.
Good afternoon. It's wonderful to be here with you, colleagues, excellencies, distinguished delegates. Let me begin by thanking our co-conveners, Bloomberg Philanthropies and Coefficient Giving. I also want to thank the member states who have brought this issue to the global agenda and have kept it here. When I joined about 14 months ago this Partnership for a Lead-Free Future, I was hopeful. Today I'm more than convinced — I'm convinced more than ever that childhood lead poisoning is both achievable and overdue. Each of us came to this meeting from a different context: cuts to health financing, emergencies, displacement, floods, impact of climate change, trade barriers, and even changing world order. Yet, in many countries where we serve, close to four in 10 children carry elevated levels of lead in their blood. The scale of investment, as you've heard, devoted to this problem bears little resemblance to the scale of the burden. Thanks to Bloomberg Philanthropies, Coefficient Giving, and the Audacious Project, we have now over $500 million available from $15 million just a couple of years ago when this partnership was stood up. But yet the challenge we face is that this issue is far larger than hunger and malnutrition, lack of immunization and zero-dose as we call it, more than children out of school and even more children that are in conflict areas. Nothing else in our collective agenda affects so many children so silently and so permanently. Lead is not another competing priority. It sits underneath many of the priorities we already have. It's foundational. If we fail to address it, every dollar invested in everything else we do in health, nutrition, learning, human capital delivers less than it should. You've heard eloquently what lead does to a child and even to an adult later in life. And most of this cannot be undone by later programs, not by better schools. And nothing else we can do can change this. It undermines every one of the sustainable development goals that we hope to achieve. Therefore, lead is a tax on human capital levied before a country earns anything. You've also heard how it impacts more and actually kills more adults than TB, HIV, AIDS, and malaria combined. Now, more evidence is coming up how it affects also NCDs, cardiovascular disease as well as even dementia in the latest research. The good news is none of this needs inventing. You've heard how Tom Frieden, when he was at CDC, what the United States did, what this state and New York City Department of Health does on a daily basis. What I've observed in my visits to four countries particularly, and I want to share these four countries. I just returned from Ghana and Nigeria. Just beginning of the year I was in Pakistan and earlier last year I was in Bangladesh. These four countries alone have a burden case of about 250 million children. They represent almost regions of the world, South Asia and Africa, where 75% of the burden sits. What do they need? Three things. First, measure: national blood survey paired with assessment of where the exposure is coming from. Until governments have that, it's regulating in the dark. Second, regulate the sources you find. You've heard all the avenues of source that lead can take. So therefore, it's a supply chain issue and therefore regulation legislation is quite important. Thirdly, enforcing what we find is the other area where most governments fail. So enforcement is the least fundable part of this work. Laboratory work and laboratory requirements is the least fundable issue that we face. So my appeal to you, to already our funders here today and future funders, is actually as much as it's not appealing, fund them anyway. This is what we hear from countries, what they lack the most. Laboratory and equipment infrastructure as well as early coordination are the least measurable but equally important tools. They're not attractive, but funding them is quite important to member states. Do not let this become another line item waiting for an international grant. Outside money can start this work. It cannot sustain it. That has to come from your own budgets. The same goes for national private sector. The children being poisoned today are its future workforce and their health and cognitive capacity are the most valuable resource of your economy. Any company that plans to be in business in 20 years has a stake in protecting children. Measuring, identifying sources, regulating, enforcing are what wealthy countries and high-income countries have done and succeeded in. So we know exactly what needs to be done. We know how it's done. It's a question of call to action. What we need to do about this. Two years ago, fewer than 10 countries could have told you how many of their children were affected. Today, 25 countries have either surveys completed, underway, or committed. Thanks again in large part to these amazing supporters. In the same period, 14 countries have introduced controls on lead levels and in November of this year, the global framework on chemicals will hopefully identify lead as a source of concern and we appeal to the countries here to support it. In September of this year, the Chemical Review Committee of the Rotterdam Convention recommended to the Conference of the Parties that lead chromate should be listed in Annex III. We also ask member states to support this because this will help us restrict the trading of lead chromate, which you've heard the impact it has on not only turmeric but others are going to be important. And finally, you've heard from the Director-General of WHO that May next year, he will be providing to the World Health Assembly an action plan. Again, we request countries and ask everyone to work on those action plans. Excellencies, ministers, distinguished delegates, we at the PLF hear you loud and clear about your commitments, convictions as well as your determinations. The international support can