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Rethink Priorities

Improving outcomes: Shifting funding to more cost-effective options

Rachel Norman, Whitney Childs
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Our Global Health and Development Department has helped to redirect millions of dollars of grants to more cost-effective options.

Traditionally, foundations in the global health and development space fund projects based on preferences toward a particular region, issue, or type of intervention. In contrast, we believe in allocating resources based on cost-effectiveness regardless of regions, issues, and interventions. Our Global Health and Development Department has completed dozens of research projects commissioned by funders who are concerned with finding the most promising, cost-effective opportunities. We have also initiated new partnerships with organizations looking to improve the cost-effectiveness of their existing programs. Our work has in turn impacted the funding allocation decisions of major funders across various neglected issues, especially around  lead exposure.

19

reports were completed by the Global Health and Development Department in 2024, assisting six clients

1.5 million

people die from lead exposure each year

8 million

dollars of a major foundation’s grant funding was shifted toward a more cost-effective lead intervention based on our research

Research unlocks solutions

Bringing attention to neglected issues

An estimated 1.5 million people die from lead exposure each year.

In 2021, Open Philanthropy commissioned Rethink Priorities to research the potential neglectedness of lead exposure and identify cost-effective solutions. Here’s what our team found:

  • Lead exposure costs approximately $5-10 trillion annually, largely due to lost income from neurological damage.
  • There are many different pathways for lead to enter the human body and exposure is common across nearly all low- and middle-income countries (LMICs).
  • Strategies for reducing lead exposure are mostly context- and source-dependent.
  • Preventing new lead from entering the environment seems more tractable than removing existing lead.
  • At the time, an estimated $6-10 million was being spent on reducing lead exposure in low- and middle-income countries each year.
  • Existing and potential nonprofit organizations had significant room for more funding.

Honing in on the problem, exploring interventions

In 2023, we completed a research project commissioned by GiveWell that focused on exposure to lead in LMICs through paint.

Here’s what our team found:

  • Lead paint accounts for ~7.5% of the total economic burden of lead exposure.
  • Lead-based paint is unregulated in over half of the countries worldwide.
  • It is more common in LMICs than in high-income countries to use solvent-based paints— which have ~20 times higher lead levels than water-based ones—for painting in residential buildings.
  • Lead-based paints are also frequently used in public spaces in LMICs, such as playgrounds, schools, hospitals, and daycare centers.

Although there is limited data available, our researchers developed a model to generate rough estimates of the potential impacts of bans on lead-based paints. The below chart compares what the team projects would occur under two scenarios: (1) there is an intervention that doubles the speed of bans, versus (2) the counterfactual in which pace remains unchanged.

The team estimated that doubling the speed of the introduction of lead paint bans across LMICs could prevent approximately 31 to 101 million children from being exposed to lead paint.

“The Rethink Priorities Global Health and Development team are creative, thoughtful researchers who have produced helpful research for us across global health, international development, and climate change. They get up to speed on new areas quickly and have been responsive to our needs as a research heavy philanthropic funder. They’ve really helped to add research capacity to our small internal team, bringing a helpful mix of backgrounds from academic research, non-profit work, and the public sector.”
— Chris Smith, Program Officer, Open Philanthropy

Driving change

In 2024, Open Philanthropy announced the launch of a new pooled fund dedicated to lead mitigation efforts.

In their announcement, Open Philanthropy recognized lead as an important and highly neglected issue where there is immense potential for philanthropy to make real change. The Lead Exposure Action Fund (LEAF) will direct at least $104M over the next three years to reduce lead exposure through measurement, mitigation, and awareness-raising efforts.

Separately, Rethink Priorities’ research on lead exposure risks resulted in an anonymous major foundation redirecting an $8 million grant toward a more cost-effective intervention to address this issue.

We’re pleased to see more resources devoted to solving neglected problems in the global health and development space. Our research team continues to work on bringing attention to neglected issues, such as fungal diseases and substandard and falsified drugs.

Contact the Global Health and Development Department to commision their work.