Untold: Opus Dei - Toxic Legacy: Bonus episode with Samantha Power

Episode Date: May 4, 2026

The FT’s Laura Hughes speaks to Samantha Power, former head of the US Agency for International Development (USAID) who spearheaded efforts to fight lead poisoning globally. They talk about why she got interested in lead poisoning, efforts at supply chain tracing Ecuadorian cinnamon, and the UK government’s new plans for a lead testing trial.For more information on how to live safely with lead, please visit the LEAPP Alliance website.Read a transcript of this episode on FT.com Hosted on Acast. See acast.com/privacy for more information.

Hello, I'm Laura Hughes. I'm a public policy correspondent here at the Financial Times, and I'm also the presenter of our last untold podcast series, Toxic Legacy, which explored lead poisoning across the United Kingdom. In the months since our podcast came out, I got a call from the UK Health Security Agency, and they let me know there's actually a pilot study going on now in Leeds looking at the lead blood levels of children living in the area. This is an enormous step at actually finding out what the scale of this problem might be. And if it's successful, they told me it could pave the way for nationwide testing of UK lead levels in children, which would be an enormous result. Over the last few months, I also heard that there was somebody else out there who

shared my interest in lead poisoning. And that person is Samantha Power. She was Obama's ambassador at the United Nations, and she was also head of USAID before Donald Trump disbanded the organisation. I reached out to her to see if she'd be willing to talk to me for this podcast series about lead poisoning globally. She agreed, and what you're about to hear is our conversation about this problem all around the world. I hope you enjoy. Could you just, for someone that might be listening to this who shockingly hasn't listened to the three episodes we put out on lead poisoning, Could you maybe speak about what lead does, especially to children? Why is it so harmful?

Well, it is the stunting in growth that is documented across countries where lead poisoning has been rife, including advanced economies, particularly when we had lead in gasoline. You'd see not only large fatality numbers of diseases induced by lead poisoning from lead in gas, but also just the, again, the stunting in the growth of kids. But it's not just physical stunting. It's also really curbing intellectual development and brain development. And once it gets into the blood, you can't get it out. And so it does its damage insidiously in kids.

And what is so heartbreaking about how it shows up, how it presents in developing countries, is that remember a lot of the low-income communities, let's say, where USA might have been working on curriculum development or teacher training over the years, over the decades, and where governments and communities are investing huge amounts to try to bring up literacy and numeracy and kids are not performing, it might be tempting to say, maybe that kid is dumb, or maybe the environment in the home when the kid goes home from school is not conducive to learning. We worked in places where there wasn't a lot of electricity. Maybe you could say, oh, well, with no electricity, how are kids going to do their homework once the sun sets? A thousand reasons you could point to for why kids' test scores, for example, might be much lower in one community compared to another or in one country, developing country,

compared to a more advanced educational system. But for all the investments we were making in educational programming over the years, lead poisoning was not really atop the list of reasons that one might give to explain really limited educational attainment. And yet it might well be that all these other investments are just going down the tubes because the paint on the school walls are poisoned with lead. Or because, and it breaks your heart really to think about pre-K kids or primary school kids who are maybe more tactile, they pick up a toy or maybe they get a school lunch, but the bowl that they're using for the school lunch has paint on it or the toy has paint on it.

And then being tactile, maybe they put their hand on a pencil and then put the pencil in their mouth. There's so many ways the lead can move from a toy or a bowl into a child. And again, it takes so little lead to cause these harmful development effects. When I started looking into this whole issue of lead poisoning back in really early 2024, I remember coming across an op-ed you wrote for the Washington Post where you were talking about the importance of screening for lead poisoning. You were part of this huge initiative that you were involved in with USAID that was tackling this issue and it meant a lot to me at the time because I was sort of questioning myself and

going, is this a story? Am I mad? Seeing you talk about it was quite sort of. of self-affirming at that moment. And it's fair to say that I've become quite obsessed with lead poisoning as an issue. And I heard you might feel the same way that I do. And I wondered, how did you get into this? Why lead? How did you hear about it? How did you get involved? I had the great fortune of being the administrator of the largest development and humanitarian agency in the world, USAID, incredible experience in every respect. And USAID has since John F. Kennedy's time, been all about how do we solve the world's toughest problems in education, in health, in environment, in economic growth, joblessness. And we have had a huge public health budget and made huge

public health investments in combating, for example, HIV, TB, malaria, building global health security with working with countries that are very under-resourced in that regard. And so I was not thinking about lead poisoning whatsoever as I did my job and as I listened and learned from my teams. And then I got a memo from a very young staffer, probably the youngest person in my front office, who had started as a special assistant basically answering phones and doing short research memos and eventually got his confidence up and himself had read a lot in the effect of altruist movement and followed open philanthropy, for example, in their frameworks for where to invest resources, principally resources of high net worth individuals, family foundations, etc.

