Africa Faces 1.1 Million Deaths Annually from Air Pollution – Second Largest Risk After Malnutrition
Traffic in Addis Ababa; air pollution is second leading cause of premature deaths in Africa for 1.1 million deaths a year.

Africa faces some of the world’s most severe health impacts from air pollution – with five countries on the continent ranking among the ten most polluted countries in the world, according to a new report by the US-based research organization Health Effects Institute. 

Those countries include Niger, Nigeria, Egypt, Mauritania and Cameroon, where the report, the State of Air Quality and Health Impacts in Africa, found fine particulate matter (PM2.5) exposures ranging as high as 65-80 micrograms per cubic meter (μg/m3).

Some 1.1 million people in Africa died prematurely from air pollution-related diseases in 2019, one-sixth of the total global estimate of 7 million deaths annually. According to the report’s findings, air pollution is the second leading risk factor for premature deaths after malnutrition, placing it well above the long-discussed issues of unsafe water, sanitation and hygiene, which ranked fourth largest risk factor for deaths.  

Meanwhile, the economic costs of air pollution in African cities will increase by 600% over the next 18 years without urgent action, warned another report by the London-based Clean Air Fund (CAF), published simultaneously on Thursday. 

But shifting away from dirty energy sources for transport, heating/cooling and electricity could save over 120,000 lives, cut climate emissions by 20%, and unlock $20 billion for the urban economies of four key cities – Lagos, Cairo, Johannesburg and Accra, Ghana over the next 17 years – where solution scenarios were further explored, the CAF report predicts.

Under a business-as-usual scenario, air pollution is estimated to cost a total of $115.7 billion from 2023-2040 across the same four cities.

Reports come just ahead of COP 27 climate conference 

Population-weighted annual average PM2.5 exposures in countries across Africa.

The two reports come just ahead of the start of the UN Climate Conference (COP27) in Sharm el Sheikh, Egypt – and in a time when scientists say that there is “no credible pathway” to keep global warming limited to 1.5C – in light of countries’ mitigation actions to date.  

Leading African policymakers remain keen on developing fossil fuel sources and skeptical about  the feasibility of a rapid green energy transition in view of their dismay over the lack of rich country finance to support climate action in developing economies.  

Just last week, South Africa’s Minister of Mineral Resources and Energy Gwede Mantashe, charged that developed economies want to use African countries as “guinea pigs” on which to perform green energy experiments.

Against that background, the health and economic impacts of air pollution, whether it’s from biomass or fossil fuel sources, have played a negligible role in the political calculus leading up to the world’s next big climate moment.

It remains to be seen if the mounting evidence about the knock-on effects of air pollution, for health, climate and economies will make a difference. 

Fossil fuels, biomass and dust among leading pollution sources

Trends in percentage of population exposed to household air pollution for the five countries of interest, 2010–2019.

Africa’s air pollution sources are by no means limited only to fossil fuels – used for transport, urban heating and cooling and power generation. 

They also include significant emissions from the inefficient burning of biomass for household cooking and heating; industry; crop and waste burning; and semi-industrial activities, such as charcoal production and artisanal mining.

In arid and semi-arid parts of Africa, including the Sahara and the Sahel region to the south, dust and sandstorms are also a major contributor to air pollution – a source that African policymakers have emphasized is a factor that cannot be easily curbed. 

West Africa, parts of which border on the Sahel, also has some of the highest PM2.5 pollution levels on the continent. It is among the most heavily dependent regions on solid fuels for household cooking and heating. In Southern Africa, where fossil fuel sources factor more widely, has comparatively lower annual average PM2.5 levels – though still more than 5 times above the WHO recommended guideline levels. 

Limited air quality monitoring and management

Not coincidentally, South Africa also has the continent’s most extensive air quality monitoring system – as well as established air quality management policies. Air quality regulations, and monitoring for their compliance, helps advance progress on cleaner fuels, vehicles and industries.  But of the African Union’s 55 member states, only 17 countries do any air quality monitoring whatsover, the HEI report notes.

On a more positive note, the overall proportion of people relying on solid fuels (biomass and coal) for cooking declined slightly between 2010-2019, the report found.   

