From developed countries to the developing world, the effects of air pollution are one of the greatest environmental risks to human health. A new research by World Health Organisation (WHO) shows that an estimated 92% of the world’s population lives in areas where air pollution exceeds safety limits, causing three million premature deaths a year. Whilst premature deaths resulting from poor air quality have declined in most developed countries e.g. EU countries, because of Air Quality Policy Package (although far from perfect…), little is heard about developing countries that are recording largest numbers of premature deaths caused by air pollution, in particular, countries in Africa and Asia.

A developing country such as Ghana, with an obligation to fulfill its commitment to global Agenda 2030 Sustainable Development Goals (SDGs) stands on the cliff-edge of a national environmental public health disaster i.e. considering how successive administrations have failed and ignored this ‘invisible silent killer’. According to a Global Health Observatory data (although five years old data), Ghana's mortality rate attributed to household and ambient air pollution per 100, 000 population, in year 2012 stands at 80.0, whilst indoor air pollution causes around 14,000 deaths every year, - which includes 3000 deaths in children below 5 years (Ghana Health Services Burden of Disease). Thus, doing the maths with a population size around 28 million; should alert authorities/decision-makers that policy initiative and measures to tackle air pollution should be treated with urgency, just as prominence has been given to tackle the environmental impacts of artisanal gold mining/galamsey. A study shows that Accra remains the only metropolis reporting to the WHO, and records high levels of particulate matter contributing to poor air quality (The Travel and Tropical Medicine Manual, 4th Edition). Consequently, the lack of data and information on air quality in Ghana is a real concern, directing to data gaps that urgently need to be bridged. For the common good, bridging the data gaps will enable citizens to better understand their natural environment air quality status, the causes and consequences in terms of the related health risks. A UNEP study also shows how Ghana’s roadside air quality to be higher than the EPA standard level, whilst recording higher PM₁₀ levels of higher acute respiratory incidence. Likewise, a study recorded higher concentrations of PM₁₀ levels (above the WHO guideline value - 50µgm-3) in the mining areas. Arguably, this causes more death amongst vulnerable groups such as children, elderly, the very poor and those with existing cardio-vascular and respiratory issues. Although the National Environmental Policy highlights on establishing a system for monitoring compliance with air, there is yet in place a coherent National Air Quality Strategy/Policy tackling this ‘invisible silent killer’.

Causes & Health Impacts

Typically, causes of air pollution could stem from oil and gas power generation; burning waste; vehicles diesel fuel combustion/emission; sulphate, nitrates, dust, black carbon as well as indoor air pollution caused by smoke from cooking stoves, firewood/biomass and heating fuels.  Interestingly, the increase use of diesel generators to power electricity e.g. during ‘dumsor’ has less been criticized on environmental health grounds. Diesel generators yield more greenhouse gas emissions, and they also emit significant amounts of pollutants such as nitrogen oxides (NOx) and particulate matter, which can be extremely damaging to health.  There are growing body of research studies that links poor air quality to increasing risks associated with strokes; asthma; lung cancer; heart attacks/diseases and strong associations with Alzheimer diseases such as dementia and diabetes, - which are all prevalent health diseases in Ghana and worldwide. For poor air quality to take a toll on human-health, scientific evidence shows that long and short-term exposures to tiny particle pollution, also known as fine particulate matter (PM2.5, - about one-thirtieth of the width of a human hair), can penetrate deep into the lungs and cardiovascular system.  

Citizens’ Rights & Way Forward

It is every citizen right to “demand or breathe clean air” (UN Environment), and national governments are responsible to ensure the implementation of air quality policy. Importantly, since Ghana is a UN member state and signatory to Agenda 2030 SDGs, it remains crucial to “substantially reduce the number of deaths and illnesses from poor air quality, by 2030”, - as clearly set-out in target 3.9. Hence, the onus falls on citizens, regulatory bodies such as Environmental Protection Agency (EPA), and in collaboration with other stakeholder groups to develop a ‘Clean Air Act’ that is fit for current and future generations. Although there is “no quick fix to tackle air pollution issues”, target 3.9 of Agenda 2030 Sustainable Development Goal (SDGs), may possibly become the policy back-drop to stimulate initial discussions for a National Air Quality Strategy. Legislative measures and schemes may well look into: i) affordable access to clean cook-stoves for the rural and urban population or a transitioning from solid fuels to liquefied petroleum gas; ii) maximizing renewable energies use and household/industrial emissions reductions; iii) scaling-up air quality monitoring plan in designating Air Quality Management Areas (AQMAs) across all regions (using low-cost sensors); iv) managing solid waste; v) implementing measures for sustainable travel and transport in major cities experiencing traffic/congestion.

A multi-stakeholder collaborative approach involving experts and scientists will also be required towards any holistic National clean air strategy. Such mechanism often provides reality check for scientific efforts. Given that, institutions including the: Public, Driver’s License Authority (DVLA), Parliament, Researchers, Association of Ghana Industries (AGI), Ministry of Environment, Science, Technology and Innovation, EPA, Ministry of Transport, Environmental Health Professionals, Town Planners and Developers, Transport Planners/Engineers, Public-Health Institutions/Officials, Chief Medical Officers, and the Media will need to provoke discussions towards changing the ‘status quo’ of this mass killer.

This is an urgent public health crisis over which the new government must seize the opportunity to deliver its vision/policy goals to "ensure Ghana becomes a shining example for the implementation of SDGs". Thus, the EPA working with relevant stakeholder groups will need to take immediate actions now to deal with illegal levels of pollution, ensure clean air to breathe and prevent tens of thousands of additional early deaths in Ghana. Such legislative requirements and measures should be robust, fit the local context, and aim to educate/strengthen public understanding of the causes, key risk factors, and effects of poor air quality in our homes, workplaces and our natural environment.

Bringing it together 

With Agenda 2030 SDGs in mind, this piece has aimed to contribute to coherent policy formulations tackling air quality issues in an African and developing world context