I dare not laugh, for fear of opening my lips and receiving the bad air.

This metaphor, from Shakespeare's Julius Caesar, eerily resonates in the context of the air pollution crisis we currently face. As the air we breathe becomes increasingly polluted, this cautionary expression reflects the silent struggle humanity collectively faces against an unseen adversary.

That the statistics say

The World Health Organization (WHO) calls air pollution "one of the greatest environmental risks to human health". The following data from WHO is alarming:

Ninety-nine percent of the world's population live in places where the WHO air quality guidelines levels are not met.

Approximately 7 million people die each year due to fine particle exposure, which infiltrates the lungs and cardiovascular system, leading to conditions such as stroke, lung cancer, chronic obstructive pulmonary diseases, and respiratory infections, including pneumonia. This annual death toll surpasses the total number of COVID-related deaths over the past three years.

Outdoor air pollution is estimated to be responsible for 4.2 million premature deaths globally, while household air pollution from using polluting fuels and technologies results in an estimated 3.8 million deaths.

Over 3 billion people, representing more than 40 percent of the world's population, still lack access to clean cooking fuels and technologies at home, the primary source of household air pollution. Air pollution is a crucial risk factor for noncommunicable diseases (NCDs), contributing to an estimated one-quarter (24 percent) of all adult deaths from heart disease, 25 percent from stroke, 43 percent from chronic obstructive pulmonary disease, and 29 percent from lung cancer.

Trash burning. Photo: Jitendra Raj Bajracharya.
Trash burning. Photo: Jitendra Raj Bajracharya.

The WHO also reports that ~90% of air pollution-related deaths occur in low- and middle-income countries, of which approximately two out of three take place in the Southeast Asia and Western Pacific regions. The disparity exists because of the difference in government actions and financial resources available. Poorer countries usually have less strict regulations regarding air pollutant emissions. The presence of coal power plants is common due to industrialization and ever-growing electrical energy need across different sectors. Developing countries are disproportionately affected by indoor air pollution.

Out of the 7 million deaths due to fine particle exposure, 3.8 million are attributable to indoor air pollution, mainly in low- to middle-income countries. This is caused by inefficient ways of cooking, heating, and lighting, using substances like kerosene and solid fuels such as wood, crop leftovers, charcoal, coal, and dung. These practices release harmful air pollutants which have serious health effects.

Air pollution costs are startling and on the rise

The human and economic costs of air pollution are equally startling. Greenpeace Southeast Asia and the Centre for Research on Energy and Clean Air recently published a report on the economic costs of air pollution from fossil fuels. Among other things, the report notes that the combustion of gas, coal, and oil leads to three times as many fatalities as global road traffic accidents. The economic ramifications of air pollution are staggering, with an estimated cost of USD 2.9 trillion, equivalent to 3.3 percent of the world's GDP.

In 2018, chronic diseases resulted in a USD 200 billion economic burden globally, while sick leave and preterm births incurred costs of USD 100 billion and USD 90 billion, respectively. China bears an annual air pollution cost of approximately USD 900 billion, the USA faces USD 600 billion, and India contends with USD 150 billion. In 2018, the economic impact of poor air quality accounted for 6.6 percent of China's GDP, 5.4 percent of India's GDP, and 3 percent of the USA's GDP.

Photo: Jitendra Raj Bajracharya/ICIMOD.
Photo: Jitendra Raj Bajracharya/ICIMOD.

Particulate matter (PM) air pollution is acknowledged as a lethal air pollution worldwide. Its impact on life expectancy is more severe than the impacts of infectious diseases like HIV/AIDS, harmful behaviors such as tobacco and alcohol use, and conditions like child and maternal malnutrition, mental disorders, and others.

The University of Chicago's Air Quality Life Index (AQLI) 2023 reveals that if the world were to consistently reduce fine particulate pollution (PM2.5) to meet WHO standards, globally the average person's life expectancy would increase by 2.3 years, resulting in a combined increase of 17.8 billion life-years.

