Ernesto Sánchez-Triana is the Global Lead for Pollution Management and Circular Economy for the World Bank, where he manages the Program on Pollution Management and Environmental Health and the Program on Pollution Management and Circular Economy. He recently shared his thoughts on the fight for clean air with Sergio Sanchez, EDF’s Senior Policy Director, Global Clean Air. 

Sergio: Why do you fight for clean air?

Ernesto: My best friend died of lung cancer when he was less than 40 years old. Like me, he had completed graduate studies in environmental engineering. In addition, one of my sons had respiratory problems associated with air pollution that resulted in bronchitis and asthma. This experience, as well as over three decades of working closely with the most vulnerable populations on the planet, have led me to specialize in this area. This is more than a professional obligation for me; it is an unconditional commitment that brings meaning to my life.

Air pollution is one of the biggest environmental threats the world faces and is the world’s leading environmental risk to human health. Exposure to PM2.5 (particles equal to or less than 2.5 micrometers in diameter) pollution, both outdoors and indoors, caused an estimated 6.4 million premature deaths and 21 million years lived with disability in 2019, according to the Global Burden of Disease Report. About 95% of those deaths occurred in low- and middle-income countries.

The World Bank has estimated that the annual health costs of PM2.5 pollution are US$8.1 trillion. Thus, in addition to causing pain and suffering, air pollution causes significant economic costs, equivalent to nearly 6.1% of global gross domestic product. Unless ambitious and concrete interventions are implemented, ambient (outdoor) air pollution is likely to increase its health and social burden in the future as low- and middle-income countries continue to urbanize, industrialize, and experience population growth.

Helping low- and middle-income client countries to address pollution-related challenges is indispensable to the World Bank’s mission of ending extreme poverty and promoting shared prosperity in a sustainable manner. The poor and other vulnerable groups, including children, the elderly, and women, are primarily affected by air pollution. They are exposed to higher concentrations of PM2.5 for reasons that include worse air quality in their neighborhoods, reliance on solid fuels for cooking and heating, and occupational exposure.

Sergio: Why do you find this work so critical, especially today?

Ernesto: Air pollution is increasingly recognized as the worldwide public health crisis that it is and a top development priority in fostering the creation of competitive, prosperous cities whose residents and visitors can breathe safe air. Recent analytical work conducted by the World Bank has demonstrated that interventions to manage air quality can deliver multiple benefits. Although the largest benefit is in health—notably through a reduction in premature death and cases of illness—there are additional benefits such as supporting more-livable cities, energy efficiency, reductions in healthcare costs and improvements in agricultural productivity, among others.

Furthermore, some air pollutants—most notably, black carbon and methane—are climate warmers. Black carbon is a component of PM 2.5 and therefore has adverse impacts on health. Consequently, efforts to reduce black carbon have benefits for health as well as for climate-change mitigation.

International health crises, such as the current COVID-19 pandemic, further highlight the need for continued action in addressing environmental pollution. Ongoing research is finding close links between air pollution and the incidence of illness and death due to COVID-19. Air pollution can cause cellular damage and inflammation throughout the body and has been linked to higher rates of diseases, including cancer, heart disease, stroke, diabetes, asthma, and other comorbidities. All these conditions can also increase the risk of death in COVID-19 patients.

Sergio: How does the World Bank help countries reduce air pollution? How much funding is the World Bank financing for air pollution control?

Ernesto: Addressing air-quality management through analytical work, technical assistance, and lending is a top priority for the World Bank. During the period FY2004–FY2020, the World Bank portfolio of lending and technical assistance that targeted pollution amounted to approximately US$49 billion, of which about US$15 billion targeted air pollution.

Sergio: Where do you see the future of air quality monitoring for Low- and Middle-Income Countries?

Ernesto: Establishment of ground-level networks to measure and monitor air and climate pollutants is key. Supporting countries in developing robust plans for managing air quality—plans driven by reliable monitoring data on air quality—provide the basis for implementing projects that reduce high levels of air pollutants in a cost-effective way. Countries need to prioritize establishing and strengthening ground-level monitoring networks that measure fine (PM2.5) and ultrafine (PM0.1) particulate matter to inform the design and implementation of effective and efficient investment and policy interventions to protect human health from air pollution’s adverse effects.

