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The Lancet Commission on pollution and health
• Lancet Commission on pollution and health shows that 92 % of all pollution-related deaths occur in low- and middle-income countries
• In total diseases caused by pollution were responsible for an estimated 9 million premature deaths in 2015
• The pollution-related welfare losses were estimated to cost more than US$4.6 trillion each year, equivalent to 6.2% of global economic output
Once upon time Londoners were almost proud of their smog, giving it a variety of romantic names such as Charles Dickens’ “London ivy”. But in real life the smog was a killer and still today, 150 years later, people are sometimes warned not to breathe too deeply when they go outside. A Commission launched by the journal Lancet reveal how the British capital is by no means alone in suffering health effects from pollution.
Globally, diseases caused by pollution were responsible for an estimated 9 million premature deaths in 2015—16% of all deaths worldwide—three times more deaths than from AIDS, tuberculosis, and malaria combined and 15 times more than from all wars and other forms of violence.
More than 90 % of all pollution-related deaths occur in low- and middle-income countries. In rapidly industrialising countries, such as India, Pakistan, China, Bangladesh, Madagascar and Kenya, deaths due to pollution can account for up to one in four deaths. What’s worse, pollution disproportionately affect the poor and marginalised in every country worldwide.
"It is of critical importance to recognize that pollution is the largest environmental cause of disease and premature death in the world today, widely exceeding the number of deaths from war, violence, AIDS, tuberculosis and malaria, combined," says centre director Johan Rockström, one of more than 40 international health and environmental authors that has been involved in the two-year Lancet Commission on Pollution and Health. He is convinced the problem can be solved and we all win so doing. But ultimately, success with the Sustainable Development Goals depends on success in abating pollution worldwide.
The goal of the Commission is to raise global awareness of the importance of pollution, and mobilise the political will needed to tackle it, by providing the most in-depth estimates of pollution and health available.
Pollution is much more than an environmental challenge – it is a profound and pervasive threat that affects many aspects of human health and wellbeing. It deserves the full attention of international leaders, civil society, health professionals, and people around the world
Professor Philip Landrigan, Icahn School of Medicine at Mount Sinai, USA, Commission co-lead
Even though the report emphasises that pollution and poverty is the most deadly combination, it also concludes that no country is unaffected by pollution. Human activities everywhere, including industrialisation, urbanisation, and globalisation, are all drivers of pollution. Now the researchers behind the Commission hope that the findings and recommendations will persuade leaders at the national, state, provincial, and city levels to make pollution a priority.
“The Lancet Commission on Pollution and Health, provides a state-of-the-art science assessment of the global challenges and pathways to solutions,” Johan Rockström says.
Dr Pamela Das, Senior Executive Editor, and Dr Richard Horton, editor-in-chief of The Lancet, adds that “This Lancet Commission should inform policy makers and serve as a timely call to action. Pollution is a winnable battle.”
Report findings show that air pollution is the biggest contributor, linked to 6.5 million deaths in 2015, while water pollution (1.8 million deaths) and workplace-related pollution (0.8 million deaths) pose the next largest risks. In 2015, the greatest numbers of deaths due to pollution occurred in India (2.5 million deaths) and China (1.8 million).
Welfare losses due to pollution are also assessed and estimated to cost more than US$4.6 trillion each year, equivalent to 6.2% of global economic output.
With many emerging chemical pollutants still to be identified, these figures are likely to underestimate the true burden of pollution-related disease and death. As the report does not either include costs related to the ecological damage inflicted by pollution, the authors again note that the full costs of pollution is most likely much higher.
The Swedish Ministry of Environment and Energy is one of the funders behind the Commission, together with for example the European Union, UN Industrial Development Organization, the German Federal Ministry for the Environment, Royal Norwegian Ministry of Health and Care Services, and the US Agency for International Development.
Together the authors conclude that the type of pollution and the related health problems countries face change as they develop and industrialise. Water pollution and household air pollution, for example, are more common in early stages of industrial development, causing high rates of pneumonia and diarrhoeal diseases. As the world develops, deaths associated with water and household air pollution has reduced from 5.9 million deaths in 1990 to 4.2 million in 2015.
Other types of pollution, on the other hand, such as ambient air pollution (including ozone), chemical, occupational pollution and soil pollution, have increased from 4.3 million (9.2%) in 1990 to 5.5 million (10.2%) in 2015 as countries reach higher levels of industrial development.
Despite this, the authors stress that pollution is not an inevitable consequence of economic development, and applying similar legislation and regulation from high-income countries to low- and middle-income countries could help to improve and protect health as countries develop.
"Pollution can be eliminated, and pollution prevention can be highly cost-effective. This has been seen in high-income and some middle-income countries where legislation has helped to curb the most flagrant forms of pollution, and has led to cleaner air and water, lower blood lead concentrations, removal of hazardous waste sites, and less polluted and more liveable cities," says Commission co-lead, Richard Fuller, Pure Earth, USA.
Johan Rockström is the director of the Stockholm Resilience Centre and an internationally recognized scientist for his work on global sustainability issues. He helped lead the internationally renowned team of scientists that presented the planetary boundaries framework, first published in 2009, with an update in 2015.
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