EA - Preliminary Analysis of Intervention to Reduce Lead Exposure from Adulterated Turmeric in Bangladesh Shows Cost Benefit of About US$1 per DALY by Kate Porterfield

Welcome to The Nonlinear Library, where we use Text-to-Speech software to convert the best writing from the Rationalist and EA communities into audio. This is: Preliminary Analysis of Intervention to Reduce Lead Exposure from Adulterated Turmeric in Bangladesh Shows Cost Benefit of About US$1 per DALY, published by Kate Porterfield on August 29, 2023 on The Effective Altruism Forum.Pure Earth is a GiveWell Grantee dedicated to reducing lead exposure in low- and middle-income countries. In collaboration with Stanford University and the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), a preliminary cost-effectiveness analysis (CEA) was performed to assess the effectiveness of an intervention in Bangladesh. The CEA presents an encouraging outlook, with a cost per disability-adjusted life year (DALY)-equivalent averted estimated at just under US$1. As this assessment is preliminary, it may contain methodological inconsistencies with GiveWell's. As such, we welcome any comments and corrections.In 2019, after investigations concluded that turmeric was the primary source of lead exposure among residents of rural Bangladesh, Stanford University and Bangladeshi non-profit icddr,b embarked on a mission to eliminate lead poisoning from turmeric. Stanford and icddr,b's investigations had revealed that lead chromate (an industrial pigment sometimes called "School Bus Yellow") was being added to turmeric roots to make them more attractive for sale. Armed with this evidence, the team coordinated with the Bangladeshi Food Safety Authority to conduct a crack-down of the adulteration by enforcing policies at the markets and raising awareness among businesspeople and the public nationwide. These efforts successfully halted the practice of adding lead chromate to turmeric: the prevalence of lead in turmeric dropped from 47% in 2019 to 0% in 2021.In collaboration with Pure Earth, icddr,b continues to monitor turmeric and other spices and coordinate with government agencies to maintain the safety of these and other food products.To gauge the effectiveness of this program in advancing the mission of reducing lead exposures globally, it is important to assess both impact and cost-effectiveness. To approach this task, Pure Earth and Stanford have completed a back-of-the-envelope cost-effectiveness analysis (CEA), incorporating preliminary data from blood lead level assessments and various assumptions. This model is built off of previous models created by LEEP and Rethink Priorities.The preliminary findings are that this program can avert an equivalent DALY for just under $1. This result is extraordinary, albeit deserving of further scrutiny. It indicates that certain interventions in the lead space could be enormously cost-effective. The body of work to reduce lead exposures in LMICs is nascent, and not all interventions are likely to be as cost-effective as spices. But clearly, more work on spices is called for, and Pure Earth, Stanford, icddr,b, and others are pursuing funding to expand these programs into other countries.Program Implementation CostsTo establish a framework for cost-effectiveness assessment, it is essential to define the terms "cost" and "effectiveness" within the context of the Stanford-led mission. The concept of "cost" encompasses the resources utilized by the project team and those expended by the Bangladesh government as a direct result of the project's activities. Specifically, we consider monetary expenses incurred by the program, which we estimate to be upfront costs of $360,000. These expenses include both the costs to identify the sources of lead exposure and implement the program, as well as continuing costs of $100,000 to monitor and continue the program after the initial implementation. Additionally, the Government of Bangladesh is expected to spend $100,000 over the course of the intervention.To facilitate comparisons with other global health interventions, we define the project's"...