A Small Country's Big Fight: Georgia's National Response to Childhood Lead Exposure

Lead exposure remains a major but underrecognized threat to children’s health and development globally. In 2018, the Republic of Georgia became the first country to include blood lead level (BLL) testing in UNICEF’s Multi-Indicator Cluster Survey, revealing that 41 percent of children aged two to seven had BLLs above the World Health Organization’s threshold of 5 ug/dl, with no child testing at zero. This case study was built on 20 semi-structured interviews with government, international, nongovernmental, and academic stakeholders, alongside a review of published evidence to document Georgia’s response: building domestic laboratory capacity, identifying adulterated spices as a major source of exposure, and enforcing existing food safety laws, and creating a national surveillance program. Follow-up data shows substantial declines in BLL, though 15 to 20 percent of children remain above the threshold. Georgia’s example shows what is possible once lead exposure becomes a political priority.