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Around 300 million children currently live in areas where the air is toxic – exceeding international limits by at least six times

In total, around 2 billion children live in areas that exceed the World Health Organization annual limit of 10 μg/m ³ (the amount of micrograms of ultra‐fine particulate matter per cubic metre of air that constitutes a long term hazard)

Globally, air pollution affects children in low‐ and middle income countries more. Up to 88 per cent of all deaths from illnesses associated with outdoor air pollution16 and over 99 per cent of all deaths from illnesses associated with indoor air pollution occur in low‐ and middle‐income countries.

Asia currently accounts for the vast bulk of total deaths attributable to air pollution. The proportions, however, are changing. In Africa, increasing industrial production, urbanization and traffic is causing the rapid rise of outdoor air pollution. As this happens, the number of African children exposed to outdoor air pollution is likely to increase, especially as the continent’s share of the global child population is set to increase markedly. By midcentury, more than one in three children globally is projected to be African.

Outdoor air pollution tends to be worse in lower‐income, urban communities. Lower‐income areas are often highly exposed to environmental pollutants such as waste and air pollution. Factories and industrial activity are also more common near lower‐income areas, and there is often less capacity to manage waste. This can result in burning, including of plastics, rubber and electronics, creating highly toxic airborne chemicals which are highly detrimental to children. Poorer families are also less likely to have resources for good quality ventilation, filtration and air conditioning to protect themselves from harmful air.

Indoor air pollution is most common in lower‐income, rural areas. Over 1 billion children live in homes where solid fuels are used in cooking and heating. While outdoor air pollution tends to be worse in poor urban communities, indoor air pollution tends to be worse in rural communities where biomass fuels are more frequently used in cooking and heating due to lack of access to other forms of energy.

Source: UNICEF (2016, pp. 8–9).

There is an urgent need to focus on policy measures that derived from UNEP/WMO for HAP as well as, those that may be gleaned from the experiences of LRTAP and its Gothenburg Protocol for their relevance and feasibility for cities in Asia and Africa with a particular focus on India where both HAP and outdoor/ambient air pollution have reached crippling toxic levels. In their analysis of HAP in LMICs, for instance, Ochieng et al. noted that improved biomass cookstoves have for a long time been considered as most immediate policy intervention, but the ability of improved biomass cookstoves to reduce exposure to HAP that meet health standards remains questionable and there is limited evidence as to adoption and use barriers. Ochieng et al. call, therefore, for additional research on policy interventions that can reduce exposure including focusing on poverty eradication as the means to advance towards cleaner energy (Ochieng et al. 2018).

It is also necessary to highlight the massive gaps in knowledge and data on air pollution – indoor and outdoor – directly relevant to developing countries. While studies have examined the relationship between air pollution and cardiorespiratory diseases, there is a shortage of data and assessments of the health risks across regions and within vulnerable populations. Hajat et al. (2015) pointed out that most North American studies have shown that areas where socio‐economically marginalized communities dwell experience higher concentrations of air pollutants. Research from Asia, Africa and other parts of the world has shown a general trend similar to that of North America, but research in these parts of the world is limited (Hajat et al. 2015, p. 440). Lelieveld et al. (2015) pointed out that it has proven difficult to quantify premature mortality related to air pollution, in regions where air quality is not monitored, and also because the toxicity of particles from various sources varies. Using a global atmospheric chemistry model to investigate the link between premature mortality and seven emission source categories in urban and rural environments, outdoor air pollution, mostly by PM_2.5, was estimated to lead to 3.3 million premature deaths per year worldwide, predominantly in Asia. Under a business‐as‐usual emission scenario, the contribution of outdoor air pollution to premature mortality was estimated to double by 2050 (Lelieveld et al. 2015, p. 367). Curbing fossil fuel related air pollution in an urgent global imperative. Access to clean air is directly linked to access to clean energy for households that rely on polluting forms of energy, as well as growing levels of urban outdoor air pollution in many of the most congested and populous cities of the world. The lack of access to clean air and energy is an essential element in not just carbon inequality as defined by Oxfam but also by extension pollution inequality. From the immediate perspective of this book, access to clean air is viewed as fundamental to improving human health and well‐being and poverty reduction. The following section outlines the scope of work undertaken in the remaining chapters.