The World Bank, through the Pollution Management and Environmental Health program, conducted analytical work on the potential for applying satellite measurements for air-quality monitoring in low- and middle-income countries. This study aimed to improve knowledge both on the extent to which satellite measurements can best be used to enhance air-quality monitoring, thus improving estimation of human exposure to air pollution, and on how satellite measurements can be brought into closer agreement with ground-level data, considering the shortcomings and advantages of satellite measurements.

The analytical work found that many different conditions—including mountainous terrains, snow, coasts, clouds, and dust—prevent accurate representations of air-pollution conditions by satellites in the cities tested. Overall, this work suggests that satellites cannot be a replacement for a high-quality ground-level monitoring (GLM) network in any of the cities evaluated, which initially included Delhi, India; Lima, Peru; and Ulaanbaatar, Mongolia; and later expanded to include Accra, Ghana; Addis Ababa, Ethiopia; Dakar, Senegal; Hanoi, Vietnam; Kampala, Uganda; and Kathmandu, Nepal.

In countries with no GLM data available, satellite estimates of surface PM2.5 concentration may have errors in the range of 22 to 85 percent. Establishment of GLM networks that include adequate quality assurance and quality control and follow standard operating procedures to ensure the data are of sufficient quality would likely enable better understanding of human exposure to air pollution specific to an individual city.

Sergio: Why should people participate in International Day of Clean Air for Blue Skies (Sept 7)?  What do you see as the role of international collaboration in the fight against air pollution?

Ernesto: The International Day of Clean Air for Blue Skies brings a global call for action toward a single, unifying objective: clean air for all by urging countries to work together to tackle air pollution around the world. The International Day of Clean Air plays an indispensable role in spurring action against air pollution. For instance, it strengthens awareness about the significant health, social, economic, and development impacts caused by air pollution and galvanizes collective action to address it.

We have seen how important public-awareness campaigns have been to increase public and private commitments to tackle environmental problems. The Bank has partnered with other organizations to raise awareness among decision-makers and the general public on the air-pollution crisis. In 2018, together with the World Health Organization (WHO), the Bank organized the First Global Conference on Air Pollution and Health. The conference concluded with a Geneva Action Agenda to Combat Air Pollution to scale up efforts and mobilize action globally. The aspirational goal is to reduce the number of deaths from air pollution by two-thirds by 2030.

Airsheds cross both domestic state jurisdictions and national boundaries, often requiring international collaboration to ensure effective regional air-quality management. For example, international collaboration is needed to address the air-quality challenges of regional airsheds, such as the Indo-Gangetic Plain and Indus Basin, and the North China Plain; airsheds covering the Gulf States, Western Balkan States, and Turkey; and major urban agglomerations along the coast of Western Africa. International collaboration also plays a role in sharing knowledge and lessons learned from airshed approaches that have been critical in improving air quality in several parts of the world.

International collaboration can also contribute to developing analytical work that can underpin effective interventions, as demonstrated by the World Bank Group’s experience in supporting air-quality management in its client countries. For instance, in China, analytical work supported by the Bank helped to identify the sources of ambient air pollution in Hebei Province, including agriculture, which had previously not been considered. As a result of the findings of the analytical work, the Bank financed interventions to reduce ambient air pollution associated with the use of nitrogen-based fertilizers in the agriculture sector. In Peru, benefit-cost analysis of alternative interventions to control air pollution informed the design of three development policy lending operations that addressed air pollution through policy reforms in the energy and transport sectors. International collaboration could be used to support analytical work to inform the design and implementation of policy reforms and investments to tackle air pollution, as well as for generating knowledge of a more global nature with application across regions.

While technical assistance, analytical work, and advocacy are key tools for achieving objectives in managing air quality, capital mobilization is critical for ensuring that investments to reduce air pollution are put in place. International collaboration is vital to attract private investors and other stakeholders with an appetite for financial mechanisms for air-pollution control, including results-based mechanisms for payment for air-quality improvements such as green bonds. The very first green bond was issued in 2007 by the European Investment Bank and the World Bank. By 2020, multilateral development banks, private investors, and governments had issued bonds with a cumulative value of more than US$1 trillion. Green bonds illustrate how international collaboration can pilot new financial mechanisms and business models that will unlock significant investments to address air pollution and other sustainability challenges.