Update: The 2017 Lancet Commission on Pollution and Health concluded that pollution is the world’s largest environmental risk factor for disease and premature death and is an existential threat to human and planetary health, jeopardizing the sustainability of modern societies.
The 2022 report, “Pollution and health: a progress update,” provides an updated analysis with a number of critical new insights, including the findings that the impact of pollution remains large, and the number of annual deaths has not decreased since 2015. Read more about the pollution progress report.
About The Lancet Commission on Pollution & Health
The Lancet Commission on Pollution and Health is an initiative of The Lancet, the Global Alliance on Health and Pollution (GAHP), and the Icahn School of Medicine at Mount Sinai, with additional coordination and input from United Nations Environment, United Nations Industrial Development Organization (UNIDO), and the World Bank. The Commission comprises many of the world’s most influential leaders, researchers and practitioners in the fields of pollution management, environmental health and sustainable development. The aim of the Commission is to reduce air, soil and water pollution by communicating the extraordinary health and economic costs of pollution globally, providing actionable solutions to policy-makers and dispelling the myth of pollution’s inevitability. The Commission Report was published in The Lancet, one of the world’s most prestigious and widely read medical journals, on October 19, 2017.
Environmental pollution is the single largest cause of disease and death in low- and middle-income countries. Data from the World Health Organization and others suggests that in 2012 exposures to polluted soil, water and air contributed to an estimated 8.9 million deaths worldwide.(1, 2) By comparison, deaths from HIV/AIDS, malaria and tuberculosis caused a combined 2.5 million deaths.(3, 4) More than one death in seven worldwide is the consequence of environmental pollution.(5) Despite the tremendous impacts on human health and the global economy, environmental pollution has been undercounted and insufficiently addressed in national policies and international development agendas.(6, 7)
Pollution is strongly linked to poverty.(8) The overwhelming majority of the disease burden from pollution—over 92%—falls on residents of low- and middle-income countries. It disproportionally affects countries that are ill equipped to deal with the problem, and vulnerable populations without the resources to protect themselves. The disproportionate poisoning of the poor is a global environmental injustice. In addition to impacts on human health, pollution carries an economic cost that is often overlooked.(9) Pollution-related illnesses result in direct medical costs, costs to healthcare systems and opportunity costs resulting from lost productivity and economic growth.
The good news is that pollution controls are feasible, cost-effective and replicable. The most effective strategies control pollution at its source. In many countries, lead has been removed from gasoline, industrial discharges to air and water have been controlled and highly toxic pesticides have been replaced by safer substitutes. These actions provide a blueprint that can be transferred and replicated globally.
Despite its importance and preventability, environmental pollution has not received the priority it merits in the international development agenda. Solving the pollution problem requires us to measure and demonstrate its true costs, and the benefits of addressing it now. With that information in hand, world leaders can explain and justify actions to solve the problem for current and future generations.
Lancet Commission on Pollution and Health: Scope and Goals
The Lancet Commission on Pollution and Health addresses the full health and economic costs of air, water and soil pollution. Through analyses of existing and emerging data, the Commission reveals pollution’s severe and underreported contribution to the Global Burden of Disease. It uncovers the economic costs of pollution to low- and middle-income countries, and compares the costs of inaction to the costs of available solutions. It informs key decision makers around the world about the burden that pollution places on health and economic development, and about available pollution control solutions and strategies. The Commission brings pollution squarely into the international development agenda.
In addition to publication in The Lancet, the Report findings were distributed widely through media outlets, reaching over 2 billion people and counting. The work of the Commission was also covered extensively through special partnerships with high-profile media organizations. The publication of the Report coincided with public events around the world highlighting pollution’s impacts.
Lancet Commission on Pollution and Health: Core Team Leaders
The Lancet Commission on Pollution and Health is chaired by Philip Landrigan, MD, a distinguished professor and physician, and the Dean for Global Health at the Icahn School of Medicine at Mount Sinai, and by Richard Fuller, Founder and President of Pure Earth and Secretariat of the Global Alliance on Health and Pollution.
The work of the Commission is overseen by a Steering Committee composed of the following representatives:
Philip Landrigan, Commission Co-Chairman and Lead Author of Commission Report Chapter 1
Richard Fuller, Commission Co-Chairman and Co-Lead Author of Commission Report Chapter 4
Maureen Cropper, Co-Lead Author of Commission Report Chapter 2
Alan Krupnick, Co-Lead Author of Commission Report Chapter 2
Karti Sandilya, Lead Author of Commission Report Chapter 3
David Hanrahan, Co-Lead Author of Commission Report Chapter 4
Tim Kasten, representing United Nations Environment
Yewande Awe, representing the World Bank Group
The Chairmen are joined by an esteemed group of Commissioners from around the world, which includes former heads of state, leaders from multilateral development agencies; Ministers of Heath and Environment; a Nobel Laureate; distinguished physicians, economists and scientists; noted environmental advocates and public figures. Commissioners contribute subject matter expertise and leadership, and serve as the Commission’s ambassadors to the public.
