In low- and middle-income countries
(LMICs), the presence of an
informal economy can lead to human exposure to toxic metals such as
lead (Pb). This paper demonstrates the local health and economic benefits
of modifying practices within the informal economic sector in Madagascar.
Specifically, leaded components in 504 locally manufactured household
water pumps were replaced with unleaded components. Prior to the intervention,
32% of the household systems exhibited lead concentrations above the
World Health Organization (WHO) provisional drinking water guideline
of 10 μg/L, but after the intervention, fewer than 3% of the
systems were in exceedance. The reduction of lead concentration is
modeled to reduce the fraction of children with elevated BLLs (>5
μg/dL) from 34 to 13%. The reduction in BLLs is estimated to
provide an average economic benefit of US$11 800 per child
based on predicted increases in lifetime productivity. This corresponds
to a total benefit of US$8.7 million for the 730 children aged 1–5
associated with the pumps, representing a return on investment of
greater than 1000-to-1. Results demonstrate how the formation of partnerships
between public, private, and civil society entities, as suggested
by UN Sustainable Development Goal 17, can realize important local
economic and health benefits in LMICs.