When Elvis Ndikum Achiri, a long-time veteran of tobacco control campaigns, began collecting data on air pollution in his community in Cameroon, he was surprised to discover how many people around him, both young and old, suffered from related illnesses even though they had never smoked – including a beloved high school teacher who had recently died from asthma.  

Since then, Achiri has become a national advocate in the air pollution space as the coordinator for the Global Youth 4 Clean Air and Climate Health Action in Cameroon. 

He shared his experiences at a World Health Assembly (WHA) side event on Thursday, “Breathing Life into Clean Air Action”.  The event, hosted by the Geneva Graduate Institute, brought together activists with UN agency leaders and funders of air pollution work to explore what civil society leaders are doing on the ground and how they can help drive real change.

Speaking of his teacher who had passed away due to asthma, Achiri said, “When we connect the experience between the patient story and the reality of the disease, the cause, the risk factor, then we begin feeling differently [about] what is happening.” 

Air pollution kills seven million people annually, said Dr Maria Neira, Director of Environment, Climate Change and Health at the World Health Organization (WHO) and moderator of the event. But in addition to data, individual stories are critical in persuading the public and politicians to take action, Achiri pointed out. 

Solutions available, but political will is needed

Some of the key takeaways from the event was that while there are solutions readily available, real change will need to involve local governments and affected communities.

“There is a greater awareness particularly among governments about the connections between climate and air pollution and how it could be managed,” said Nathan Borgford-Parnell, science affairs coordinator at the Climate and Clean Air Coalition Secretariat who rued the lack of a political will. 

“This is the moment, and we need to capture it,” Bogford-Parnell said. “We cannot afford to let this thing go by.” 

‘Urban Better’: a 3 point paradigm for healthier cities

Dr Tollulah Oni, the director of clinical research at the University of Cambridge and the founder of Urban Better, a citizen driven campaign for clean air pointed to a fact that few people know: air pollution now the second largest cause of death in Africa. 

“Only a fraction, sort of 6% of children on the continent, reside within 50 kilometres of an air pollution monitoring station. So how can we change what we are not even measuring? This is what we need to tackle,” she said.

In response, she created the ‘Urban Better’ initiative which aims to act on what Oni describes as the three main leverage points for healthier cities: clean air, healthy spaces and places for physical activity and access to healthy, nutritious foods.

In particular, policymakers need to be thinking about public spaces that enable people to exercise and move about safelyas part of health equity, Oni said.

“We say… okay, how do we think about open infrastructure as critical health infrastructure, and so we work through the air we breathe, our places and spaces, and the food we eat as three critical pathways through which we can create health in the context of climate vulnerability,” Oni said. 

She explains that by addressing air quality, as well as the physical “spaces and places” where people move about,  the rampant rise in non-communicable diseases can be addressed.  

“We know that leisure physical activity has additional benefits, both physical and mental well being. In the same cities, we’re seeing that physical activity is not something that is supported,” she lamented. 

“But what we spend a lot less time on is looking at the built environment that needs to support but it’s currently largely poorly optimized for this. So we really need to start thinking about moving from individual awareness to a supportive environment,” she added.

Citizens for clean air

With respect to clean air, in particular, Urban Better has spun off youth action groups in Cape Town, Lagos and Accra, which have engaged in fact-finding around air pollution in their communities to design solutions they can advocate to local officials. 

The initiative also engages youths by giving them portable air quality devices that they can use to collect air quality data in their neighbourhoods as they run. The participants post the data on an interactive platform. 

Participants then post the data on an interactive platform and use it to generate key messages at the local level and engage with their peers and local leaders to find solutions. 

Professional athletes have been a part of the initiative and one of the youth made it to the climate summit COP27 last year, taking their advocacy to the global stage. 

“They used those data stories to generate key messaging that they then used to then re-mobilize the the peers,” Oni said. “[They were] Pushing towards increasing that demand for clean air and you can see how that connects to both inspire and conspire really trying to build this community.” 

In identifying pollution sources, the groups also take to the streets on bicycles and with wearable pollution monitors to identify pollution hotspots. 

In video clips of their findings, the same sources reappear over and over again, with dirty vehicles topping the charts from Cape Town to Lagos.  Waste burning takes second place, while traditional wood-burning cookstoves and dust from roads,  construction and natural sources, come third. 

‘Majority Demographic’

Oni spoke of the immense readiness among the youth to get involved in solutions, stressing that their potential has not yet been fully harnessed. 

“My experience is that there is just so much hunger and so much drive to be part of the solution,” Oni said. “We do ourselves a disservice when we simply pat ourselves on the back by engaging youth to say, ‘Oh, look how good we are, we engaged.’ 

“They have so much more to contribute,” Oni added. “I say this every time I speak right we’re particularly on the African continent, we really have to front and centre the majority demographic.”

To curb waste-burning, look to women, youth and vulnerable groups

Air quality is an equity issue. Poorer communities, women and those in developing countries are the worst-affected. Solutions too, the speakers agreed, have to engage women, youth and vulnerable communities.

