Liberia stalls on lead rules, with children at risk

[MONROVIA, SciDev.Net] When a Liberian mother brings her child to hospital with learning difficulties or seizures, doctors cannot check whether lead poisoning is the cause.

There are no facilities for analysing blood samples. And despite regulations signed over a year ago to restrict lead in paint, there is still no law they can point to that would have prevented exposure in the first place.

“There could be a lot of cases that we may not be diagnosing because we are not checking for it,” says Patience Dono Franklin, a consultant paediatrician and haematology specialist at the John F. Kennedy Medical Center in Monrovia.

Lead poisoning is a global health emergency hiding in plain sight. The World Health Organization has declared no level of lead exposure safe for children, warning that even small accumulations in the blood cause irreversible neurological and behavioural damage, cardiovascular disease, and permanent brain injury.

Critically, there is no cure and the damage lead inflicts on a developing brain cannot be reversed. The latest data from the Institute for Health Metrics and Evaluation estimates more than 1.5 million deaths were attributed to lead exposure in 2021, primarily from cardiovascular causes. This figure has since been revised upward, with 2023 estimates placing lead as the eighth largest cause of death globally.

Liberia sits squarely within this crisis, yet the damage remains largely invisible.

Data vacuum

The country received a stark warning when its Environmental Protection Agency (EPA), with support from the Lead Exposure Elimination Project (LEEP)—a UK-based international charity advocating for lead paint elimination in low- and middle-income countries—confirmed that both imported and locally manufactured paints contained dangerous levels of lead.

Stakeholder consultations had begun as far back as 2019, leading to the formation of a technical working group in 2021. Yet despite years of groundwork, a critical gap remains: Liberia has no equipment capable of testing for lead—neither at its hospitals nor at the EPA itself, officials told SciDev.Net.

Without blood testing infrastructure, the true burden of lead exposure among Liberian children is entirely unknown.

Franklin is direct about what that means in practice: “There is no positive data on lead poisoning to know how many children are affected every year, month or days.” The Ministry of Health has published no reports on lead’s impact on child health.

This data vacuum has real consequences for clinical care. Lead poisoning shares its symptoms—learning disabilities, seizures, developmental delays—with many other conditions. Without a patient history pointing toward exposure, and without access to blood tests, clinicians cannot confirm a diagnosis.

“Unless you get the history,” Franklin explains, describing a scenario in which a mother reports seeing her child with a battery in their mouth before developmental changes emerged. Without that direct link, the connection to lead goes unmade.

The risks to children begin even before birth. Lead stored in the bones of pregnant women can be released into the bloodstream during pregnancy, exposing the developing fetus—a serious risk identified by the WHO that remains entirely unmonitored in Liberia.

Regulation without teeth

In January 2025, Liberia reached what many described as a milestone: the EPA and the National Public Health Institute of Liberia jointly signed Lead Paint Regulations that align the country with ECOWAS standards, capping the permissible lead content in residential and decorative paints at 90 parts per million. The agreement committed both institutions to monitoring compliance and supporting manufacturers in transitioning to lead-free production within three years.

But according to Jerry Toe, the EPA official leading the regulation, it has still not been published in the official gazette—the formal step that gives any regulation legal force and makes enforcement possible.

Without this, the regulation remains aspirational. Manufacturers face no binding obligations, inspectors have no legal basis to act, and Liberians buying paint are unprotected. The toxic products the regulation was designed to remove remain, for now, legally available to buy.

EPA’s director of environmental research and radiation standards, Rafael Ngumbu says the agency has initiated procurement of lead-testing equipment and funding has been secured.

“We already have some funding. We will be tailoring it this year,” he says, estimating that the EPA would have in-house testing capacity within the next two quarters. It is progress—but without a firm deadline, and with the regulation still unenforced, the window of risk for children remains wide open.

Multiple hazards

Lead is not only a problem of paint. It enters the environment through gasoline, plumbing pipes, ceramics, solders, batteries, and cosmetics. Mining, smelting, manufacturing, and recycling activities all release it into soil, water, and air. In Liberia, paint reaches consumers through two channels—imported products and local manufacturers—both of which have already been confirmed to carry unsafe levels of the toxin, Toe says.

Outdoor workers face direct and prolonged exposure. Car sprayers who routinely use oil-based paints to refinish vehicles inhale the toxin with little or no protection—a growing occupational hazard that receives almost no formal attention in Liberia.

Globally, the scale of the problem is staggering. A 2023 report by the Center for Global Development found that 815 million children—one in three worldwide, and more than half of all children in low-income countries—have blood lead levels high enough to cause measurable harm.

Lead exposure, the report found, accounts for more than a fifth of the learning gap between high-income and low-income countries and costs the global economy an estimated US$1.4 trillion in lost intellectual capacity every year.

Reducing risks

In the absence of testing infrastructure or enforceable standards, Franklin is calling for sustained public awareness campaigns to help mothers and caregivers identify and reduce exposure risks—keeping children away from old paint, batteries, and other known lead sources.

“Limiting exposure in children, especially those under five is important,” Franklin says.

However, until the testing equipment arrives, the gazette is published, and regulations gain the force of law, the true toll on Liberia’s children will remain, as Franklin warns, largely invisible.

This piece was produced by SciDev.Net’s Sub-Saharan Africa English desk.