The impacts are disproportionate, but change is possible

Similar to other public health challenges, the impact of air pollution is not distributed evenly worldwide. Developing and industrializing nations in Asia bear the greatest impact from particulate pollution. Nowhere else on Earth is the detrimental effect of pollution more apparent than in South Asia, which houses the world's four most polluted countries as well as nearly a quarter of the world's population. AQLI data for Bangladesh, India, Nepal, and Pakistan show that residents could lose an average of about 5 years off their lives if the current elevated pollution levels continue.

Globally, in various historical periods, countries have faced significant air pollution as they have undergone rapid industrialization. These nations largely succeeded in addressing their pollution issues due to a demand for change from their citizens and the implementation of robust policies.

The challenges Beijing and Delhi currently face as they try to balance economic growth with environmental quality mirror the struggles once experienced by cities like London, Los Angeles, or Osaka. The transformation of former pollution capitals into rich, lively, and considerably cleaner cities stands as proof that today's pollution doesn't have to determine tomorrow's fate. However, the improvement in air quality in these regions was not accidental; it resulted from strong policies and their implementation.

In the United States, legislative initiatives like the Clean Air Act have contributed to a 64.9 percent reduction in pollution since 1970, extending the average lifespan by 1.4 years. Similarly, in England, pollution has decreased following the enactment of the Clean Air Act of 1956. Japan witnessed a decline in air pollution levels comparable to Europe's standards due to a series of lawsuits and environmental protection laws starting in the 1960s. China's National Air Quality Action Plan in 2013 successfully cut particulate pollution by 39.5 precent. Mexico City, once humorously dubbed "Makesicko City," has reduced its pollution by 57.8 percent through the implementation of ProAir policies in 1990, leading to residents living 2.9 years longer.

Why the 1.5 threshold and the Paris Agreement matter

The Paris Agreement is a legally binding international treaty on climate change, adopted by 196 Parties at the UN Climate Change Conference (COP21) in Paris in 2015. This agreement aimed to limit the global average temperature increase to well below 2°C above pre-industrial levels. However, the UN's Intergovernmental Panel on Climate Change has recently warned that surpassing the 1.5°C threshold could trigger more severe climate change impacts.

To assess progress, countries participating in the COP have been submitting their national climate action plans, known as nationally determined contributions (NDCs), since 2020. Each successive NDC is expected to demonstrate a higher level of ambition compared to the previous version.

The NDC Synthesis Report from last year confirmed that the world is significantly off course in stabilizing the global temperature rise at 1.5 degrees. The report indicated that the NDCs of all 192 Parties together would result in a substantial increase in global greenhouse emissions by about 16 percent in 2030 compared to 2010. The latest findings from the Intergovernmental Panel on Climate Change suggest that if not swiftly addressed, this increase could lead to a temperature rise of about 2.7°C by the end of the century.

What to expect at COP 28

In COP 28 this year, the global stock take will be discussed for the first time. The global stock take will reveal the collective progress of countries and stakeholders in achieving the goals of the Paris Climate Change Agreement, highlighting areas of success and areas that require more attention.

The UN Environment program says that air pollution and climate changes are the two sides of the same coin. For example, particulate matter from diesel engines, a form of air pollution, circulates globally and reaches remote areas, including polar regions and mountains. When it settles on ice and snow, it darkens them slightly, reducing the reflection of sunlight into space and contributing to global warming.

"Air pollution threatens us all, but the poorest and most marginalized people bear the brunt of the burden," says Dr Tedros Adhanom Ghebreyesus, Director-General of the WHO. "It is unacceptable that over 3 billion people – most of them women and children – are still breathing deadly smoke every day from using polluting stoves and fuels in their homes. If we don't take urgent action on air pollution, we will never come close to achieving sustainable development."

With COP 28 starting on 30th November in Dubai, ensuring this to be a transformative event that "supercharges solutions" as pledged by the organizers requires delivering specific steps to reduce air pollution. There's no time for further delay.

The world eagerly awaits for this COP to come up with a firm and resolute action plan for addressing the critical issue of air pollution. Otherwise, it will simply become a massive climate festival: more than 70,000 people – taking part in a flashy climate change expo.

Ghimire is a student at KISC Lalitpur.