Research and drafting for the Commission Report is coordinated through the office of Pure Earth, and includes contributions from Lead Authors, Commissioners, partner organizations, advisors, consultants and in-house staff.
The Lancet Commission on Pollution and Health report was put through three phases of review before publication: an initial review by the steering committee, a review by the Commissioners; and a full peer- review process according to the internal publication guidelines of The Lancet.
The Report from The Lancet Commission on Pollution and Health analyzes and communicates the massive scope of the health and economic costs of air, water and soil pollution. Through analyses of existing and emerging data, the Report reveals pollution’s severe and underreported contribution to the Global Burden of Disease. It uncovers the economic costs of pollution to low- and middle-income countries, and compare the costs of inaction to the costs of available solutions. It informs key decision makers around the world about the burden that pollution places on health and economic development, and about cost-effective pollution control solutions and strategies. The Commission will bring pollution squarely into the international development agenda.
The Lancet Commission On Pollution And Health
Click here for the full report, summary, and to listen to the podcast featuring Gina McCarthy, former EPA Administrator, and Commission leads Philip Landrigan and Richard Fuller join Gavin Cleaver for a discussion of the problems of pollution and the solutions available.
Pollution Causes 16% Of All Deaths Globally.
Diseases caused by pollution were responsible in 2015 for an estimated 9 million premature deaths – 16% of all deaths worldwide – three times more deaths than AIDS, tuberculosis, and malaria combined; and fifteen times more than all wars and other forms of violence. It kills more people than smoking, hunger and natural disasters. In some countries, it accounts for one in four deaths.
Pollution Disproportionately Kills The Poor And The Vulnerable.
Nearly 92% of pollution-related deaths occur in low- and middle-income countries. Within countries, pollution’s toll is greatest in poor and marginalized communities. Children face the highest risks because small exposures to chemicals in utero and in early childhood can result in lifelong disease and, disability, premature death, as well as reduced learning and earning potential.
Pollution Is Closely Tied To Climate Change And Biodiversity.
Fossil fuel combustion in higher-income countries and the burning of biomass in lower-income countries accounts for 85% of airborne particulate pollution. Major emitters of carbon dioxide are coal-fired power plants, chemical producers, mining operations, and vehicles. Accelerating the switch to cleaner sources of energy will reduce air pollution and improve human and planetary health.
Pollution Is Neglected By Funding Agencies Worldwide.
Despite significant health impacts, the international development and health agendas have largely overlooked pollution. Funding is sparse when compared to resources for infectious disease and other environmental issues. No large foundations include environmental health and pollution as a focal area. Pollution control will also advance several of the Sustainable Development Goals. Despite the fact that more than 70% of the diseases caused by pollution are non-communicable, interventions against pollution are barely mentioned in the Global Action Plan for the Prevention and Control of Non-Communicable Diseases.
The Cost Of Inaction Is High, While Solutions Can Yield Economic Gains.
Spending on pollution-related diseases accounts for up to 7% of health budgets in middle-income countries. Welfare costs from pollution are estimated to be $4.6 trillion per year – equivalent to 6.2% of global GDP. In the United States, each dollar invested in air pollution control has returned an estimated $30 (USD) in benefits (range, $4 – $88) since 1970. Higher IQs and increased productivity from removing lead from gasoline has returned an estimated $200 billion (range, $110-$300 billion) each year since 1980 ($6 trillion total). The claim that pollution control stifles economic growth and that poor countries must pollute to grow is false. Transition toward a circular economy will reduce pollution-related disease and improve health. Decoupling development from the consumption of non-renewable resources will minimize the generation of pollution and other forms of waste by recycling and reuse.
What’s Novel About the Report’s Findings
This is the first global analysis of the impacts from all forms of pollution (air, water, soil, occupational) together as well as exploring the economic costs and the social injustice of pollution. The economic costs are enormous—$4.6 trillion using welfare cost estimates. The report features solutions and recommends how the problem can be solved. It includes examples and case studies of pollution control success.
The report details gaps in our data and knowledge of pollution’s toll, showing a need for research into soil, heavy metals and chemicals related to the burden of disease as these aspects do not have fully defined risk factors, and therefore are significantly underestimated. Other gaps in knowledge related to exposures, and disease correlations are also indicated, including those associated with developmental neuro-toxicants, endocrine disrupters, new classes of pesticides, chemical herbicides, and pharmaceutical wastes.
It highlights aspects of pollution that have been largely ignored in development circles, despite their significant toll on human health. The report speaks to a broad audience and aims to elevate pollution to an issue of global scale, ready for solutions.
