Key takeaways
- Dirty air kills millions annually, more than malaria, TB and HIV/AIDS combined
- 99% of people breathe unsafe air
- Air pollution drains 6% of global GDP every year
- Smog and fumes are overwhelming hospital wards and trapping families in poverty
At 6 a.m. in Lagos, the air is already heavy. Street vendors wrap scarves around their faces as danfo buses cough out grey smoke. Comfort, who sells roasted corn by the roadside, tries to stifle another cough that she can barely afford to be treated for.
Millions share her reality. According to the World Bank, about 6 million people die prematurely each year due to the effects of air pollution, a toll greater than that of malaria, tuberculosis, and HIV/AIDS combined. The State of Global Air 2024 report paints an even grimmer picture, indicating 8.1 million deaths in 2021, making it the second-leading risk factor for death worldwide. More than 700,000 of those deaths were children under five, representing roughly 15% of all under-five deaths globally.
Global dirty air crisis
About 99% of the world’s population now breathes air that exceeds WHO safety limits. Nearly 80% of those exposed to unsafe air live in low- and middle-income countries, where poverty, congestion, and weak regulation converge. In cities like Delhi, Dhaka, and Lagos, PM2.5 concentrations, fine particulate matter that is small enough to enter the bloodstream, are 10 to 15 times higher than the recommended levels.
The UN’s 2025 Sustainable Development Goals Report warns that progress on reducing pollution-related deaths is off track globally, with low- and middle-income countries, where urbanization, waste burning, and transport emissions intertwine, being hit the hardest.
The economic toll of air pollution
This is not just a health emergency; it is also an economic issue too. Exposure to PM2.5 costs the global economy between US$4.5 and 6.1 trillion annually, roughly 5–6% of global GDP. Lost productivity, declining labor income, and rising healthcare costs push communities deeper into poverty. South Asia alone loses up to 8.9% of its GDP to health problems arising from dirty air.
Yet, funding to address air pollution remains shockingly low. Just 1% of international development aid went to clean air initiatives between 2015 and 2024. South Asia and sub-Saharan Africa, which together bear over 80% of global pollution-related deaths, received less than 5% of the total funding for clean air.
Human lives behind the numbers
In sub-Saharan Africa, the rising numbers of those with respiratory illnesses are quietly overwhelming fragile health systems. Tricycle driver Kwesi, who lives in Ghana’s capital, Accra, spends 10 hours a day trapped in exhaust fumes. In Nairobi, single mother Grace spends most of her income treating her five-year-old’s chronic bronchitis, caused by smoke from charcoal and traffic fumes.
This burden is felt deeply in clinical settings. In Dhaka in Bangladesh, where traffic jams and textile factories create a constant haze, hospital doctor Ayesha Akter told WHO researchers that polluted air fills the wards, not just the streets.
This daily exposure shortens lives and drains economies. In India, air pollution eats away 1.3% of GDP annually, while in Ethiopia and Ghana, it costs 1.2% and 0.95% respectively. Every asthma attack, stroke, or day missed from work deepens inequality and slows economic growth.
Policy and progress
While the challenge is massive, progress is possible and measurable.
- Rwanda, one of Africa’s clean air leaders, banned the import of used cars and diesel vehicles in 2019. Within five years, the air quality in Kigali had improved by over 25%, according to UNEP data.
- India’s National Clean Air Programme (NCAP), launched in 2019, aims to reduce particulate matter by 40% by 2026. Although progress has been uneven, pilot cities such as Indore and Ahmedabad have shown measurable improvements.
- In Chile, investment in electric buses has reduced emissions equivalent to those from 2,900 wood-burning stoves.
The World Bank estimates that achieving its Clean Air Targets and halving PM₂.₅ exposure by 2040 would require about US$3.2 trillion in investments but deliver up to US$2.4 trillion in economic returns – proof that cleaner air is an investment, not a cost.
As one report notes, managing pollution favorably will impact human capital and help to lay the foundation for sustainable recovery in developing economies.
Why clean air matters for development
Dirty air undermines the achievement of multiple Sustainable Development Goals:
- SDG 3 (Health) by causing millions of preventable deaths
- SDG 8 (Decent Work) through lost productivity
- SDG 11 (Sustainable Cities) as pollution worsens urban living
- SDG 13 (Climate Action), since the causes of air pollution and greenhouse gas emissions stem from the same fossil fuels.
The World Bank’s 2025 modeling shows that without stronger policies, annual deaths from air pollution could rise from 5.7 million in 2020 to 6.2 million by 2040. The number of people breathing hazardous air above 25 µg/m³ will increase by 21%, with the steepest rises being in sub-Saharan Africa, Central Asia, and the Middle East.
A call to clear the air
The evidence is overwhelming: air pollution is far more than an environmental footnote; it is a fundamental obstacle to human development. From the millions of young lives cut short to the staggering loss of GDP across developing economies, dirty air traps nations in a cycle of illness and poverty. Until the global community addresses the current imbalance in funding and action, the costs, in both human and economic terms, will continue to escalate, holding back the very populations that are striving to meet their sustainable development goals.
