Common causes of air pollution include emissions from household cooking and heating using open fires or inefficient stoves fueled by kerosene, biomass, or coal. Photo credit: ADB.
Focusing on health outcomes results in holistic solutions across multiple sectors.
About 4 billion people in Asia and the Pacific live with dangerous levels of air pollution. High exposure to unclean air may result in premature death and serious health issues, including lung and heart disease.
A policy brief from ADB prescribes a health-focused multisectoral approach to root out the sources of air pollution and to better protect public health. It cites viable solutions from within and outside the region, including from Southeast Asia. In some parts, like the Greater Mekong Subregion, countries need to work closely together to address cross-border pollution sources, such as seasonal haze from forest and peatland fires.
“A health-focused multisector approach that includes sustainable urban development, clean energy transitions, and strengthened environmental health governance is key to reaping the enormous health and its related economic benefits from clean air,” the policy brief says. Studies show “the cost of the health benefits exceeds the costs to improve air quality by a factor of 32 to 1.”
Maximizing impact
The health-related economic benefits of clean air are “immediate and cumulative.” These include lower heath care costs due to improved symptoms or disease prevention; fewer sick leaves at work or school, resulting in increased productivity and improved educational outcomes; and reduced climate-related loss and damage.
The policy brief notes that “climate change and air pollution are interconnected environmental challenges with significant impacts on human health and the planet.” Common causes include emissions from the agriculture, manufacturing, transport, and energy sectors as well as household cooking and heating using open fires or inefficient stoves fueled by kerosene, biomass, or coal.
“Integrated approaches that target both issues can lead to more efficient and impactful solutions, improving public health and environmental quality while combating global warming,” it says. “For instance, reducing fossil fuel use and transitioning to clean energy sources, improving energy efficiency, promoting sustainable agriculture, and increasing urban green spaces can all have positive impacts on both air quality and climate change.”
The policy brief identifies actions for integrating activities of non-health sectors (i.e., agriculture, transport, energy) in health programming and vice versa. For example, in agriculture, sustainable practices, such as precision farming, should be promoted while harmful methods, including crop residue burning, which contribute to regional haze, should be discouraged. Complementary measures in the health sector would entail public policy and community interventions, such as supporting science-based decision making and promoting public awareness of the adverse effects of agricultural air pollution on health.
It cites ADB’s Blue Skies Jakarta study as an example of how urban health, energy, and governance may be integrated into a road map and investment plan to achieve clean air in a megacity.
Tested solutions
The policy brief sees four key actions for improving the health outcomes of pollution control measures. It provides best practices in each area from around the world, including in Southeast Asia.
1. Scale up urban health solutions.
Nonmotorized public transportation modes, such as a cable car system, can improve the mobility of residents while offering a low-carbon alternative to buses.
In Tokyo, green corridors, parks, rooftop gardens, and greenery on buildings help reduce the urban heat island effect and improve air quality.
Heat waves are associated with air pollution. Under ADB’s Climate and Health Initiative, which addresses both heat stress and air pollution, urban heat mapping helps design health-focused climate adaptation as well as pollution mitigation measures that target at-risk communities.
Technology-based solutions include installing smart management traffic systems and shifting to electric vehicles and cleaner cooking technologies.
In Indonesia, the government aims to electrify public transportation, including buses, by 2045 and designate more low- and ultra-low emission zones across the country to curb traffic-related emissions.
Singapore’s electronic road pricing system automatically charges motorists each time they pass through heavily used roads during peak hours. The country is a pioneer of the congestion pricing scheme, which enables it to avoid an estimated 80,000 kilograms of carbon dioxide emissions per day.
2. Promote net-zero health systems.
The health care sector accounts for up to 5% of net global emissions. By 2050, total greenhouse gas emissions from health care could triple.
To decarbonize health systems, there is a need to promote greater energy efficiency, reduce climate and environmental impacts of hospital buildings and other facilities, and improve medical waste management practices.
Good practice models include certification and progressive standards-setting schemes, such as Singapore’s Green Mark Certification Scheme and Japan’s Top Runner Program.
“Sustainability is also gaining traction in hospital design and management for both established and new facilities,” as in the case of Singapore General Hospital. Though built in 1821, the hospital is noted for its sustainability initiatives in energy efficiency, water conservation, and waste management.
3. Strengthen environmental health governance.
The European Union has shown that the enforcement of air quality standards and regulations is possible both at the country and regional levels.
The People’s Republic of China, Japan, and Republic of Korea have implemented robust air quality monitoring networks. “At the country level, such networks would include ministries of health in collaboration with other line ministries, such as those for the environment, transport, urban development, energy, and agriculture,” says the policy brief. A promising solution for strengthening governance is enabling citizens to access and monitor online air quality data, helping increase public awareness of the dangers of air pollution.
4. Enhance regional cooperation.
The policy brief underscores the importance of regional cooperation because air pollution crosses borders. Countries need to put in place “regional air quality agreements and action plans that designate clean air as a regional public good.”
ASEAN was the first to adopt a regional legally binding agreement on transboundary haze. Signed in 2002, the agreement entered into force in 2003.
Other recommended actions include harmonization of standards and monitoring protocols, building capacity in health and environmental impact assessments, sharing knowledge and best practices, and joint research on transboundary pollution.
Implementing a multisector approach, however, can be “challenging because of the transaction costs of forging coalitions and agreeing on trade-offs,” says the policy brief. “The process can be simplified by being upfront about what each sector might contribute, then working through the priorities for a multisector package suitable for a given geography (e.g., regional, national, subnational).”
