Two years ago the World Health Organisation (WHO) identified air pollution as the world’s worst environmental health risk. It estimated that more than seven million people die prematurely due to air pollution every year. That is a staggering one in every eight deaths globally.
More than half of these deaths are as a result of household air pollution, almost all of which occurs in low- and middle-income countries. Africa has the highest number of these deaths after South East Asia and the Western Pacific. This is driven, in part, by the large percentage of the population using domestic solid fuel. Sub-Saharan African countries are estimated to have among the highest rates of deaths related to indoor air pollution from domestic fuel use.
Yet the WHO has not put in place an air quality programme for its sub-Saharan Africa region, even though these exist for other regions. The programmes include reviewing evidence on the health effects of air pollution, developing methods to quantify health risks and helping countries develop sustainable air quality policies.
It is not clear why there is no WHO air quality programme in sub-Saharan Africa. A possible explanation may be that environmental health risk factors have always been overshadowed by other risk factors like malnutrition, HIV, TB and malaria.
Africa’s acute problem
The 2016 update of the WHO Global Urban Ambient Air Pollution Database notes that people living in cities in low-income countries suffer the most from air pollution.
Onitsha, in Nigeria, has the highest calculated annual mean of PM10. PM10 are very small particles in the air and are so small that they can get into the lungs, potentially causing serious health problems. The country has a PM10 level of 594 micrograms per cubic metre, nearly 30 times higher than the WHO guideline of 20 micrograms per cubic metre. Although the calculation is based on limited data, there is no doubt that Nigeria has a serious problem.
Many areas of South Africa also have high levels of pollution. Particulate matter concentrations have been found to be up to 140% higher in township sites than in industrial sites. The average maximum PM10 value in these township sites on winter evenings is 200 micrograms per cubic metre.
A study conducted in Cape Town found that people faced a much higher risk of dying from heart and lung diseases than those living in developed countries. Outdoor air pollution levels in Cape Town are on average very similar to those of major European cities. The South African population may be more vulnerable due to high poverty and high rates of existing diseases such as HIV, TB, lung and heart disease.
Global action to improve air quality
Soon after the WHO released its report in 2014 the United Nations Environment Programme (UNEP) adopted a resolution to promote air quality. This urged leaders to take action to improve air quality with the support of the United Nations body. It also developed an implementation plan that included activities focused on:
2. on climate, energy and health being formed in South Africa under the umbrella of the Public Health Association of South Africa.
African scientists can also work to develop local regional working groups focused on air quality under initiatives like Future Earth.
Ensuring all players work together towards more visibility, collaboration and support for air quality in Africa is crucial.
Janine Wichmann, Associate Professor, University of Pretoria; Caradee Yael Wright, Specialist Scientist (Public Health), South African Medical Research Council, and Rebecca Garland, Senior Researcher in Climate Studies, Modeling and Environmental Health Research Group, Council for Scientific and Industrial Research