“If you know anything about waste in Africa and a lot of developing regions, you will understand that the informal sector provides waste services and provides almost all waste management on the continent,” said Dr. Andriannah Mbandi, who leads the waste programme at UNFCCC Climate Champions. “That means if you’re looking at waste, curbing waste mismanagement, you need to look at women, youth and vulnerable groups.”

Waste contributes to about 12% of greenhouse gases, 20% of methane, and 11% of black carbon globally. Open waste burning also contributes about 29% of fine particulate matter emitted annually, Mbandi said to point out the link between waste, air pollution and climate change.

Need for flexibility, no magic bullet

Clean air action is climate action. Integrated climate action is key. We cannot address air pollution and climate challenges separately., highlights@SergioSCleanAir of @EnvDefenseFund_ pic.twitter.com/BYBnZhbw1h

— UrbanBetter.science (@UrbanBetter) May 25, 2023

Gillian Holmes, programme director at the Clean Air Fund, asked those attending what they’d recommend funders to consider in awarding grants. 

Oni said flexibility is the key. “We can’t have a very prescriptive and linear approach to building for investing in clean air. So we have to create the space for unintended and unanticipated urges and allow that pivoting to happen.” 

Sergio Sanchez,  senior policy director of the Global Clean Air, Environmental Defense Fund agreed, adding that there is no catch-all solution to the problem of air pollution. 

“One of the lessons is that there’s no silver bullet,” Sanchez said speaking remotely from Mexico. “It’s a long term effort. All institutions need to be aligned across the society.”

The key ingredients are a strong social advocacy and political will, and that funders “be consistent and allocate the resources to cities, to countries to address this issue,” he said. 

Sanchez spoke on the example of Mexico City, where strong public advocacy helped trigger political action on key pollution drivers that has significantly improved air quality over the past decade.   

Children among the most vulnerable groups

While most premature deaths from air pollution occur among older people, children are also among the most vulnerable groups. Many die or suffer through lifelong impacts from polluted air, said Dr Camilla Kingdon, president of the Royal College of Paediatrics and Child Health, in the United Kingdon. 

The impact of air pollution on children has become a major issue in the United Kingdom following the death of 9-year-old Ella Kissi-Debrah from asthma in 2013. Ella later became the first person to have air pollution listed as a cause of death following a protracted legal battle by her mother, Rosamund Adoo-Kissi-Debrah, who has since set up the Ella Roberta Foundation to advance the cause of air quality.

“There’s now plenty of evidence to link air pollution with infertility, miscarriage, prematurity and intrauterine growth restriction,” said Kingdon. “A study published just last month by teams at King’s College and Imperial College London showed that air pollution directly impacts the development of a new-born brain in a negative way.”

Kingdon also spoke of the links between air pollution, poverty and race. 

“If you grow up in poverty, you’re much more likely to be exposed to poor air quality. And in a study last month from Harvard, researchers were able to confirm the link between air pollution causing death, and poverty,” she said.

The study done in the US found that Black Americans are exposed to higher levels of air pollution every year compared to White Americans, and thus likely to be more prone to its health effects. 

Become Air Pollution “Terminators”

Neira, meanwhile, called upon participants in the session to become “air pollution terminators” and play a more active role in pressing policymakers.

“Anything we can do to mitigate the causes of climate change will be generating massive results in terms of public health,” Neira said. “Unless our citizens understand that this is an issue we will not be able to put pressure on our politicians.”

WHO first took up the air pollution issue in 2015, when it passed a landmark resolution “Health and the environment: addressing the health impact of air pollution”.

The resolution identified 13 measures that member states should strive to implement, including more continuous monitoring of air pollution levels; public awareness-raising; stricter air pollution standards; and mitigation measures.  

Since that time, more and more member states are monitoring air quality with some 6000 monitoring sites reported in WHO’s last update.  But significant gaps still exist, particularly in sub-Saharan Africa where few monitoring stations exist.

Despite global efforts to tackle the issue, air pollution deaths overall have not declined significantly. While there are now positive signs of transition to cleaner household fuels in South Asia and Sub Saharan Africa,  ambient (outdoor) air pollution continues to rise in many developing cities, seeing rapid population growth, and along with that, soaring traffic and waste management issues due to uncontrolled sprawl.  

The trajectory is not only deeply worrisome from a health standpoint but also from a climate perspective, insofar as the major sources of air pollution also are climate polluters. 

Traffic, coal, oil and gas power generation, waste burning and fires all emit huge amounts of planet warming CO2 as well as methane, black carbon, and ozone precursors, which are short-lived climate pollutants (SLCPs).  Cleaning up SLCPs would also generate quick wins for climate as their lifespan is measured in weeks to decades, as compared to centuries for CO2, pointed out Borgford-Parnell.  

“Here [at WHA] we are talking about addressing the causes of those diseases and air pollution is one of the big causes of the problem,” Neira concluded. “The multi-sectoral approach is needed.”

Health Policy Watch was a co-sponsor of this event along with the Clean Air Fund and the Climate and Clean Air Coalition. 

Image Credits: Clean Air Fund , US Mission Geneva .