Air pollution is often referred to as Africa’s “silent killer”; it kills more people on the continent each year than HIV/AIDS, TB and malaria combined
The global health and economic burden of air pollution is increasing year on year. From 2015 to 2021, international development funders committed $46.6 billion to prolonging fossil fuel extraction and production, while allocating a mere $1.5 billion to reducing air pollution. That’s a whopping 3 000% difference in investment. Meanwhile, the World Bank estimates that $8 trillion is spent annually on addressing the health effects of air pollution, and this figure is expected to rise. These conflicting numbers reveal a fundamental misalignment where governments and development financiers recognise the costs of air pollution but remain undeterred by its underlying causes.
Earlier this year, the World Health Assembly adopted a new target to halve global deaths from air pollution by 2040. While this signals a growing recognition of air pollution as a major public health crisis, it’s important to remember that every one of these deaths is preventable if pollution is tackled at its source. Now, as South Africa hosts the G20 presidency for the first time on African soil, it is a critical moment for the world’s largest economies to turn promise into action and align global financial flows with global health and climate goals on reducing air pollution.
Air pollution is often referred to as Africa’s “silent killer”; it kills more people on the continent each year than HIV/AIDS, TB and malaria combined. In 2019 alone, air pollution caused people in Africa to lose 2.3 million years they could have lived in good health and without disability. Diseases like silicosis and other chronic conditions are emblematic of the health crisis facing frontline communities living around highly polluting extractive industries. Exposure to air pollution has been linked to increased hospital admissions for non-communicable diseases (NCDs), particularly various respiratory diseases, such as asthma, pneumonia, bronchitis, progressive lung disease and deadly cardiovascular events including, heart attacks, strokes and heart failure. The effects of air pollution are also concerning for maternal and neonatal health. A global analysis estimates that air pollution contributes to roughly three million underweight babies each year, especially across regions like sub-Saharan Africa and South-East Asia.
Because air pollution threatens public health on a massive scale, the healthcare sector, including government health departments and medical institutions, has a critical role to play in addressing the climate crisis leading by example in mitigating carbon emissions, building resilience and adapting to the climate crisis. The global healthcare supply chain is both highly susceptible to climate disruption and responsible for 5% of all global greenhouse gas emissions. Because this sector has a healing mission, it has a moral responsibility to forge our response to the climate crisis. It should use its purchasing power (estimated at about 10% of the global GDP) in driving market transformation and help lead a low-carbon transition to clean energy and a circular economy. Health professionals are often among the most trusted voices in society. They can inform policymakers and help the public to understand that the climate crisis is a health crisis.
To protect public health, healthcare systems must not only reduce their own emissions but also lead on integrated health monitoring that links air quality data with health outcomes and develop early warning systems for at-risk populations. Ensuring healthcare services remain operational during extreme weather events, which are increasing due to climate change, is essential, and investing in climate-resilient and low-carbon health systems is a global priority. Supporting frontline communities, particularly those affected by pollution or climate disasters, is also central to healthcare’s adaptation role.
Addressing air pollution offers significant benefits beyond just healthy air: it supports healthier communities, reduces health costs, lowers greenhouse gas emissions, and improves societal resilience. These co-benefits demonstrate that investing in climate-smart health systems is not only essential for human health but also a cost-effective investment for both human and environmental well-being, and contributes to broader climate action.
Rico Euripidou is a campaigner at groundWork, Friends of the Earth South Africa.
Mafoko Phomane is the environmental health campaigner at groundWork, Friends of the Earth South Africa.
Neo Tsotetsi is the climate engagement coordinator at Doctors Without Borders (MSF) Southern Africa.
Dr James Irlam is a senior lecturer in the Department of Family, Community and Emergency Care and in the Division of Environmental Health at the University of Cape Town, Faculty of Health Sciences.Members of the Africa Civil Society Organisations G20 Climate, Energy & Sustainable Finance Network.