Air pollution and development in Africa: impacts on health, the economy, and human capital

Background Africa is undergoing both an environmental and an epidemiological transition. Household air pollution
is the predominant form of air pollution, but it is declining, whereas ambient air pollution is increasing. We aimed to
quantify how air pollution is affecting health, human capital, and the economy across Africa, with a particular focus
on Ethiopia, Ghana, and Rwanda.
Methods Data on household and ambient air pollution were from WHO Global Health Observatory, and data on
morbidity and mortality were from the 2019 Global Burden of Disease Study. We estimated economic output lost due
to air pollution-related disease by country, with use of labour income per worker, adjusted by the probability that a
person (of a given age) was working. Losses were expressed in 2019 international dollars and as a proportion of gross
domestic product (GDP). We also quantified the contribution of particulate matter (PM)2·5 pollution to intelligence
quotient (IQ) loss in children younger than 10 years, with use of an exposure–response coefficient based on previously
published data.
Findings Air pollution was responsible for 1·1 million deaths across Africa in 2019. Household air pollution accounted
for 697000 deaths and ambient air pollution for 394000. Ambient air pollution-related deaths increased from 361000 in
2015, to 383000 in 2019, with the greatest increases in the most highly developed countries. The majority of deaths due
to ambient air pollution are caused by non-communicable diseases. The loss in economic output in 2019 due to air
pollution-related morbidity and mortality was $3·02 billion in Ethiopia (1·16% of GDP), $1·63 billion in Ghana
(0·95% of GDP), and $349 million in Rwanda (1·19% of GDP). PM2·5 pollution was estimated to be responsible for
1·96 billion lost IQ points in African children in 2019.
Interpretation Ambient air pollution is increasing across Africa. In the absence of deliberate intervention, it will
increase morbidity and mortality, diminish economic productivity, impair human capital formation, and undercut
development. Because most African countries are still early in development, they have opportunities to transition
rapidly to wind and solar energy, avoiding a reliance on fossil fuel-based economies and minimising pollution.