September 7, 2020

UHC is: Clean Air For All

The First Ever International Day of Clean Air for Blue Skies Underscores the Environmental Link to Human Health

UHC Benefits from Clean Air

For the inaugural International Day of Clean Air for Blue Skies on September 7, 2020, HGHI and the One by One: Target 2030 campaign is highlighting clean air as a necessity to achieving Universal Health Coverage (UHC). Contributing to over 7 million premature deaths every year, the burden of air pollution on healthcare systems threatens any achievement towards effective UHC. While air pollution is the largest environmental risk to public health globally, it is a solvable problem. Many affluent countries have greatly improved their air quality in recent decades. However, air pollution continues to inequitably affect populations in low-and middle-income countries, and in particular, women and children. Across the African continent, the economic costs of premature deaths from outdoor and indoor air pollution are estimated to be almost USD$450 billion annually or equal to the entire GDP of Nigeria. With air pollution’s relationship to climate change and crop yields, as well as its implications in the current COVID-19 pandemic, ensuring clean air will not only save lives but support cleaner environments, alleviate poverty and increase shared prosperity. For these reasons, UHC advocates must integrate reduction of air pollution into Universal Health Coverage initiatives, and national and sub-national plans for UHC must work in collaboration with efforts to promote clean air and energy.

Impacts on Health Outcomes and Access

Air pollution causes both acute and chronic diseases and is one of the leading contributors of preventable death in Africa, including 400,000 annual infant deaths. These deaths are mainly due to non-communicable diseases such as stroke, chronic obstructive pulmonary disease (COPD), adverse pregnancy outcomes, and lung cancer, which often require visits with specialized medical personnel, expensive drugs and treatments like chemotherapy and reliable access to a healthcare facility. These medical costs cause a formidable strain on families and health systems. By improving long-term health outcomes and reducing healthcare costs, ensuring clean air can help save lives and support a higher quality of life

Impacts on Health Systems

Air pollution is inextricably tied to energy. Barriers to access clean energy, as an alternative to fossil fuels, not only increase pollution but also make communities and health facilities more vulnerable to power outages and costs. Energy sources such as kerosene for lamps, diesel generators for energy and open fires for cooking all require the burning of fossil fuels like coal, crude oil and natural gas. Each of these fuels emits harmful pollutants and toxic chemicals, emissions that would be eliminated with the adoption of solar or wind energy. The lack of these sustainable or “clean” energy sources also contributes to a lack of quality care within health facilities. In sub-Saharan Africa, only 28% of healthcare facilities have access to reliable electricity. Lack of energy access can mean vaccine spoilage, interrupted surgeries, equipment failure, lack of access to electrically-pumped water, and unsafe birth practices, all barriers to care for patients suffering from air pollution-related illnesses. Renewable energy can provide health facilities an


efficient, low-cost, and reliable source of energy, while cutting down on harmful emissions that contribute to air pollution and climate change. Having reliable energy can also help expand and improve health care access and delivery in remote rural areas where electricity is lacking. Small photovoltaic (PV) solar power systems are already widely in use across Africa, and help health workers provide care and diagnoses, charge cell phones for communication, and safeguard vaccines and other medications in portable cooler units. Therefore, efforts to achieve sustainable energy for all is integral for reducing pollution, and is a critical investment for sustainable UHC. 

Impacts on Social Equity​

Air pollution is foremost an equity issue. Due to traditional gender roles that relegate activities such as cooking and raising children to women, women spend more time indoors, they are more likely than men to suffer from air pollution-induced diseases. Of the 7 million annual deaths due to air pollution, more than half are of women and children. In 2015, 920,000 children died of pneumonia; over 50% of these deaths occured in African countries. Air pollution is associated with roughly half of these childhood deaths from pneumonia. For women in low-and-middle-income countries, household air pollution is the single leading environmental health risk and is the main cause of non-communicable diseases like strokes, COPD, lung cancer and heart disease. In Africa, only 17% of the population has clean cooking access, meaning the majority of the population still cooks with biomass or open fires and is thus exposed to indoor air pollution. Poverty is also strongly correlated with disproportionate exposure to air pollution because of low-income populations’ reliance on unclean energy sources. The health burden associated with the use of such energy sources is further compounded by the lack of information and access to health resources. The burden from air pollution can keep populations in unending cycles of poverty.


Next Steps

To achieve sustainable and effective Universal Health Coverage in Africa, clean air is essential to protecting human health. Reducing air pollution is not only fundamental to our quality of life, but to breathe clean air is a human right. Air pollution is a solvable problem and there are many steps that governments, communities and health systems can take to improve the quality of air. For the first-ever International Day of Clean Air for Blue Skies, those who advocate Health for All should support clean air initiatives and improve sustainable energy access as a key component to all Universal Health Coverage plans. To learn more about how clean air can be integrated as a priority in universal health coverage plans, visit: