– by Nina Renshaw, Director of Policy and Advocacy at NCD Alliance (GCHA member) We are less than a month away until countries meet in Madrid, Spain at the Climate Conference to decide on climate action to keep us at 1.5 C.

Climate change was also the first topic mentioned at the opening of the World Health Summit 2019 at the end of October, which recognized that it poses an unquestionable threat to human health, affecting everyone on the planet and children in particular. There is an urgent need to address it, ensuring that health systems can face the challenges extreme temperatures bring, and taking action to limit the impacts of man-made activities.

Air pollution is a direct consequence of such activities, and it is a public health emergency, here and now.  It is the world’s major environmental cause of disease and is increasing globally – with disproportionately higher impact in low- and middle-income countries. Polluted air even reaches unborn babies. Women and children are the most affected, because of their increased exposure to household air pollution, mainly in Africa and Asia where fossil fuels are used for cooking in poorly ventilated areas. WHO estimates overall that air pollution claims 7 million lives each year worldwide. Of these deaths, approximately 80 percent are due to non-communicable diseases (NCDs) like respiratory disease, stroke, heart disease and cancer, making the number of NCD deaths due to air pollution comparable to mortality from smoking.

It is not for nothing that WHO Director-General Dr Tedros Adhanom Ghebreyesus has called air pollution “the new tobacco”.  In 2018, the World Health Organization recognized air pollution as a major global health risk factor, placing it alongside tobacco, harmful use of alcohol, unhealthy diets, and physical inactivity. Fossil fuel combustion is the primary source of air pollution worldwide. Yet fossil fuel production and consumption is still not being treated as a public health issue.

Inspired by the comparison, and the successes of the worldwide tobacco control movement, NCD Alliance teamed up with the International Institute for Sustainable Development (IISD) on our recent report Burning Problems, Inspiring Solutions.

The fight against tobacco is far from over and hasn’t been easy, but there is now plenty of evidence as to which measures work to save lives. Thanks to smart policies, as well as international conventions like WHO’s 2003 Framework Convention on Tobacco Control, warning messages, anti-tobacco campaigns, smoke-free zones, and additional taxes on tobacco products are now a part of everyday life. Can we imagine similar approaches for air pollution?

Burning Problems, Inspiring Solutions looks at some of the crucial actions taking place around the world that can inspire and guide others in the fight against air pollution from fossil fuels. Some key areas for action have been identified, including:

  • Naming and addressing fossil fuels as the root cause of air pollution and the resulting diseases, just as was done with tobacco. This entails raising awareness among the population of the negative health effects, both locally and globally, of the combustion of fossil fuels, beyond the environmental impacts.
  • Regulating and implementing government policy measures to curb the production and use of fossil fuels through the many instruments available, such as getting market prices right through subsidy reform, tax measures, and the introduction of regulations banning the specific production and consumption of certain products.
  • Defining adequate, fair and just transition plans away from unhealthy commodities, recognising the needs of those groups depending on oil, gas and coal, whether they be consumers or employees.

In light of the damage that burning fossil fuels does to our health, ecosystems and climate, it may come as a shock to many to hear that our governments still heavily subsidise the industry. Another piece of recent research, Fuelling an Unhealthy Future, published by Vital Strategies and NCD Alliance, highlights that, globally, governments provide nearly USD $300 billion in pre-tax subsidies for fossil fuels. This is just a fraction of the over USD $2.7 trillion burden that fossil fuels impose on us in health costs. Of course, the industry will fight as if their lives depended on it – with little regard for ours – to retain such generous support.

By now, we’ve gathered decades of experience of how unhealthy commodity industries respond to NCD activists who challenge them. We’ve seen the CEO of Shell recently claim in the media that there is no alternative to investing in fossil fuels, because consumers demand it – arguments reminiscent of the tobacco industry decades ago. But modern consumers and voters see through the spin and are far less likely to accept the blame for the toll of killer products. On the contrary, the unprecedented wave of protests around the world, against air pollution, climate breakdown and extinctions, with a new generation taking the lead, fills us with hope that we can pick up the pace of change.

A number of national and provincial initiatives have already achieved successes in weaning themselves off their deadly addiction to fossil fuels, such as the subsidy reform in Indonesia, and the Ontario coal-phase out. Last year 2018, Costa Rica’s newly-elected President announced a plan to permanently ban fossil fuels and to make Costa Rica the first fully decarbonised country in the world. Important lessons can be taken from first-movers who have taken pioneering steps to end support for and use of fossil fuels, like France, which passed legislation in 2017 banning all oil and gas exploration and extraction by 2040. New Zealand and Belize have announced an end to new offshore exploration activities for oil and gas. In early 2018, Ireland took its first steps towards a similar legislation.

Most people say they would never go back to the days when restaurants, offices, and even aeroplanes were filled with cigarette smoke. Soon, we may be able to talk about air pollution in the same way. Now that it’s known that air pollution, largely created by the production and combustion of fossil fuels, finds its way into every part of the body, causing a wide range of deadly diseases, why aren’t we seeing posters with gruesome photos and warnings that fossil fuels kill at every petrol station?

With the evidence base developing quickly, the global health community is responding by stepping up our calls for climate action and for rapid policy responses for cleaner air. The health community has a solid track record: ahead of the Paris Climate Summit in 2015, over 13 million health professionals showed their support by calling for an ambitious agreement, resulting in groundbreaking recognition of health in the Paris agreement. Easy wins against the fossil fuels industry – as with other unhealthy commodity industries – are unlikely. However, as with tobacco and sugary drinks, the evidence linking pollution from fossil fuels to the rampant NCD epidemic is undeniable and growing. Similarly, as we follow the examples set by clean air cities, recognition of just how quickly action for cleaner air and climate measures give rise to health benefits – often a difference can be measured within a matter of days – will encourage more governments to accelerate the transition.