Dr Soumya Swaminathan is returning to the international stage after leaving the World Health Organization (WHO) in late 2022, just as the world was recovering from the COVID-19 pandemic.

She became the agency’s first Chief Scientist just before the pandemic, a position that propelled her to become a widely-known global voice for WHO, analyzing and communicating the latest information on the pandemic.

Now, the 64-year-old is co-chairperson of Our Common Air (OCA), a new global commission that has been launched by Clean Air Fund (CAF) in London, and the Council on Energy, Environment and Water (CEEW) in New Delhi. The other co-chair is Helen Clark, former Prime Minister of New Zealand.

“We bring complementary strengths,” Dr Swaminathan told Health Policy Watch, referring to Clark’s international political connections and her own scientific credibility. She was speaking just ahead of a closed-door meeting in Bellagio, Italy, with leaders of the new initiative, OCA, which aims to raise the political and financial investment in air pollution.

The OCA aims to drive more funding from governments, developmental, and the private sectors to cut down air pollution globally. Air pollution causes 8.3 million deaths a year –  almost 16 deaths a minute – whereas it received only 1% of international development funding, a study by CAF shows.

“We want to raise that profile of air quality as an important determinant of health, as well as bring attention to the actions that individuals, as well as companies, communities, cities, and governments, need to take urgently in order to address this big huge global problem,” said Swaminathan.

Air pollution has short-term and long-term impacts on health, many studies have shown. These range from heart attacks, diabetes, and strokes, and in pregnancy it increases the risk of low birth weight, stillbirth, and miscarriage due to long-term exposure.

Short-term exposure over a few hours or days to high pollution can affect lung function, worsen asthma, and increase hospital admissions related to respiratory and cardiovascular conditions.

A study backed by CAF and the Confederation of Indian Industries (CII) showed pollution is estimated to have cost India $95 billion or about 3% of its GDP. This includes loss of the workforce to deaths, loss of productivity by employees not fully functioning at work because of the effects of pollution, lower attendance at markets on high pollution days, and the stunting of crops among other things.

“What business leaders have to understand is that some of the impacts of climate change – air pollution, heat, food, and nutrition and security – is really going to impact their productivity,” Swaminathan told Health Policy Watch.

Air pollution’s cost-to-company

Despite all the science and data, there is little funding for air pollution control measures. Philanthropic funding between 2015 and 2022 was $330 million. The biggest chunk, about 35%, of philanthropic pie, went to North America, while Europe and India got 15% each and China 15%. Just 2% went to Latin America and 1% to Africa.

Swaminathan admits that OCA has an uphill task. Their targets are not just governments and donor organizations but also businesses.

“There’s enough evidence out there. What will it take, ultimately, to convince I don’t know. When you’re talking about globalization, and companies having employees all over the world, employees will be very much more reluctant to relocate to places where the air quality is poor, they may ask for extra compensation and things like that.

“I’ve seen this happening with some diplomats, for example. They don’t want postings in places with poor air quality. It’s not just a reputational issue, but it becomes a real issue when it comes to getting the work done.”

Pollution is a double whammy for developing countries

Swaminathan describes air pollution as a “double whammy” for developing countries: “It is one of the most important risk factors for non-communicable diseases, which, of course, are on the rise worldwide, as well as in India, and the developing world. So it’s a double whammy because the burden is increasing because of the risk factors. And because care, diagnosis, and treatment are not accessible to everyone, then we’ll also have a higher mortality.”

One of the first major successes she recalls soon after she joined WHO was over air pollution. As Deputy Director General of Programmes, she had a “huge scope.”

This enabled her “to address some very obvious disconnects, which I found, which perhaps had not been addressed in the past because of the siloed nature of WHO.” Air pollution and non-communicable diseases (NCDs) were handled by different teams despite the pollution being a critical risk factor for NCDs like heart disease, strokes, and chronic lung disease.

“By bringing (the two teams) together, we were able to say air pollution is the fifth major risk factor for non-communicable diseases and it goes into the documents. And it then went to the high-level political event in New York in 2018, as one consolidated set of recommendations rather than separately.”

A core focus area for Swaminathan has been tuberculosis. When she was appointed Chief Scientist, it allowed her to make an impact on guidelines. “I was able to put in place improved and more forward-looking and futuristic ways of doing our norms and standards, moving away from individual opinion base to a much more systematic way of synthesizing evidence, including the use of artificial intelligence.”

‘Politically driven’ attacks

Swaminathan is frank about her WHO tenure during COVID-19 when she was targeted by, among others, the US Food and Drug Administration (FDA) during the Trump administration, and the Indian Bar Association. In both cases, she and the WHO were proven right, she points out.

The WHO and Swaminathan were critical of the US FDA’s decision to give emergency approval to Remdesivir as a COVID treatment based on limited evidence, whereas the WHO’s Solidarity Trial found no measurable benefits for the drug’s use.

She dismisses the second attack – over her comments against the use of Ivermectin as a treatment for COVID – as one by a “fringe group” and points out that the WHO was proven right by numerous studies.

“There were extreme views on things during the pandemic, a lot of it was politically driven. But there were also people out there who just wanted to create trouble and wanted to spread misinformation and had some very strange beliefs about things like vaccines and drugs,” Swaminathan said.

“That was very surprising for me – to face that kind of criticism and opposition, but it was also difficult to handle because of the visibility that I had, and the social media presence that I had, and it’s very easy to harass you on social media.”

‘Learned to live with criticism, harassment’

“I would not say that I would do anything differently based on that experience because I think, difficult as it was, it was something that I learned to live with. I would say, it did not impact my work and didn’t impact the work of the organization. And in the end, I think we got credit for having stuck to the science.”

Swaminathan says she had the backing of WHO Director General Dr Tedros Adhanom Ghebreyesus, who told her he would back her if she could defend what she said: “To that extent, I had full freedom.”

“It was DG Tedros who was actually facing the most attacks, including from the President of the United States and from various other quarters. So compared to that, I think the attacks on me were minor. But I did have his backing and the backing of the WHO because, before we said anything, we would discuss it internally.”

When she’s away from the international stage, Swaminathan is busy running the MS Swaminathan Research Foundation back home in Chennai. It was set up by her legendary father, Professor MS Swaminathan, in the late 1980s. He and his foundation have made a huge contribution to food security in India through research on plant genetics, agricultural research and development, and the conservation and enhancement of natural resources.

Her new challenge perhaps presents an opportunity to create a similar legacy.

Image Credits: BreatheLife/WHO.