Air pollution is a major global health threat — why don’t we treat it like one?

This year, more people will die from exposure to poor air quality caused by fossil fuel combustion than have died from COVID-19 during the entire pandemic — by more than a factor of two. These deaths are not distributed equally and often occur in the planet’s most vulnerable populations. The World Health Organization estimates that more than 90 percent of deaths inflicted by air pollution occur in low- and middle-income countries.

Yet, you would never know how large of a global health issue air pollution is by looking at the current international development funding landscape. According to a report released last month by the Clean Air Fund, less than 1 percent of official development funding worldwide is spent on improving air quality. The U.S. government devotes 0.4 percent of its international development funding toward air pollution.

I know firsthand this disconnect between the size of the global air pollution problem and the tiny bit of funding dedicated to it. I worked at the U.S. Agency for International Development (USAID) as their first senior air quality adviser up until resigning in September.

While at USAID, I met numerous employees at missions located both in countries facing severe air pollution and serving in Washington, D.C., who were passionate about working on air pollution initiatives in order to meet the obvious need for cleaner air in the countries in which they worked. These staff seek ways to incorporate air pollution solutions into their programs as best they can, but they are tightly constrained by highly specific congressional directives that control how they may spend their budgets and these structures do not let them directly build programs for clean air. In fact, one of the objectives of my job was to help these staff figure out how they could manage to include bits and pieces of air pollution work within existing non-air pollution programs. 

Even for global health priority areas seemingly well-aligned for supporting projects that tackle air pollution, like maternal and child health, the underlying congressional directives that control USAID’s budget are not flexible enough to implement air pollution programs that address the quarter of all newborn deaths attributable to air pollution exposure.

While the Biden administration’s push for the U.S. to reemerge on the world stage of climate change has resulted in U.S. commitments to reduce short-lived climate pollutants globally, these commitments were not made with a primary focus on public health.

Finding ways to slip in air pollution work here and there and treating it like a secondary objective are nowhere near the levels of action that will make a dent in the largest — yet entirely solvable — environmental public health threat on the planet.

In order for U.S. international development work to address air pollution, we need individuals in Congress to become global clean air champions and to push for funding to specifically support tackling air pollution’s impact on public health. In 2021, congress supported $1.56 billion for a global fund to fight AIDS, Tuberculosis and Malaria, diseases that kill fewer people per year than air pollution — combined. About 500 times less was spent across the U.S. government on all air pollution-specific international development initiatives from 2018 to 2019.

U.S. international development’s most senior leadership also needs to champion — and at the very least know about — the need for clean air. In my last few weeks at USAID, I had trouble getting a report that called out the gap between the global burden of disease air pollution imposes on public health and the lack of funding from donor organizations on USAID Administrator Samantha Power’s desk. The reason? Her staff was seemingly concerned that the report would read as an indictment of USAID’s lack of focus on the issue. But this is precisely why Power — and all international development leaders — need to see such reports.

Private foundations working on public health could play a much more powerful role in changing the scant landscape for air quality funding, too. Currently, just 0.1 percent of philanthropic foundation funding goes toward clean air.

The international development community is doing far too little about the largest environmental threat to public health on the planet. Shying away from this discrepancy will not make our air more breathable, and people will continue to die. So who, amongst the planet’s most powerful and influential global health leaders, will tackle this problem head on and become a champion for clean air?

Christa Hasenkopf is the former senior air quality and energy adviser at the United States Agency for International Development.