only be catalytic, but the support should come from member states. We exist to support governments, agencies, funders from the same plan. We want a plan done in Accra should be replicable in Dhaka. We want a coordinated effort so that the resources available are not duplicated and are not wasted. In Nigeria, Ghana, Pakistan and Bangladesh, I saw governments, technical officials, private sector, civil society activists committed and willing to do the work that needs to be done. Let's help them. Let's help enable them while the bulk of the resources will have to come from them. UNICEF last year has come up with an investment case of about 1.6 billion dollars. We are already a third of the way there. Bulk of the resources again in that estimate will come from the countries, almost 6 to 8 billion, where they will have to come up either in-kind or new resources. What our partnership does is to keep those efforts pointed in the same direction, focused on common solutions so that governments asking for help receive a coherent answer rather than five competing priorities. We're helping map funding sources. We're helping map activities. So therefore, all of us are working from the same sheet of music. And soon this community will come up with a lead hub that will be a centralized, searchable platform that brings all of the exposure data, policy, guidance, tools as well as best practices. 41 governments and more than 50 organizations now work from one framework instead of 50 competing agendas. What we built together was never meant to depend on any one of us. It was meant to outlast us all, to grow beyond us, and to belong to all of us. That work continues. The movement is yours to carry forward. Let's fix the foundation first. Thank you very much.
Please welcome to the stage the Minister of Health of the Republic of Zambia, the Honorable Minister, Professor Roma Chileni.
Good afternoon, ladies and gentlemen, and thanks to the Bloomberg Philanthropies and to Resolve to Save Lives and other organizers for having us participate in this conversation. Well, I'm here to really briefly make a point that the subject of lead poisoning in countries like ours, where the focus has predominantly been on dealing with infectious diseases and battling conditions that preoccupy the health sector, render conditions like lead and other heavy metal poisoning neglected — completely neglected. Now I want to say that in Zambia we know firsthand the problem of lead poisoning because in 1994 we had a big mine in the central part of Zambia in a place called Kabwe that was closed and when it was closed it left an estimated 6.4 million tons of lead-bearing waste. And the soil samples reach up to 60,000 mg per kg or approximately 300 times higher concentration than you would expect in the United States hazard thresholds. And between anything between 170,000 and 200,000 people living close in that area exposed and a significant proportion of children in this area obviously exposed and studies done show samples in a significant proportion of children having greater than 10 micrograms per deciliter of lead. Now the resulting burden from this kind of exposure is one that we can only speculate about because we've not taken time to assess it objectively or measure it. We know that of 3.1 million Zambian children, approximately 26% of those aged 0 to 19 in the country — it's a very young population — tend to have blood levels of 5 micrograms per deciliter of blood levels of lead, which is higher than you would expect. Now we know that lead is associated with deaths up to 2,000 deaths per year or 1.4% of all deaths. And that costs well over 53,900 healthy lives lost. Put in context, for us in Zambia this is a huge challenge and we are happy to have joined the Lead-Free Future program and it is our anticipation that the next time we are here we should be able to give very precise and very specific information around this challenge that we have in the country. And so we are very excited to be part of this effort and we look forward to cooperating with others in this space and trying to figure out what we need to do in order to ensure that there's a lead-free future for our children in Zambia. Thank you very much.
Please welcome to the stage Bloomberg's Scarlet Fu.
Thank you everyone. Let's turn now to solutions. When it comes to addressing lead poisoning, there are a multitude of steps countries can take. We talked about measurement. We talked about regulation, enforcement. So each of these steps of course requires coordination, active coordination, working across multiple departments of government. It's a very large effort. So I want to introduce our esteemed panelists. They are current and former health or environmental leaders with firsthand experience of taking action. To my left is Dr. Tom Frieden. He is founder and CEO of Resolve to Save Lives. It's an NGO that tackles global public health issues. We also have Dr. Patricia Clark, Secretary of the General Health Council of Mexico. We have Secretary Adalberto Maluf. He is the national secretary for urban environment, water resources and environmental quality with the Ministry of Environment and Climate Change in Brazil. And we have the Honorable Dr. Ivan Butera, the state minister at the Ministry of Health in Rwanda. Thank you so much everyone. So lead poisoning is called a silent epidemic because exposure is insidious. There's no single source of lead exposure as we were just hearing from the speakers before me. It can be found in things like gasoline and paint emissions, plumbing systems, batteries, and in Mexico's case, through traditional ceramics and pottery as well, with lead-containing glazes. So, Dr. Clark, I'd like you to start us off and just tell us a little bit about how Mexico identifies and tracks blood lead levels across the country because as Mike Bloomberg was reminding us, if you can't measure it, you can't manage it.
