Here’s the underlying study which suggests that USAID saved the lives of nearly 92 million people from 2001-21.

Just in 2025 the cuts will cause the deaths of ~1.8 million, including nearly 700 thousand children under 5.

Leading Rethink Priorities' work on lead exposure has been incredibly gratifying. I think that with more research, organizational capacity, and resources, we can achieve a lead-free future for our kids.

My full post on lead exposure, and efforts to end it: amarcusdavis.substack.com/p/how-my-chi...

This issue hits close to home for me. Chicago still has 400k+ lead pipes—the most of any US city. In my last apartment, from 2020-23, I spent $70/month on filtered water.

Around the world, millions face the same contamination, but aren't aware of the risks or can't afford protection.

Last year, major funders including @openphil.bsky.social, @gatesfoundation.bsky.social, and USAID launched the Lead Exposure Action Fund (LEAF), aiming to invest $100M+ by 2027—more than quintupling philanthropic resources dedicated to lead.

www.openphilanthropy.org/research/ann...

New organizations are stepping up to fix this. Lead Exposure Elimination Project's work in Malawi reduced "dangerously high" lead levels in paint from 50%+ to 33% in under 3 years. They've now expanded to 20 countries representing 45% of global infant births.

Inspiring work: leadelimination.org

But it's a problem we can solve. The global phase-out of leaded gasoline proved it's possible. However, only 43% of countries have legally binding restrictions on lead paint. In other words, more than half the world still allows manufacturers to sell toxic paint.

Lead is everywhere: in batteries, paint, spices, water pipes, cosmetics, toys. Lead poisoning caused ~1.5M deaths in 2021 and costs low and middle-income countries $300-500 billion annually in reduced earnings from cognitive damage.

But globally? The picture is still devastating. 600-800 million children worldwide—1 in 3 kids on the planet—have blood lead levels of at least 5 mcg/dL. That's roughly the entire population of Europe. India alone has ~200 million affected children.

Progress in the US has been extraordinary. Mean blood lead levels in US kids dropped 95% from the late 1970s to 2016. Only 1% of kids under 11 now have levels above 5 mcg/dL (vs 99%+ in the late 70s). The CDC called it a top 10 public health achievement of the 21st century.

Here's the thing about lead: there's NO safe level of exposure. As we learned more, the CDC kept lowering intervention thresholds—from 10 mcg/dL to 5 mcg/dL in 2012, then to 3.5 mcg/dL in 2021. Under today's standards, kid Marcus would have needed intervention.

Chicago was hit especially hard. Between 1993-1998, the city had to test 33-59% of kids under 7 EVERY YEAR. Chicago youth were 2-4x more likely to have severely elevated lead levels compared to the rest of Illinois.

In the 1970s, *88%* of American children had blood lead levels over 10 mcg/dL. By the 90s (when I was tested), that figure had dropped to 9%—still alarming, but a massive improvement owed to interventions like the elimination of leaded gasoline.

At a basic level, the ideas and arguments that guide our efforts to improve the world deserve scrutiny, whether they emerge from academic theory or hard-won experience.

Please join me in applying some of that scrutiny.

amarcusdavis.substack.com

I'm uncertain about how best to help improve the world, but I also know it would be naive to think everyone shares this vision.

After all, Lincoln originally proclaimed "charity for all" during the middle of a civil war!

Still this mandate is hard! I have real uncertainty about what to do.

At my day job, at Rethink Priorities, we've worked with a huge range of actors which includes GiveWell and Charity Navigator but also farm animal welfare, nuclear risk, and how to make decisions in the face of moral uncertainty.

Broadly, I try to apply the principles of effective altruism, namely caring about the scope of how much good you can do, trying to be impartial, and explicitly recognizing there are tradeoffs to make as you can't support every cause. But this isn't a panacea.

These are guidelines, not dictates.

That I work to do the same doesn't make me special. What I think does distinguish me a bit is how I approach doing good. I think we should seek to help improve the world as much as is viable.

This means not treating the accident of my birthplace as important. It means prioritizing based on need.

Millions of people get up every day and try to make the world a better place. This includes people from all walks of life. From people protesting governments, to those battling homelessness in wealthy countries, to those in low income countries working tirelessly to improve child nutrition.