with the lack of extensive Ethiopian pro- grams and policies, necessitates funded plans to enable lead assessments, surveillance, research, mitigation, and prevention efforts (Ericson et al., 2021). The Ethiopian Lead Poisoning Prevention Coalition provided a necessary multifac- eted approach reflecting the importance of local contexts to meaningfully address long- lasting, low-visibility, and low-salience envi- ronmental hazards. African countries should prioritize action beyond awareness of lead exposure and introduce programs, policies, and regulations for mitigation and control (Kordas et al., 2018; Tong et al., 2000). The following are some lessons learned from the Ethiopian Lead Poisoning Preven- tion Coalition: • Longstanding NGOs/donors: The previous assessment and regulation work of IPEN and GIZ in Ethiopia greatly facilitated the formation of working groups, coalitions, and government entities. The importance of groups such as IPEN and GIZ cannot be overstated in creating a precedent for advo- cacy and regulation. • Working group and coalition: Establishing a national lead coalition and agreements between the ministries and authorities responsible for health and environment provided a necessary platform for a compre- hensive government and society approach to create space and commitments to collec- tively address lead poisoning. • Resource allocation: Providing preliminary data so that both governmental and non- governmental agencies could appreciate the scope of the issues and recognize the need for staffing, funding, and other resources in maternal and child health, environmental health, surveillance, and regulation. • International donor organizations: These organizations were key to the convening of groups, signing of agreements, and leveraging of funding. These accomplish- ments were made possible by the initial momentum created by USAID and GIZ, along with ongoing efforts by Pure Earth and UNICEF. • Community-based mitigation: Despite advances in lead laws and regulations, it is still unclear how to best protect the most vulnerable populations, develop community-based mitigation efforts, pre- vent future contamination and exposure,
and establish long-lasting public health surveillance systems that detect lead. • Extended producer responsibility: A draft of extended producer responsibility was developed through GIZ for future integra- tion with child health programs. • Awareness: Important first steps were orga- nizing Ethiopia’s first National Lead Day, engaging an NGO (FHI360) to support public awareness, and developing culturally appropriate health promotion materials. The coalition that formed in 2024 resulted in an increased emphasis on lead poisoning and the inclusion of new partnerships such as Pure Earth, Vital Strategies, the Ethio- pian Standards Institute, the Ethiopian Food and Drug Administration, the Ministry of Agriculture in Ethiopia, the Clinton Health Access Initiative, and the Ethiopian Confor- mity Assessment Enterprise. Based on the coalition’s assessment and find- ings, some future directions for Ethiopia are: • Establish a joint national clearinghouse between the Ministry of Health in Ethiopia and the Ethiopian EPA to support health communications and outreach efforts about lead. • Stimulate research within the government and academic community to better under- stand sources and routes for human lead contamination. • Address ULAB assessment and mapping, foster private sector engagement, and iden- tify hot spots in Addis Ababa via commu- nity-based participatory research. • Determine how to sustain efforts through funding and staffing of key governmental entities; include Pure Earth, IPEN, and global coalitions. • Strengthen broader efforts in waste man- agement, recycling, and addressing heavy metal exposure—areas where most African countries are still developing foundational public health systems. Conclusion Despite substantial scientific evidence in the 20th century demonstrating that even small amounts of lead are toxic to children, indus- try pressure and uncertainty have caused major delays in action (Markowitz & Ros- ner, 2014). Governments in Ethiopia and across Africa should take preventive mea- sures, even without the presence of longitu- dinal studies. In the U.S., private sector resis-
tance slowed progress, which is similarly being seen now in Ethiopia with the paint and informal battery sectors. In advancing a lead agenda, the government in Ethiopia should maintain its commitment to this multisector coalition focused on advancing testing, research, prevention, mitigation, and regulation. Lessons from the experiences of developed countries can inform the adoption of a pro- active approach that goes beyond screening and treatment, focusing instead on eliminat- ing lead in paint, addressing informal recy- cling, and improving waste management. In the U.S., as noted in Lead Wars , enforceable regulatory systems were developed only after significant harm had occurred (Markowitz & Rosner, 2014). The Ethiopian approach to prioritize and address major sources of lead exposure by forming a multisectoral coalition well posi- tions the country to significantly reduce lead in the environment and BLLs. Ethiopia should harness this forward momentum to implement and enforce lead-safe laws that ban lead products, regulate recycling, gener- ate income for lead contamination preven- tion from producers, and encourage private sector growth. Currently, public aware- ness in Ethiopia remains limited, particu- larly around empowering communities to demand safer environments. The international development commu- nity, particularly GIZ, UN agencies, and the U.S. government, deserves recognition for elevating lead-contamination awareness to a global priority, particularly given the nega- tive outcomes that can be averted in cogni- tive development and overall human health. For nearly two decades, WHO recognized lead as one of the top 10 elements of pub- lic health concern and the pivotal role that international collaboration plays in forming programs and policies to protect individuals. The experience of countries such as the U.S. demonstrates that long delays between recognizing the harm and acting come at a great cost, even though the danger was clearly understood by national leaders across the centuries. Hubert H. Humphrey (U.S. Vice President, 1965–1969) observed that a soci- ety is judged by how it treats its children, and inventor Benjamin Franklin (1706–1790) warned of the danger in knowing the truth about lead yet failing to act on it.
29
November 2026 • Journal of Environmental Health
Powered by FlippingBook