Lisa Sama is a 19-year-old medical student in Cameroon. As far back as she can remember, she has lived with asthma, and in recent years, she has turned her attention to the role that air pollution plays in her health. 

“From the very beginning, my life involved inhalers, medication, hospital visits, and many sleepless nights. One of my earliest memories [is of] having my first serious asthma attack at just five years old… it felt like someone was pressing on my chest…That moment was terrifying, and little did I know, it was only the beginning. In my community, air pollution is part of our daily life,” she said, speaking at a webinar ahead of the Africa Clean Air Forum in Pretoria in July 2026.  

Lisa is not alone, and on a continent where the average age is 19 years, air pollution requires urgent attention and intervention to halt the impacts on developing bodies and minds. 

Significant health impacts across the continent 

In 2023, there were an estimated 1.2 million deaths in  Africa and of these, 371,584 deaths were in children under five years of age, mostly from exposure to smoke from cooking with charcoal or firewood. Nearly 970 million Africans still depend on wood and biomass used for household cooking; in some countries, nine out of 10 people use polluting fuels for cooking. 

In southern Africa, energy generation is a major source of air pollution. Research in South Africa, which is still heavily dependent on coal power, found that people living in municipalities with coal-fired power stations face a 6%  higher risk of air-pollution-related health impacts than those who don’t.

This means an increased risk for heart disease,  an increase in hospital visits due to lung diseases, including tuberculosis and chronic obstructive pulmonary disease, and ultimately, a lower quality of life for residents and higher healthcare system costs for the government.

The continent also receives polluting second-hand diesel vehicles from Europe and Asia. Diesel generators provide backup power in many homes, businesses and hospitals to make up for unreliable grids. This adds to poor air quality, especially in cities.   

Double burden of disease 

Breathing polluted air early in life can have immediate and long-term impacts. In some African countries, nearly one third of lower respiratory infection deaths in children under five years of age are linked to air pollution. 

Where people live, what they do, what fuels they use to cook food, and how they travel are all factors that determine the levels of air pollution an individual is exposed to. 

Air pollution exposure from household use of solid fuels and fossil fuel sources combines with demographic and other shifts affecting the underlying health of the population. This causes uneven impacts across countries in Africa where rates of chronic noncommunicable conditions (such as heart disease and diabetes) are rapidly rising while the relative burdens imposed by communicable diseases such as lower respiratory tract infections, tuberculosis, and malaria remain high. 

Africa has the youngest population of all continents. Millions of babies, children and young people breathing polluted air risk their lives and the continent’s future. 

The cost of inaction

Behind each of these statistics is a lived experience – loss of school days, missing work to take care of a family member, frequent hospital visits, the cost of medication, not being able to play a game of football. These impose substantial social and economic burdens on children, their families, and health systems. 

Across the continent, air pollution causes the loss of billions of dollars lost due to medical expenditures, productivity losses and missed workdays, and premature deaths. 

An estimated 5-10% GDP equivalent is lost due to ambient and household air pollution across African countries – 9.1% in Burkina Faso, 7.8% in Sierra Leone and 5% in South Africa and the Democratic Republic of the Congo. High pollution may also deter businesses, and skilled workers, as has been seen in some South Asian cities.   

Growing awareness 

Encouragingly, awareness is growing along with political willingness to act on air pollution, and governments are taking steps to expand air quality monitoring, set up air quality standards, and raise awareness about the health harms of air pollution. 

This was evident at the Africa Clean Air Forum in July, as well as in political expressions around the recent International Clean Air for Blue Skies days, and in the increased focus on air quality at the continental scale through the African Union (AU) Africa Clean Air Programme. 

During its 2024 AU Presidency, South Africa led the adoption of the first-ever G20 ministerial declaration on air quality, and is now actively working to engage members of the Southern African Development Community (SADC) region to identify opportunities for clean air action. 

Health worker involvement

Doctors, nurses, and community health volunteers see the lived reality of air pollution every day – a child admitted for an asthma attack, an older patient whose Chronic obstructive pulmonary disease (COPD) keeps worsening despite treatment, or a baby born early due to complications. 

Dr Maria Neira, former director of climate and health at the World Health Organization (WHO), has called for health professionals to support calls for investment in clean air for Africa. 

“We have more than enough [evidence] to promote very, very strong interventions, particularly on access to clean fuels at the household level and interventions to reduce air pollution at the outdoor level,” said Neira.

In South Africa, health professionals and civil society worked together in the Highveld Priority Area (HPA), an area with extremely poor air quality due to coal-fired power plants, to secure a landmark court ruling affirming clean air as a constitutional right.

Investing in Africa’s future 

African cities and countries are already offering locally relevant solutions, and the time for bold investments is now. The continent needs investment, not only financial, but also in human capital, infrastructure, and community. 

In the last few years, the infrastructure to measure and monitor air quality has rapidly expanded, but there is a need to also strengthen and enhance health data collection and link up air quality, health, and other sectors, including finance.  

Reducing the health burden of air pollution will mean fewer hospital beds, medications, and staff time- resources that can be invested in expanding care elsewhere. 

A new global analysis has identified Africa as one of the regions with the highest returns on investment in clean air and climate action: every dollar spent on clean air and climate action in Sub-Saharan Africa results in $11 in benefits, while in southern Africa, every dollar invested results in $26 in return. 

We have the data, and the evidence is clear: this is the moment to invest boldly in clean air action and improve the health and well-being of people across Africa. 

Dr Pallavi Pant is Director of Global Initiatives at the Health Effects Institute. 

Xoli Fuyani is the Director of Black Girls Rising. 

Dr Obianuju Ozoh is the current President of the Pan-African Thoracic Society and a Professor at the University of Lagos, Nigeria.

This article reflects discussions at a webinar organized by the Health Effects Institute, in partnership with the Pan-African Thoracic Society, Makerere Lung Institute, Africa Clean Air Network, and the South African Medical Research Council and deliberations at the Africa Clean Air Forum 2026.  

Image Credits: Gulshan Khan / Climate Visuals , Loise Akello, Gulshan Khan / Climate Visuals , Prince Junior Asilevi.