But such declines have not always translated into health benefits as population growth means that even more people continue to breathe dangerous household smoke. 

For example, the report found that the proportion of people in Nigeria using solid fuels declined from 82-77% between 2010 and 2019.  But due to population growth, some 29 million more people were cooking with solid fuels in 2019, as compared to 2010. 

Cities a nexus of old and new air pollution sources – and solutions

PM2.5 levels in Africa’s top 10 most populous cities in 2019.

In addition to the human toll in deaths and health impacts from breathing polluted air, the annual cost of health damages due to disease related to air pollution amounts to an average of 6.5% of GDP across Africa, the report said.

Across Egypt, Ghana, the Democratic Republic of the Congo, Kenya, and South Africa, the combined annual cost of health damages from PM2.5 exposure is more than 5.4 billion U.S. dollars.

In many developing African cities, old and new air pollution sources directly collide in a potent toxic stew. The mix typically includes smoke from household cooking and heating with biomass; uncontrolled waste burning; emissions from old diesel vehicles running on congested streets and from diesel generators that back up unreliable electric grids, as well as industrial emissions.  

Khartoum, Sudan. In Africa’s Sahara and Sahel regions, dusts storms can also be a major air pollution factor.

But where there are problems, cities can also find solutions. Some of Africa’s fastest growing cities could unlock tens of billions of dollars more for their economies – as well as saving lives and cutting greenhouse gas emissions if they invest in greener patterns of growth, according to the Clean Air Fund report, which makes the case for investing in air pollution – for dual health and climate change benefits. 

The CAF analysis mapped the health, economic and climate impacts of increasing air pollution along a “business as usual” growth path for four major cities, Lagos, Cairo, Johannesburg and Accra, Ghana. It contrasted that trajectory with an alternative scenario in which cities implement clean air measures as they grow. 

Those measures include cleaner and more efficient public transport, cleaner cookstoves and alternative fuel sources;  greener industrial technologies and energy systems; reduction of slash and burn land clearing, and open waste incineration.

Projecting out the alternative scenario in the same four cities, the report found that such policies could replace the vicious cycle of pollution and health impacts with a virtuous cycle of over 120,000 lives saved and $20 billion in economic benefits between 2023-2040.  Lagos, Africa’s largest city, would also enjoy the largest total savings, amounting to  $12.5 billion and 64,000 lives over that period. And these benefits could be extrapolated to other African cities, too, the report found. 

Health impacts of air pollution, large and varied 

The percentage of the population using solid fuels for cooking in countries across Africa in 2019.

Health impacts of air pollution tracked in the two reports range from common knoweldge causes – such as lung diseases, cardiovascular diseases, stroke and hypertension –  which mainly affect older people, to less discussed impacts among newborns and young children.  

According to the HEI report, some 236,000 African newborns die within the first month of life from air pollution exposures, mostly related to household air pollution from biomass and charcoal use. 

In 2019, 14% of all deaths in children under the age of 5 across Africa were linked to air pollution, situating air pollution as the third largest risk factor for those deaths after malnutrition, unsafe water, sanitation and hygiene in sub-Saharan African regions.

The impacts on newborns and infants also have long-term consequences for overall health, including issues with lung development, increased risks of asthma, and increased susceptibility to communicable diseases such as lower respiratory infections in young children.

“This report gives evidence of the substantial threat air pollution poses to the health, and even life, of babies and children under the age of 5 years,” said Caradee Wright, Chief Specialist Scientist with the South African Medical Research Council. “This vulnerable group needs special attention to mitigate their exposures through policy and intensive awareness campaigns with practical solutions for mothers and caregivers.”

Added Pallavi Pant, HEI head of global health and one of the report’s key contributors: “The tremendous health impacts from air pollution exposure across Africa, especially in young children, creates an urgency to expand Africa’s clean and green energy infrastructure. Meeting these challenges will bring significant improvements to air quality and public health as well as reduce greenhouse gas emissions.”

Image Credits: Health Effects Institute – State of Air Quality and Health Impacts in Africa l Air, State of Global Air, State of Air Quality and Health Impacts in Africa .

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