Nearly nine in 10 people who die prematurely from outdoor air pollution are in low- and middle-income countries, where poorer communities often face the highest exposure while having the fewest resources to protect themselves, the United Nations has warned.
The UN said air pollution is deepening existing inequalities, with about 99 per cent of the world’s population living in areas where air quality falls below World Health Organization guideline levels. Outdoor air pollution alone caused an estimated 4.2 million premature deaths globally in 2019, with about 89 per cent of those deaths occurring in low- and middle-income countries.
The warning comes as countries work towards the 17 Sustainable Development Goals, with the UN linking cleaner air to efforts to improve health, reduce poverty, strengthen food security, expand access to clean energy and tackle climate change by 2030.
“Nearly 9 in 10 premature deaths from air pollution happen in low- & middle-income countries, where the most vulnerable are least protected, further worsening global inequalities. In the fight for clean air, no one should be left behind.”
WHO estimates that air pollution contributes to about seven million premature deaths every year, mainly through stroke, heart disease, chronic obstructive pulmonary disease, lung cancer and acute respiratory infections.
The pollution comes from several sources, including vehicles, factories, power plants, waste burning and the use of dirty fuels for cooking.
Household air pollution remains a major concern, with about 2.1 billion people worldwide still relying on open fires or inefficient stoves using fuels such as kerosene, wood, animal dung, crop waste and coal. WHO estimates that household air pollution was linked to about 2.9 million deaths in 2021, including more than 309,000 children under five.
The burden is particularly heavy in sub-Saharan Africa. WHO says 923 million people in the region lacked access to clean cooking in 2022, leaving millions of households dependent on fuels and technologies that produce harmful smoke.
The UN said the problem is closely tied to poverty. Poor households are often forced to depend on cheap and easily available fuels, increasing their exposure to harmful pollution.
“People living in poverty often rely on readily available and cheap unclean fuels for cooking and heating, leading to increased air pollution and greater vulnerability to its impacts.”
Air pollution is also threatening food security, the UN said, as pollutants can damage crops and lower agricultural productivity. It added that cutting methane emissions and tackling air pollution alongside climate change could help reduce crop losses and protect food systems.
Health remains one of the biggest concerns. WHO estimates that exposure to both outdoor and household air pollution is linked to about 6.7 million premature deaths every year.
Women and girls are also more exposed to household air pollution, particularly in poor and rural communities where they are more likely to spend time cooking with polluting fuels.
The UN said expanding access to clean energy is therefore key to reducing the health burden.
About three billion people still use dirty fuels to cook or heat their homes, according to the UN, with women and children bearing much of the health impact.
“The resultant air pollution kills almost 4 million people each year, mainly women and children. Clean and renewable energy will save lives and boost economic development.”
WHO's latest estimate puts deaths linked to household air pollution at about 2.9 million a year.
The UN also called for cleaner industrial technologies as countries pursue sustainable development, saying industrialisation must go hand in hand with efforts to cut pollution and use resources more efficiently.
Rapid urban growth is another challenge. Under the Sustainable Development Goal on sustainable cities, the UN said better planning of transport, waste management and energy systems will be critical as more people move into urban areas.
The UN estimates that cities account for about 75 per cent of global carbon emissions, while 70 per cent of the world’s population is expected to live in urban areas by 2050.
Better management of chemicals and waste will also be needed, including action to reduce pollution from practices such as open waste burning.
The UN further linked air pollution to the climate crisis, noting that many activities that release harmful air pollutants also produce greenhouse gases. Cleaner transport, energy and cooking systems can therefore help improve health while also reducing pressure on the climate.
“Actions to improve air quality —such as switching to cleaner energy, cooking and transport solutions — will also address the climate emergency.”
WHO says policies promoting cleaner transport, energy-efficient homes, cleaner power generation, sustainable industries and better waste management can help reduce major sources of outdoor air pollution.
The UN said governments, industries and communities will need to work together to achieve cleaner air.
With almost the entire global population exposed to air quality that fails to meet WHO guideline levels, the UN said the fight against pollution should be viewed not only as an environmental issue, but also as a matter of public health, economic development and equality.
For poorer countries, the challenge is even greater because communities often face heavy pollution exposure while having fewer resources to reduce the risks.
The UN said cutting air pollution could therefore help countries make progress across several Sustainable Development Goals, including poverty reduction, food security, better health, clean energy, sustainable cities and climate action.