How governments should cut air pollution – from a doctor

Dr Yuri Carvajal is a board member of the Global Climate and Health Alliance and President of the Environment Department of The Medical College of Chile.

Clean air is a fundamental right, not a privilege. Yet as the World Health Organization’s second global conference on air pollution and health opens in Cartagena, Colombia, millions of people globally are breathing toxic air with devastating health consequences.

There are many ways to counter this: cut air pollution at the source, nurture nature’s ability to clean the air, and pump government investment into national health systems. As doctors, we know where we need to get to, and we have just released a roadmap to get there.

Air pollution is the second leading risk factor for mortality globally. causing seven million premature deaths annually. Just 17% of cities worldwide meet WHO air pollution guidelines, while only seven countries meet WHO’s particulate matter (PM) limits.

In my own country of Chile, the challenge is enormous; in 66 cities, 70% of people are exposed to PM 2.5 levels exceeding local limits - already ten times higher than WHO recommendations.

We even have industrial "sacrifice zones" in areas like Arica, Tocopilla, Mejillones, Ventanas, and Coronel, where air pollution far surpasses safe levels and residents breathe components such as sulfur dioxide, nitrogen dioxide, ozone, benzene, and lead.

Monitoring is sporadic at best, while airborne arsenic and other volatile organic compounds go unregulated. These pollutants accumulate in soil and water, affecting humans and wildlife.

Clean air is a public health necessity, and the profound and far-reaching health impacts of air pollution demand that governments make urgent and coordinated responses. We must reconsider air pollution not as an emissions reduction or technology challenge, but as a critical and preventable threat to the public health and wellbeing of people.

Air pollution places a significant burden on public health systems, costing the global economy 8.1 trillion in health damages in 2019.

Respiratory diseases, cardiovascular conditions, and cancers linked to pollution overwhelm hospitals, particularly in countries where healthcare resources are already stretched.

Treating these illnesses requires extensive medical care, from emergency visits to long-term treatments, increasing the workload for health professionals and diverting resources from other pressing health needs.

Investing in cleaner air will reduce hospital admissions and cut healthcare costs. By integrating air quality measures into public health planning, governments can equip health professionals with the tools and resources needed to mitigate impacts, conduct research, and implement public health initiatives.

Health ministries can work with environmental agencies to ensure holistic and cross-sector responses. As well as demonstrating how air pollution impacts our health systems and our lives, this approach will gather health data and evidence to support decision-makers.

Public awareness and leadership is key. Community members who understand the relationship between health and the environment are more likely to support stronger clean air policies, and robust social engagement can support accountability and accelerate positive change.

As a physician, I know that human health depends on a healthy planet. Clean air isn’t just about reducing pollution - it’s about restoration of biodiverse ecosystems, and protecting the forests and oceans that absorb carbon dioxide and provide the oxygen we breathe.

But fossil fuels are driving deforestation, climate change, and toxic air. If we want to safeguard health, we must go beyond quick fixes and address the root cause. That means phasing out fossil fuels, restoring ecosystems, and ensuring access to clean air.

The health community must be a catalyst for systemic change, providing care for those affected while driving the transformations needed to combat air pollution. But we also need political leadership to provide us with the tools, strategies and partnerships to transform air pollution into an opportunity to advance public health, social equity, and sustainable development.

Healthcare solutions alone are not enough, nor bolstering nature’s ability to clean the air if we continue polluting it. Instead, clean air must become a given, not a luxury. This will ensure healthier lives, stronger communities, and a more equitable and just world.