CARTAGENA, Colombia – From toxic methane flares in the Amazon rainforest to the death of a nine-year-old girl from London smog, the second WHO Conference on Air Pollution and Health opened Tuesday  with a series of emotional testimonials on the deadly effects of smog. 

Behind the human stories, however, stands  a mounting array of evidence about the adverse effects of air pollution on everything from newborn health to brain health and ageing that the three-day conference will explore.  

The conference is the first on the topic to be convened by WHO since 2018. It takes place at a time when the evidence about the adverse effects of air pollution on everything from newborn health to brain health and ageing continues to snowball. 

The conference sessions and side events, ranging from the emotional and artistic to the drily scientific, are covering a widening range of air pollution topics that has grown even broader since the last conference was convened. 

Some sessions cover relatively new topics for the health sector such as the  impacts of air pollution on agriculture, new knowledge on wildfires and dust storms, and opportunities for the health sector to reduce its own emissions through shifting to renewable energy and climate resilient health facility design.

Goal to halve deaths attainable with right investments

Meanwhile, a new World Bank report estimates that some two million deaths annually from outdoor air pollution can be avoided if the number of people exposed to deadly PM2.5 pollution particles above 25 micrograms per cubic meter was halved by 2040.

But investments in clean air strategies would need to increase from $8.5 billion to nearly $14 billion annually to meet that 2040 goal, said World Bank analyst Sandeep Kohli. 

At the same time, with the costs of air pollution amounting to over $8 trillion annually, or some 10% of global GDP today, the economic gains would be immediate and significant. 

In the most optimized strategy of integrated action in the energy, transport, waste and industry, reducing air pollution emissions would yield between $1.9 and $2.4 trillion over the coming 15 years  (in 2021 dollar terms) and reduce deaths from outdoor air pollution alone by about two million annually – from about 6.2 million to 4.2 million deaths annually, according to the new World Bank Report, Accelerating Access to Clean Air for a Livable Planet.

Integrated strategies will slow warming trends

 Well-planned, integrated strategies would also reduce emissions of major climate “super pollutants” that have an outsized impact on global warming but also much shorter lifespans than CO2, putting the brakes on climate change if they are reduced.   

“Reducing the number of people exposed to PM 2.5 concentrations above 25 micrograms ..globally, by 2040 by half, is both feasible and can be affordable,” said Helena Naber, Senior World Bank Environmental Economist. 

 “An integrated approach, combining conventional air quality management measures, clean energy and climate policies that are designed to achieve other goals, such as energy independence reducing greenhouse gas emissions, could achieve substantial progress ….by 2040 reducing mortality that is associated with air pollution compared to current policies.”

The benefits are not only theoretical, stated Hongbing Shen, vice-minister of China’s National Health Commission, who made the long journey to the Cartagena conference site to relate the story of China’s “Asian miracle” in battling extreme levels of air pollution. 

You can have simultaneous achievements of improving air quality AND steady economic growth! The China country experience at the @WHO’s Conference on air pollution and health. #CleanAir4Health2025 pic.twitter.com/UKbLtDjs1q

— Dr Maria Neira (@DrMariaNeira) March 25, 2025

WHO Director-General sitting out the event 

In contrast with the high-level Chinese presence here, not a single United States government delegate was in attendance.  And against the new narrative of climate denial being advanced by the new administration of President Donald Trump, even the most compelling environmental health and economic arguments still risk being pushed aside.

Inside WHO, which is battling for survival in the wake of the US withdrawal and a deepening budget crisis, climate and environment risk being marginalized even more as there are soaring demands for the body to respond to health emergencies from a growing array of disease outbreak threats and regional conflicts. 

A telling sign is that WHO Director General Dr Tedros Adhanom Ghebreyesus will not be visiting for the high-level portion of the meeting Thursday where countries will make national commitments to reduce air pollution in line with the stated conference goal of reducing deaths from air pollution by one-half by 2040. 

Latin America venue has plusses and minuses

Another challenge is travel difficulties for African and Asian officials to the event – people from the very regions that are the world’s biggest pollution hotspots today. Due to the limited travel routes, some Asian and African participants spent 30 to 48 hours in transit.  

But the conference comes at an opportune moment for Latin America, which has relatively better developed air pollution monitoring systems, and where cities like Bogota and Barranquilla in Colombia, as well as Curitiba in Brazil, have been long-time pioneers in Bus Rapid Transit and bicycle lanes. 

About a dozen ministers of health, mostly from the continent, are expected to participate in the day of high-level commitments Thursday, where countries will outline their national objectives for reaching the 50% air pollution mortality reduction goal.  

Amazon region is becoming a risk for health  

Against the political inertia, speakers in the keynote sessions – including bereaved mothers, lung specialists, youth leaders and activists – pleaded for politicians to wake up to the reality of what air pollution is doing to health, environment and communities. 

Brazilian activist Fany Kuiru described how dozens of methane gas flaring sites in areas of oil and gas extraction are killing indigenous community members in Amazonia region.  

A lawsuit against the Government of Ecuador in 2021 failed to lead to real change, as  there has been a 23% increase in emissions in 2023 in comparison to 2021, said the Kuirut, coordinator of the Organization of Indigenous Communities in Amazonia. . 

“Each gas flaring system is a death system for the Amazon and its inhabitants,” she declared. 

Throughout Amazonia the rain forest is taking a big hit from air pollution of multiple forms. 

“Forest fires, contaminants released from illegal mining… All of this evaporates into air, so that the Amazon region, which is supposed to save life, is becoming a risk for health,” said Kuiru.  

‘Every asthma attack was associated with a pollution peak’

“My daughter Ella would be 21 today had she survived, and yet her legal case has only just ended,” said Rosamund Kissi-Debrah, founder of the Ella Roberta Foundation.  She has waged more than a decade long legal battle in the UK to have air pollution recorded as the cause of her daughter’s death in February 2013 at the age of nine. 

Ella was diagnosed with severe asthma at seven after being seen by a doctor for a “persistent cough that just wouldn’t disappear,” Kissi-Debrah told a plenary audience of hundreds on the conference’s opening day. 

“Over the next thirty months, she was hospitalized over a dozen times.  Her siblings had to know what to do in times of emergency,” said Kissi-Debrah.

“She survived five comas and managed to fight back from them… until the final, severe asthma attack on 15 February, at age nine.  The horror of those years is not something I would wish upon any family.”  

While the cause of death was initially recorded as “respiratory failure” an autopsy revealed that her lungs “resembled those of a smoker.”

“It wasn’t until she died and they opened her up did we really see the horrors of what was going on,” he mother said. Belatedly, the family realized that the triggers for Ella’s acute episodes and hospitalizations all were linked to spikes in air pollution along the heavily trafficked London freeway where they lived.  

‘Air pollution is killing us’

“This meeting is about one thing. Air pollution is killing, killing, killing us,” declared Maria Neira, director of WHO’s Department of Climate, Environment and Health and the ‘doyenne’ of the global air pollution and health movement. 

“Have we advanced, yes,” she said. “Have we advanced to the level of commitment required, no.” 

Looking around the huge conference auditorium that looks out onto the Pacific Ocean one the one side  and onto streets choked with diesel traffic on the other, she recalled that Cartagena is the setting for Gabriel Garcia Marquez classic novel, “One Hundred Years of Solitude” that established a new style of “magical reality” in storytelling. 

“This place is a magical one and reality is here as well…We are hoping that in a few years from now, the reality will be changed,” said Neira, adding, “We need to make our lungs healthy again.”

Image Credits: Sophia Samantaroy.