The authorship is rich and deep in policy and political figures as well as academics. Input was provided by major global actors, including World Bank, UNEP, UNDP, European Union, and dozens of bilateral and international organizations, all under the umbrella of the Global Alliance on Health and Pollution.
The preparation of the report already has seeded results. UN Environment’s next global conference will focus exclusively on pollution and the WHO has increased its focus on pollution-related disease. The report has new science. Several sub-risk factors of soil, chemicals and heavy metals have been fleshed out, showing a path for more detailed work in this underserved area.
The connection between pollution and the Sustainable Development Goals is also made, showing pollution playing a part in achieving many aspects of the SDGs. The aim of The Lancet Commission on Pollution & Health is to raise the global awareness, resources and political will needed to address pollution. To advance this aim, recommendations are presented at the conclusion of each section in the report.
Here are the highlighted solutions:
- Six Recommendations from the Report
- 12-Step Roadmap to Pollution Control
- Actions for Governments
- Actions for Donors, Foundations, and Individual Philanthropists
- Actions for People Affected by Pollution
- Examples of Solutions for Mercury and Lead
Six Report Recommendations
Elevate Pollution As A National And International Priority, And Integrate It Into Country And City Planning Processes.
Pollution can no longer be viewed solely as an environmental issue. It now affects the health and well-being of entire societies. Government leaders at all levels should prioritize pollution control within their agendas; integrate pollution control into development planning; and link pollution prevention to commitments on the SDGs, climate change, and non-communicable disease control.
Increase Funding For Pollution Control And Prioritize By Health Impacts
The level of funding for pollution control in low- and middle-income countries is meager and should be substantially increased, both within national budgets and among international development agencies. International support for pollution control is most effective when it leverages additional actions and funding by others. Examples include support for pollution prioritization and planning processes within rapidly industrializing cities and countries; regulatory and enforcement assistance; building technical capacity; and supporting direct interventions to save lives. Financing programs should be monitored to assess cost-effectiveness and to enhance accountability.
Establish Systems To Monitor Pollution And Its Health Effects.
Data collected at the local and national levels are essential for measuring pollution levels, identifying and apportioning pollution sources, evaluating interventions, guiding enforcement, informing civil society and the public, and assessing progress toward goals. The incorporation of new technologies such as satellite imaging and data mining into pollution monitoring can increase efficiency, expand geographic range, and lower costs.
Build Multi-Sectoral Partnerships For Pollution Control.
Inter-agency partnerships and public-private collaborations can proved to be effective tools in the development of clean energy sources and clean technologies that ultimately will prevent pollution at the source. Cross-ministerial collaborations that involve Health and Environment Ministries, but also Ministries of Finance, Energy, Agriculture, Development, and Transport are essential.
Integrate Pollution Mitigation Into Planning Processes For Non-Communicable Diseases.
Interventions against pollution need to be a core component of the Global Action Plan for the Prevention and Control of Non-Communicable Diseases.
Conduct Research Into Pollution’s Impacts And Pollution Control.
Research is needed to understand and control pollution and to support change in pollution policy. Pollution-related research (research of the “pollutome”) should:
- Explore emerging causal links between pollutants, diseases, and subclinical impairment, for example between ambient air pollution and dysfunction of the central nervous system in children and in the elderly;
- Quantify the burden of disease associated with known toxic chemicals such as lead, mercury, chromium, arsenic, asbestos, and benzene.
- Characterize the health impacts from newer chemical pollutants such as developmental neuro-toxicants, endocrine disruptors, novel insecticides, chemical herbicides, and pharmaceutical wastes;
- Identify and map pollution exposures in low- and middle-income countries;
- Improve estimates of the economic costs of pollution and pollution; and
- Improve estimates of the cost of inaction and returns from interventions.
12-Step Roadmap To Pollution Control
The report from The Lancet Commission on Pollution and Health includes short, medium and long-term solutions. Click here to download infographics, see highlights of 12 key strategies for countries and cities to reduce pollution and save lives.
Actions for Governments:
Integrate pollution challenges and control strategies into planning processes;
prioritize programs according to health and economic impact.
Ask for support from development assistance agencies.
Design and implement programs that reduce pollution and save lives.
Actions for Donors, Foundations & Individual Philanthropists:
Include pollution planning, interventions and research in their strategies.
Actions for People Affected by Pollution:
Visit pollution.org to review data related to toxic exposures in their neighborhoods, document and upload their own stories, connect with agencies that can help with solutions.
Examples of Solutions For Mercury and Lead
Pure Earth’s global mercury and lead programs have conducted more than 1,000 field assessments of sites contaminated with lead, more than 500 field assessments of sites contaminated with mercury, and successfully completed multiple cleanups in communities worldwide. The proven strategies that have been developed to eliminate lead and mercury, and to reduce health risks, can be scaled and replicated. Learn more, see project examples, and download our guide.