And this young man, Garrett Lamb, is his name, wrote me a memo, wrote a memo to the administrator in which he made the case for why our agency should turn our attention in a big way to combating lead poisoning. And I remember reading this memo like it was not just yesterday, but five minutes ago, because it was one of the most powerful experiences I've ever had where somebody so powerfully contrasted the scale of the loss of life, which at that time was estimated to be 1.6 million killed every year needlessly, right, because it's totally preventable. And the contrast between that huge number, which is more than HIV and malaria, combined and other harms like the educational attainment gaps that stem from kids in developing

countries having elevated levels of lead in their blood. And the estimate in this memo was between one and two and one and three kids having lead poisoning as we speak, even to this day. So the contrast with that and those harms, which are devastating, with the amount of money that was being invested by the philanthropic community, by donor governments like the United States and European governments. And that number was so relatively speaking minuscule that this just seemed like one of the most incredible opportunities with modest resources to make a world of difference. And the tractability of the issue, Garrett underscored, was knowable because in advanced economies like that in the United States, while the issue of lead poisoning has not been eradicated, if you compare it to where we were 40 years ago, it's night and day. And the contrast that Garrett drew in the memo was between Flint, Michigan, where we had a massive outbreak of lead poisoning here, not long ago within the last decade, which was a horror and the harms and the pain and the suffering of the families is hard to find words for. But that was one in 20 kids in Flint,

and it was a huge scandal. And what Garrett was telling me was that every day in developing countries, the number is not one in 20. It's one in two or one in three. And we had a huge scandal and many, many resources thrown at the problem belatedly too late for the kids who have lead poisoning in Flint, Michigan. But nonetheless, it could generate that kind of outrage and firestorm and resource allocation, whereas nobody's paying much of any attention, Garrett argued, to the one in two or one in three in every developing country. So when I saw that how much we are spending rightly on HIV AIDS and malaria and then saw that it was a tiny minuscule fraction of that, I think the high watermark was $15 million spent annually on an issue that was killing 1.6 million people and holding all these kids back from learning.

I said, oh, my gosh, I'm in. You know, where do I sign? And then the question became, how do we replicate this experience that it sounds like you had looking into it? I had. How do we replicate what Garrett has done? How can I become Garrett and go to other people, the head of the World Bank? the United Nations Secretary General, President Biden, heads of state from around the world, whose countries are suffering from lead poisoning epidemics, but they're not testing the blood-led

levels in the kids, and so they're not even aware of it. And they're certainly not aware of how little it would take to get the lead out of some of the more obvious sources like paint or spices or cosmetics. So that became our mission was to go door to door among those with influence and to say, here's the predicament, but here's the good news, we can do this. We can actually get the lead out together. Well, we can't do heartbreakingly. I hate this about lead poisoning, is you can't do anything for the people who already have elevated levels of lead in their blood.

And so it really just underscores the urgency of getting on this as a matter of prevention since the ability to mitigate it after it's happened is very limited. When you look at this globally, where is the lead? Where are we finding it? Because for me, there's two angles to this. There's the legacy of lead. So there's the lead that we once used, that we were legally using in paint, in pipes, etc. or environmental lead lead from old mining. But then I know that there are still countries around the world where lead paint hasn't been banned. It's not illegal to use it. Where are you, and in your work that you've done, where were you seeing the lead source? Where we're, where we're seeing the lead source? Where we're, where we're, where we're was it coming from? I think your two categories align with what we find in developing countries, legacy lead and then incoming, ongoing infusions of lead into the environment in different ways. And the targeting is easier if it is on consumer products, I think, lead in paint, a very large percentage of the hundred countries in which USAID worked. and had missions and teams working on health, education, environmental programming,

