Global | Commitments, call to action, and key takeaways from the WHO Air Pollution Conference

Health Care Without Harm participated in the First WHO Global Conference on Air Pollution and Health in Geneva, Switzerland from October 30 – November 1, 2018. Learn more about our engagement at the conference at

“The health of the nation is in peril and the future of our children is at stake. It is time for resolute action, not just seasonal lament.”

– Dr. K. Srinath Reddy (President of the Public Health Foundation of India, a Health Care Without Harm partner) in a recent op-ed

The Health Care Without Harm team at the conference, L-R: Shweta Narayan, Josh Karliner, Jennifer Wang, Viktor Jósa

The Geneva Action Agenda to reduce air pollution deaths by two-thirds by 2030

Heading into final day of the conference, the sense of urgency for decisive action on air pollution was clear as (a pollution-free) day. Participants recommended an aspirational goal of reducing the number of deaths from air pollution by two-thirds by 2030. “Reaching this goal will save significant global health care costs every year. The wider economic impacts of premature deaths due to ambient air pollution amount to US$ 5.7 trillion in welfare losses, or 4.4 percent of global GDP in 2016,” according to the WHO.

To reach this goal, the WHO identified a set of core elements for a Geneva Action Agenda to Combat Air Pollution. Among them are “to scale up efforts and mobilize action globally… to reaching WHO air quality guideline levels by 2030,” “to burn less in any form” (including cleaner and more efficient energy and transport solutions), “to protect the most vulnerable populations, especially children,” “to increase energy access in health care facilities,” and “to strengthen universal health coverage, health systems and health workforce capacity to engage and implement actions that prevent air pollution-related diseases.”

When polluters pay, people benefit

We steadfastly support the Geneva Action Agenda and the WHO for generating this important outcome at the conclusion of a successful conference. And yet we also want to call out the elephant in the room: the power and influence of polluting industries and the governments beholden to them.

Let’s be clear: air pollution is a negative externality. That is, it kills 7 million people and costs the public trillions each year precisely because those who generate it—primarily the fossil fuel industry—do not pay for the harm it causes.

It’s the reason Health Care Without Harm and other health groups have been comparing air pollution to tobacco for years, an analogy underscored by the WHO Director General in the lead-up to the conference. Given the abundant evidence of widespread harm, the burden of responsibility should not merely rest on the individual—to quit smoking, to ignore advertisements, to buy solar panels, air purifiers, electric vehicles—rather, the polluting corporations must be held accountable and the policies that enable them changed.

In this context, what will make an aspirational goal to drastically cut air pollution into a realistic and achievable goal is something that is only implied in the Geneva Action Agenda: a groundswell of political will to transition away from fossil fuels and to clean, renewable energy.

Fortunately, health benefits are compelling motivators for urgent action, countering both the “What’s in it for me” and the “Isn’t it too expensive” arguments, as climate scientist Drew Shindell from Duke University elegantly demonstrated during the Evidence to Advocacy plenary.

Two of the artistic posters about air pollution and health that Health Care Without Harm introduced at the conference.

Clean air commitments… or lack thereof

Since what we need is “political will” and when we need it is “as soon as possible,” it was heartening to see the 80+ commitments announced by countries, cities, regions, intergovernmental organizations, and nongovernmental organizations during the High Level Action Day that closed out the conference. Notable commitments include both performance-based goals like meeting the WHO air quality guidelines (e.g., Thailand, Monaco, United Arab Emirates) as well as prescriptive goals like ending the sale of new conventional diesel and petrol cars and vans by 2040 (United Kingdom). The Netherlands committed to create a fully circular economy by 2050 and invest EUR 100 million in biking. The World Bank committed to screen all projects for pollution prevention and to promote synergies between development and air pollution mitigation.

Unfortunately, some countries with the most serious air pollution challenges were conspicuously absent at the conference, sent only deputy officials, or declined to announce voluntary commitments. On everyone’s radar was India, for which a deputy secretary at the environment ministry said unofficially that the country will aim to reduce air pollution by 20% to 30% by 2024, as a part of the National Clean Air Programme.

Dr. Arvind Kumar (Lung Care Foundation) gave two plenary talks on the role of doctors in motivating action on clean air.

In contrast, Health Care Without Harm partner Dr. Arvind Kumar (Sir Ganga Ram Hospital and Lung Care Foundation) was unequivocal in his op-ed published in India while he was with us in Geneva. “Every man, woman and child must educate themselves on the perils of air pollution, understand guidelines on what constitutes healthy air, and then demand immediate, unambiguous action plans on slashing air pollution,” he wrote. “If they do not, losing their health to pulmonary and cardiac diseases and cancers brought on by toxic air will be too high a price to be paid.”

The growing health sector movement for clean energy and healthy air

The role of the health sector in motivating action was clearly recognized at the conference, but the question is how. In connection with the Geneva Action Agenda, WHO’s summary report recommends that the global health community assess the health and economic impacts of air pollution and catalyze actions that reduce air pollution in cooperation with other sectors. To this end we want to highlight our own commitments and those of other health organizations announced during the High Level Action Day.

Invited for an encore presentation during the morning plenary, Dr. Kumar underscored Christiana Figueres’ announcement during the Opening Plenary about the launch of Every Breath Matters, a global campaign spearheaded by a group of clean air champions who will be using their voices to raise awareness about the devastating health impacts of air pollution. Dr. Kumar urged the global community to do everything it takes to clean the air we breathe. He countered the typical arguments for inaction (i.e., cost, labor, and inconvenience) with the charge that complacency brings disease, disability, and death. He then shared Lung Care Foundation’s commitment to establish a Doctors for Clean Air advocacy network (to thunderous applause once again).

Jennifer Wang presenting Health Care Without Harm’s clean air commitments during the closing roundtable plenary facilitated by Dr. Maria Neira (WHO Director of Public Health, Environmental and Social Determinants of Health) and Gina McCarthy (Former U.S. EPA Administrator under President Obama and Director of Harvard’s Center for Climate, Health, and the Global Environment).

Health Care Without Harm also announced two interconnected commitments: First, to mobilize hospitals and health professionals as champions for clean air by establishing networks of real-time air quality monitors and air quality and health information hubs at health facilities in at least 15 cities in India by 2019, and in six additional countries by 2020. And second, to build the movement for health care to transition to 100% renewable electricity, with current commitments from 20 health care institutions representing the interests over 1,200 hospitals and health centers in 12 countries.

A selection of other notable health sector commitments:

  • International Federation of Medical Students Associations committed to integrate climate-health in all aspects of medical school life, including research, advocacy, training, and university health care systems by 2025.
  • Health and Environment Alliance committed to monitor and evaluate at least 10 national and/or local air quality action plans in at least 4 countries by the end of 2019.
  • WONCA committed to launching the Air Health Train the Trainer Program, with 40 health professionals recruited and trained by the end of 2019.
  • World Heart Federation committed to advocate for further research on heart health and air quality and climate change.
  • World Medical Association committed to making climate change a priority issue for the WMA and constituent members and create policies and initiatives that mitigate the effects of climate change on health, including those which occur through the effects of air pollution.

Our key takeaway is that leading health institutions, organizations, and practitioners are increasingly and explicitly committed to catalyzing action for clean air. We hope to return to the next WHO Global Conference on Air Pollution and Health with resounding successes to share and commitments to elevate our ambition. In the meantime, we have our work cut out for us.

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