Well, yes. Basically what is happening right now in Mexico City is that we have a law and we have an effort, as we've been saying in my council since 2019, with a very nice program going to different sources in which we have lead intoxication and contamination. But unfortunately then after the program started very early in 2019, the pandemic came and then you know it was impossible to pursue this program until now this year in which again we are retaking this program and we have analyzed everything there and we know there is a very important — actually the very — we have identified all these glazed pottery or glazed clay that we have in Mexico City which is probably the second cause of lead intoxication. So we're building right now a program to work with different regulatory systems in my country who regulate these type of things but also we're working with the health secretary in order to operate and then we are working with the culture and all these type of things, also to work with the artisans. We have more than a thousand artisans, family artisans working in that. And you could see that the prevalence is higher exactly where they are. So it's very low in the north. But then when you go to the places in which the families do this glazed clay, you see how the prevalence raised. So we're working on that in very various levels, trying to make a sensible program, starting to make a program from 2026 to 2030.
I hear a lot of coordination and a lot of efforts to talk to folks around the country. Thank you for sharing that. Secretary Maluf, Brazil has found lead exposure through the environment such as mining of course as well as used lead-acid batteries and my understanding is that Brazil set up a battery recycling program to actively limit exposure. Can you tell us about that?
Yes, sure. Well, first of all, it's a pleasure to be here surrounded by colleagues from the health departments and us as Ministry of Environment. It's really important that we further always integrate these actions. Well, last year Brazil was able to prepare its first national strategy for lead contamination in which we examined all the areas in which we had to act from prevention to capacity building and action. And the recycling of lead batteries, lead-acid batteries, was one of the most challenging areas for us because since the legislation prohibits import of waste coming from other countries. Brazil exports a lot of lead-acid batteries to Uruguay, Argentina and Paraguay. And because of a new legislation, we couldn't import to recycle back. So what happened was that basically we had 52 illegal recycling miners on the border with these countries. So we made now a new proposal for the president on a presidential decree to create this exemption to bring it back so that we could recycle. And right now we are working very actively on these sites and also other sites together with Pure Earth and to try to find solutions to decontaminate it.
Let me just follow up because my understanding is that Brazil has built a lot of its lead prevention work through environmental regulation overall and your ministry recently led the way on updating regulation on lead in paint to align with global recommendations and this was a multi-year effort. Can you tell us a little bit about the impetus to make that change and now the challenges with implementing it?
Yeah, well I think the impetus came as a lot of domestic policies that we wanted to upgrade, you know, and raise the bar. We're also part of international alliance. Brazil was signed on the global framework on chemicals. So we reduced it by the legislation from 600 to 90 but especially we made it more clear about the exemptions because before there were so many exemptions, almost everybody were in the exemptions and now we just let the exemption be two very specific paintings and anti-corrosive for ships, you know, in the ocean which were okay. And now together with a working group that we created inside our national chemical safety commission, you know, that involves all civil society partners from different areas. We have this action plan to deliver the national strategy and parts of it are related to the implementation of the lead. So we have some ministerial decrees and presidential decrees coming. Hopefully we will approve — the legislation was approved this year but it enters in force in June next year. That's why right now we are working once again together with Bloomberg and Pure Earth and Vital and World Health Organization in really assessing the reality of the paint out there. So we are going to really get all the paints that are sold around the country, see how much lead is there. I never forgot when I had our colleagues from Pure Earth and Vital there. They brought this little thing, you know, that you can spray at the wall to see if there's lead. I don't know if you have seen that. I brought this to my house, you know. I put it on all the things in my house. Okay, I'm not cooking anymore on this. And I remember when I put it in the wall, it was incredible. You know, in the wall of my house in Brasilia, there were a lot of spots. I'm like, 'Oh, we got to do something really fast on that.'
Well, thank you for sharing that. That's vivid in my mind now. Dr. Butera, can you tell us a little bit about how Rwanda is working on policies to address lead and paint? Tell us about some of the key steps that you are taking, that your country is taking.