a very high percentage of those countries did not have regulations on the books banning lead-in paint. One of the amazing upstart NGOs, really just a couple individuals, famously unable to mobilize huge resources or get the government's attention in the country of Malawi, just went to all the local paint stores with a tester and bought the paint, tested the paint, gathered the data in this ad hoc way, not the way to run a rodeo, they'd be the first to say, and then we're able to go to the government and show that they had a lead poisoning problem in their paint. And then it didn't take much at all. I think this whole effort was maybe $15,000, $30,000, something of that nature. Then the government finally moved out with a regulation. And then, of course, after the regulation,

you need the enforcement of the regulation, but fairly rapidly with the data and the knowledge, unsystematic though it might have felt to those who were gathering it, it had a political effect. So paint, I think, lends itself to that. There are really good examples of lead being used in spices in turmeric in Bangladesh, where, again, an enterprising young woman working on her PhD, discovered the high concentration of turmeric and work with the Bangladeshi authorities to get rid of turmeric in spices.

The lead there is used to give, like with paint, to give the color a pop and also to add some weight to the spices, which will increase, of course, the cost of the spice. So lead in spices, in the country of Georgia, in India, in Bangladesh, this is a thing. You do have legacy sources like plumbing, like lead in soil, probably the hardest to reach source of lead poisoning today is lead acid battery

recycling, which is being done. And that's going to be, feels like the low-hanging fruit is the spices and the cosmetics, which I haven't mentioned, but also there's lead in cosmetics for color and the like, the paint. Those you can imagine how with regulation and enforcement and community awareness, those sources of lead exposure can be tackled. The informal sector is always harder to regulate. And so that is where citizen awareness, government embrace of this challenge, community awareness, particularly of the effects on children to rally around is going to be very, very important. How difficult has it been or was it politically to get governments around the world on board with what you guys were saying and the regulations you were suggesting that they might

want to introduce? I think on the one hand, it is challenging because most countries do not want to be known as countries where there's a high concentration of lead poisoning. It's just not good not good branding, whether it's tourists that you want to come to a country or you want your spices to be purchased, as was true of the Republic of Georgia. It's just not a good look, right? Lead poisoning. On the other hand, it's usually, in my experience, a very shocking piece of news for heads of state or even just senior ministers to learn that this problem, has been harming, particularly kids, but harming citizens for such a long time without any political attention. And so in that sense, I have found actually a lot of receptivity,

you know, more of a kind of, oh, no, really? That was the kind of reaction that this incredulity, really, that the problem could be as bad as described. Many of the heads of state that I talked to when I would use the example of there being the spate of lead poisoning in Flint, Michigan, and that being one in 20 kids, and in the country whose leader I might have been talking to, it'd be one in two or one in three. You could just see they're just the most human of reactions. What? Because they were more familiar with the scandal of lead poisoning in Flint, Michigan, in a country in sub-Saharan Africa than they were with the steady state lead poisoning that was happening every day in their country invisibly. So all in all, I would say no one's thrilled

to have a new challenge also on top of all of the other disease burdens a lot of these countries are carrying. But the fact that there's a playbook and that we were able to say to these countries, we know we can get rid of lead in almost all of these sources working together and supporting your efforts and we are bringing resources to bear. So we didn't have the conversation before we had also mobilized fairly substantial resources. So it wasn't, hey, got some bad news for you, good luck. It was, we stand with you and want to hear from you how you would like to go about getting also more scientific blood-led level samples because we had some macro data, but not nearly the kind of data you would wish to have as you were figuring out how to prioritize within a country.

But that is always the recommended approach if you're going to go to somebody with a problem to be able to bring alongside some articulation of the problem a path ahead and then how that can be resourced. And so we were able to do that, which I think created more of an open door. And I imagine there as well, if we look at the legacy and then the kind of new lead problem that we're creating. It's easier to just span the production of it, ban the sale of it, ban the use of it. But remediating the lead we've once used and clearing that up, I imagine that is a much more expensive problem and it's much more complicated and questions of who is responsible for doing that when we're talking really granular on the ground that is individual people's houses maybe.

