This piece aims to quantify how air pollution is affecting health, human capital, and the economy across Africa, with a particular focus on Ethiopia, Ghana, and Rwanda.
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.
It is estimated that 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) pollution to intelligence quotient (IQ) loss in children younger than 10 years, with use of an exposure–response coefficient based on previously published data.
Air pollution was responsible for 1·1 million deaths across Africa in 2019. Household air pollution accounted for 697 000 deaths and ambient air pollution for 394 000. Ambient air pollution-related deaths increased from 361 000 in 2015, to 383 000 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.
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.
Africa's population, currently the world's youngest with a median age of 19·7 years, is projected to more than triple in this century, from 1·3 billion to 4·3 billion.
The continent is urbanising and is projected to have 13 megacities by 2100. African countries are advancing economically, industrialising, and building infrastructure.
The continent is undergoing a transition in environmental risks from traditional to modern sources of pollution. Household air pollution is still the predominant form of air pollution, but it is declining, whereas ambient air pollution is increasing.
At the same time, Africa is passing through a massive epidemiological transition from communicable to non-communicable diseases.
The three sub-Saharan countries that are the focus of this analysis have pursued differing pathways to economic development. From 1958 to 1973, Ethiopia sought to boost its economy by focusing on producing consumer goods for the domestic market, attracting foreign investors, and expanding the manufacturing sector.
In the mid-1980s, after the revolution, Ethiopia attempted to shift economic priorities away from agriculture and towards import substitution and labour-intensive industries.
In 1965, 8 years after gaining independence, Ghana began to implement a broad, long-term strategy to move the country from low-income to middle-income status by the year 2020. The country was able to halt and reverse the downward trajectory of its economy and repair broken infrastructure by reshaping its industrial structure, decreasing reliance on imports, and focusing on import substitution.
Additional priorities included poverty reduction, protecting the vulnerable, and achieving financial growth. Through these actions, Ghana has grown its gross domestic product at an average annual rate of 11·2% and has moved from low-income to lower-middle-income status.
A Guest Editorial