At a Glance
Goal: Pure Earth’s SCALE Initiative will reduce lead exposure in countries that are home to over half of all lead-poisoned kids and accelerate progress globally.
Approach: Reveal the crisis, pinpoint exposure sources, and reduce exposure, with strategic communications and government ownership built in throughout
Implementing Partners: UNICEF, Vital Strategies, the Institute for Health Metrics and Evaluation, the Partnership for a Lead-Free Future. This initial group of partners will expand as Pure Earth’s SCALE Initiative grows.
Funders: The Audacious Project funding community
Duration: 2026–2033
Why Lead?
Lead exposure is a significant public health challenge in low- and middle-income countries where it disproportionately affects vulnerable populations, particularly children. In these regions, lead contamination is often linked to poorly regulated industrial activities, and the widespread use of lead in consumer goods such as foods, spices, cosmetics, toys, cookware and paints. Lead exposure is responsible for an estimated 3.5 million deaths each year. More than one billion children are estimated to have elevated blood lead levels, damaging brain development, limiting learning and educational attainment, reducing earnings, and increasing the risk of lifelong illness and death. This has broad economic impacts, with lead poisoning draining $6 trillion from the global economy annually. Stealing the potential of one child is a tragedy. A billion children is a number too large for the word “tragedy” to hold.
We prioritize lead poisoning not only because its toll is immense, but also because it is solvable today, with the tools we already have. Preventing lead poisoning does not require new technologies or the reordering of global economies. It just requires our will to act. And the benefits are enormous. By preventing lead exposure, our work improves health, educational outcomes, and socio-economic development. Children can reach their full cognitive and emotional potential, and societies are better equipped to solve the next set of challenges they face.
The Three Pillars
The SCALE Initiative is organized around three pillars that together let us reach half of children with elevated blood lead levels.
Deepen. Advance work in countries where foundational data already exists, moving directly into national planning and source-specific action to reduce exposure.
Expand. Launch our full approach, beginning with blood lead surveys and source identification, in countries where lead exposure is widespread and under-addressed. This pillar rolls out in staged cohorts over the life of the initiative.
Accelerate. Build and launch the Lead Exposure and Action Data Hub (LEAD Hub), a global platform that links exposure data to proven solutions, and other tools to extend the initiative’s impact to countries well beyond our direct footprint.
Our Approach to National Programs
Pure Earth implements evidence-based solutions alongside governments and trusted public health partners. Our approach draws on more than 25 years of experience and is tailored to each country, with phases that overlap and adapt to local priorities.
1: Reveal the Crisis
Working with health agencies, implement nationally representative blood lead level (BLL) surveys to reveal the true prevalence, severity, and distribution of exposure. These surveys generate country-owned data that transforms lead poisoning from a modeled estimate into documented national evidence that governments can use to prioritize and act.
2: Pinpoint Exposure Sources
Conduct in-depth exposure source assessments to understand where lead is lurking. Everyday items including food, spices, paint, cookware, cosmetics, water, and soil are systematically tested in homes, markets, communities and at contaminated sites. Because exposure sources differ across cultural practices, industry norms, and market dynamics, this work ensures exposure mitigation efforts are based on context-specific evidence.
3: Reduce Exposure
Armed with data, develop and implement national strategies to detect and prevent exposure, remove contaminated items and soil, strengthen product testing and supply chain monitoring, improve regulations, and build enforcement capacity. Targeted exposure mitigation efforts are focused on the most critical sources of exposure, ensuring maximum impact.
Throughout all three phases, we communicate with stakeholders at every level and build governments’ capacity to lead and sustain this work long-term.
Where We’re Working
“Deepen” countries ready to act on existing evidence
In countries where the foundational data already exists, including places such as Bangladesh, Colombia, India (Maharashtra), Indonesia, Kyrgyzstan, and Peru, the work moves directly into reducing exposure. Here, blood lead surveys and source testing have already identified the main culprits, so the focus is on national strategy and source-specific action: removing toxic additives from spices, reforming unsafe battery recycling, setting safety standards for cookware, tightening oversight of cosmetics, and remediating contaminated sites, all carried out through government systems so the gains hold.
“Expand” countries ready to collect exposure data
Pure Earth’s SCALE Initiative will roll out the full three-phase approach, beginning with nationally representative blood lead surveys, to additional countries in staged groups through 2033. Because selection depends on government readiness, impact data, and decisions by other stakeholders, countries will be added on a rolling basis rather than in one fixed group.
About The Audacious Project
Launched in 2018, The Audacious Project is a collaborative funding initiative dedicated to supporting bold ideas with the potential to change the world. Housed at TED and powered by the belief that ideas change everything, Audacious leverages a global network of visionary social entrepreneurs and funders to support bold solutions to the world’s most urgent challenges. Audacious is issue-agnostic and supports grantees to balance audacity and achievability for lasting, systemic impact. Since 2018, Audacious has catalyzed more than $7 billion for 70 projects, demonstrating what’s possible when we dream bigger and act together. The funding community includes respected donors and philanthropists including ELMA Philanthropies, Emerson Collective, MacKenzie Scott, Pivotal Ventures, Reed Hastings and Patty Quillin, Skoll Foundation, Valhalla Foundation and more.