How did you guys have approached that double challenge, one of which I think would be easier to overcome than the other? Well, I would add another piece of context and complexity, which is that is going to be the most expensive lead to eradicate. And so I think it's really important given the inability to remediate once the lead goes into people's blood, it's really important to aggressively move out on prevention in the first instance. For example, the lead paint regulations and the enforcement around that, which is no small thing. Enforcement generally of laws on the books in many underdeveloped countries is lacking. It's not like they have cracked teams as they would have in the United States through EPA or through a state environmental regulation or health agency. I mean, most of the countries we're talking about just don't have those teams on the ground.

So I think the idea was, okay, let's get it out of these consumer products. And again, every country is different because they're coming up with their own plans. Right now it's been a bit of a top-down effort in terms of this issue being put on the map in these countries by virtue of engagements with key ministers or heads of state, maybe by when President Biden was in power. certainly by the United States, and we tried to get other governments active in this before leaving office, recognizing that you can never predict what's going to happen in a subsequent administration. But with leaders embrace of the challenge, there are still budget questions, prioritization questions, and political questions, because none of the leaders are super eager and it's human nature, they're not going to want to issue a countrywide SOS.

if none of the remediation infrastructure is in place or the teams are in place to do much about it. But at the same time, in order to sustain investments and reach the harder to reach areas and the more expensive areas, it's going to require more than top-down enthusiasm. It's going to require the community asking for this from government. So it feels like there's a long way to go before these, everything from the informal, Battery recycling, I mentioned, or your question of going into someone's home, some of these communities are places where even getting the pipes in the first place was a huge lift and took decades and maybe only got access to piping maybe 10 years ago. And now someone's going to come

along and say, oh, no, there's lead in your pipe. We're going to have to remove this. And that's big money involved in water infrastructure compared to doing enforcement on cosmetics or spices, et cetera. A lot of these countries are spending more servicing their debt to China over the Belt and Road initiative than they are on water and education combined, right? So their ability to do big infrastructure is going to be limited. That's why getting this also instilled as a design feature of every World Bank project on the front end, because the remediation is so expensive and so hard, let's make sure by God, that everything being built henceforth doesn't suffer this feature.

And I imagine one of the ways you get community buy-in is if people realize or think that it's their children that are getting poisoned. And I think I'm right in saying some of the work that is going on internationally is focused on screening programs. So that means going into countries and actually getting the blood-dead levels of children. So you have the data, you have the evidence, because at that point, when you know the children are being affected, you think about where it's coming from, that gives you the political impetus to go and deal with the problem. How important is screening children for you as part of this whole kind of issue and dealing with it? You've put it very well. I think it is

the sine qua non of building community awareness and community outrage is getting the data around lead poisoning clusters, period. And because it's very hard to, not only is it hard to change what you can't measure, but it's hard to interest anybody if these are abstract ideas of a generic lead poisoning problem, when it is your community, this neighborhood, with this number of kids with elevated levels of lead in their blood. That's going to be a game changer. It is also very hard. And this is, again, where the contrast between advanced economies and developing countries, it has taken a lot of work to get this kind of testing introduced alongside the other things that are tested in blood samples

that are taken from kids. Kids are a natural pool. because they are in many communities getting blood tested for other diseases. But there's a status quo bias in every institution. We have a colleague from the Republic of Georgia who made it his mission to try to change what the pre-existing blood sampling tests were testing for and to get this added. And it was just an absolute nightmare pushing water. a pill just to add something, you know, it adds cost, it adds, you have to find lap capacity, just making change in general can be challenging. As you said, without that ground swell of demand,

when you're just trying to change the system for its own sake, even if you have a good argument for doing so, there's just often a lot of resistance. And so I think that resistance now has been overcome. The Gates Foundation has been critical here, World Health Organization, UNICEF. So I think there is a broad embrace that where kids' blood is being tested for other diseases or other elements, that this be integrated. And that then provides, should provide a basis for informing communities of the challenge that afflicts them and then hopefully creates a virtuous cycle of political pressure and political momentum on the back end. If we can just talk a little bit about the US situation, because again, when I was looking into this, I kept looking at what other developed economies were doing.

