Air Pollution Does More Damage Than Previously Understood, Leading To Chronic Health Impacts

Air pollution is doing more damage than previously understood, causing a range of chronic health impacts that go even beyond the annual 7 million deaths estimated by the WHO, said panelists yesterday at a World Health Assembly (WHA) side event, Every Breath Can Do Damage: The Urgency of Air Pollution Action.

Nina Renshaw, Director of Policy and Advocacy at NCD Alliance, explained that air pollution “is really doing more damage than we may have initially realised,” affecting every organ in the body, and causing more damage than “the most obvious physical impacts,” citing a recent NCD Alliance policy brief.

Air pollution is “the fifth leading risk factor for mortality worldwide,” causing “nearly one in ten deaths,” said Sandra Mullin, Senior Vice President of Policy, Advocacy and Communication at Vital Strategies, which co-organised the event with NCD Alliance.

(Left to right) Nina Renshaw, Director of Policy and Advocacy, NCD Alliance; Daniel Kass, Senior Vice President, Environmental Health, Vital Strategies; Shri Lav Agarwal, Joint Secretary, International Health, Ministry of Health and Family Welfare of India; & Dr Sophie Gumy, Team Lead on Ambient Air Pollution, World Health Organization.

Mullin further explained that the economic costs of air pollution to the global economy are about US$255 billion in lost labor income and over US$5 trillion in welfare losses. “These are obviously enormous costs,” she said.

Some 90 percent of the global population breathes unhealthy air, according to WHO. Addressing this threat in the air we breathe requires more than face masks and good intentions, it calls for concerted investment, strategic policies and systemic change – panelists at the side event emphasized.

To guide policy action on air pollution, the World Health Organization is now in the process of updating its air quality guidelines through a “long and rigorous process started in 2016,” with the new guidelines expected to be published in 2020, said Dr Sophie Gumy, Team Lead on Ambient Air Pollution at the WHO, and moderator of the event.

Gumy also noted that this week, WHO will launch its new Global Health and Energy Platform of Action, co-led with United Nations Development Programme (UNDP), with the aim of accelerating the transition to clean energy to improve health and livelihoods.

The new platform will “strengthen the political and technical cooperation between the health and energy sector through a multi-stakeholder platform that will gather government, civil society, UN agencies, and the private sector,” she said.

Air pollution is also central to a new WHO global strategy on “Health, environment and climate change,” A72/15, which will be discussed in a formal WHA session tomorrow. The strategy, which is up for approval this week by the WHA, notes that “failure to tackle air pollution and to mitigate climate change together result in a lost opportunity to gain the health, economic and environmental multiple benefits.”

A webcast from the side event can be viewed here.

Reducing Air Pollution Requires Systemic Change

Panelists explained that reducing the negative health impacts of air pollution will require systemic change, driven by cooperation across sectors. While such systemic change will require long-term efforts, panelists underlined that there are readily available, tried and tested, cost-effective solutions, or ‘best buys,’ that can be implemented in the short-term.

If implemented, even without other policy measures, these ‘best buys’ will save 9 million lives by 2025, Renshaw of NCD Alliance, said.

Drawing from the experience and success of tobacco control, these ‘best buys’ include fiscal measures that can expand the fiscal space of countries to be able to invest more in universal health coverage. Such fiscal measures primarily consist of taxing polluters, including the obvious sources – transport and energy – but also agriculture, waste, shipping, aviation, as well as new polluters emerging from the shift to the digital economy. She noted that these fiscal measures could also include stripping back fossil fuel subsidies.

“We need to tax the things that are damaging our health in order to make more space for things that can help our health,” she said.

“The air pollution problem is driven [not by the health sector, but] by the other sectors, and the policies of the other sectors,” Saleban Omar, Senior Regional Programme Advisor at UNDP, said, adding that there is need for multilateral action and cross-sectoral collaboration if the health sector will effectively address air pollution and NCDs.

One major argument for investing in reducing air pollution, he noted, is an economic one. He said that UNDP is currently “developing a methodology to account for the environmental determinants of NCDs,” that will “look into the direct and indirect costs of the productivity loss and the return on investment for the priority interventions.”

Changing systems, however, is not just about policies, but perceptions, noted Daniel Kass, Senior Vice President of Environmental Health at Vital Strategies, which recently released a report on public perceptions about air pollution.

“Public and journalist discourse about air pollution overwhelmingly discusses obvious, but not the most important sources of emissions for air pollution,” he said. “They focus on acute rather than chronic health effects, they rarely discuss solutions, and they obsess about daily variation rather than continuous exposures.”

Even the current health-based messaging around air pollution “only encourages this by focusing on air quality and disease rather than chronic health impacts. We have to reorient this discussion, or there will be little demand for truly health preventive policies,” he said.

Image Credits: Vital Strategies.