And I was struck and I know the US isn't perfect, but I was interested in the fact that America screens children on a regular basis, this is the kind of normal part of your healthcare, that there is legislation when it comes to selling houses, being a landlord. eradicating lead pipes, that sort of thing. And I always looked to it when I was feeling, is there a gap in the UK policy here? I was looking at what the US was doing and how much we diverged. And for someone listening to this, I wondered if you could maybe give a brief overview

of how does the US deal with its lead legacy problem? A lot of the attention to lead, as was true in developing countries, belatedly concentrated on lead in gas, The health damage caused by having lead and gas for so long and all the lobbying against taking the lead out was crazy. But you're absolutely right about renting properties and the responsibilities that accrue the regulations around safe drinking water. I got a notice here not long ago that they were testing all the pipes in the area and had found residue of lead and we're going to have to do a revamp. in our DNA are fairly substantial detection methods,

but that doesn't stop not only a Flint, Michigan scandal from happening, but we also had a spate of lead poisoning when applesauce was being consumed by kids, and dozens of kids got sick from applesauce, and when the supply chain tracing was done, it emerged that cinnamon in Ecuador, but maybe cinnamon, I think, that derived from Sri Lanka, went on the applesauce, brand name applesauces, that any parent would feel safe buying in their local supermarket. And thus, kids in the communities where the applesauces made their way felt very, very ill.

It was a lead poisoning cluster here in the U.S. And this is really recent, just in the last few years. That example, I think, is very important because while there's a lot of talk post-COVID of supply chain resilience and some skepticism about globalized markets, there's no putting the genie back in the bottle of how integrated so many of our products are. And so it is important if, for example, American kids are to be safe, it is important to make sure that there is not led. in cinnamon, in this instance, in Sri Lanka or in Ecuador. And so we are part of a global economy where different components of even our food staples come from different places. And I hope that can help politically sustain enthusiasm to care and to see through this effort to end lead poisoning and developing countries. If you were advising the UK government now, you got shipped over here

and you were put in a meeting with our health secretary or prime minister, and they said, what do we do? Where should we start? Because in my own mind, I have many different solutions. You'd change housing policy, environmental policy, food testing policy. But I would probably advise you go first with the screening of our children to get an idea of what we're looking at. What would you advise the UK government to do? Talk to Laura would be my first recommendation.

But actually, I mean, that the, learning that has happened that have fueled the partnership for a lead-free future globally came from people who weren't formally reporters out there doing the kind of detective, disease detective work you've been doing. They weren't technically journalists, but they were acting like journalists. They were, in the case of Malawi, buying up the lead paint and testing the lead paint and then gathering the data and going to another paint store and doing the same in the case of Jenna in Bangladesh, you know, was buying up the turmeric, doing the testing on the turmeric, realizing how pervasive it was. And so I actually think that any government would benefit

from hearing the stories of how little it actually takes to get a better handle on the challenge. Because one of the first things that a government is hearing, most governments hear, is this is so big, the very breadth of the challenge, the very pervasiveness of the harms in education, the economic drag that lead poisoning causes, of course, the deaths, that can overwhelm even an advanced economy. Showing the tractability, I think, is a really important part of what governments need to hear from the very beginning, that there is a way to make a difference. No, you can't wave a wand. It doesn't go away tomorrow. Yes, it's not the brand. ideal for a nation or a city or a community. Nobody wants to be the next Flint, Michigan,

to be known and associated with lead poisoning. Nobody wants that. But that it's solvable. If you're a government and you have limited resources, you start with the testing. You start with getting some handle on where your clusters are. As soon as you can detect a cluster, then you dig into the sourcing, as soon as you detect a cluster and that becomes known, the rest is history. Because as we saw in Flint, as we see in developing countries where lead poisoning has become better understood and measured, that's when you start to get the bottom up political traction. And politicians or executives don't love inciting that with the release of data, but often they go in optimistic that they're going to find good news.

And so once they've unleashed the data gathering phase, you know, this is not data that's going to be held back. So that is definitely where you start looking to see concentration prevalence of elevated levels of lead in the blood of kids. And then as soon as you do that, the testing is really sophisticated in that it very quickly leads you to the source. It's not the detective work after you have those samples taken, as I understand it, is fairly straightforward.

And then you dig into remediating the lead poisoning that is harming your people. Thank you so much for speaking with me. Thank you so much, Laura. This has been a bonus episode of Untold Toxic Legacy with Samantha Power. Thanks for listening.