AQLI 2024 Report English

Index®
AIR QUALITY LIFE INDEX® | 2024
Annual Update
By Michael Greenstone, Tanushree Ganguly, Christa Hasenkopf,
Nishka Sharma and Hrishikesh Gautam
Table of Contents
05 Letter from AQLI
06 At a Glance
08 Section 1 - Global pollution levels drop, but countries fail to
meet their own pollution standards
12 Section 2 - South Asia reverses its trend of year-on-year increase
in pollution, but continues to breathe polluted air
16 Section 3 - Pollution emerging as a major health threat in parts
of Central and West Africa
19 Section 4 - Middle East and North Africa emerges as a new
pollution hotbed
22 Section 5 - Air Pollution remains a Major Burden in Southeast
Asia
26 Section 6 - Most Latin Americans are Breathing Air Exceeding
the WHO Guideline
29 Section 7 - China continues to make progress in reducing
pollution
31 Section 8 - Stricter air pollution standards reveal air pollution
inequalities in the United States and Europe
34 Conclusion
35 Appendix I - Methodology
39 Appendix II - The Evolution of Satellite-Derived PM2.5 Data
40 References
AQLI 2024 Annual Update | 3

ACKNOWLEDGEMENTS
We would also like to deeply thank Prof. Randall Martin, Dr. Aaron van Donkelaar and the Atmospheric Composition Analysis Group at
the University of Washington at St. Louis for their continued partnership in providing us with global satellite-derived annual ground level
PM2.5 data. We would like to acknowledge Aarsh Batra for providing excellent data analysis and Avi Sharma for his support in generating
maps for this manuscript.
Dear Friends and Colleagues,
We’re pleased to bring you the latest data from the Air Quality Life Index (AQLI). This data shows that fine particulate air pollution
remains the greatest external threat to public health. But pollution is also unequally distributed amongst the world, with those
breathing the dirtiest air (top quintile) expected to see almost 3 years cut from their lives if high pollution persists compared to
those breathing the cleanest air (bottom quintile).
In this year’s report we build off a theme from last year: that pollution is unequal because the basic tools and infrastructure
countries have to fight pollution is unequal. The missing tools we highlighted last year focused on funding availability, monitoring
and open data access. To help confront this global challenge, this year we launched a new initiative—the EPIC Air Quality Fund—
to support local groups and organizations in installing monitors and providing open data to communities that could benefit the
most. Providing this data allows citizens to understand the depth of the pollution problem where they live and call for change.
Open access to data also provides a necessary guidepost for setting and evaluating air quality standards—the theme of this
year’s report. Our report shows that if countries adopt ambitious standards and implement policies to achieve them, global
life expectancy would significantly improve. These standards—some strong and some weak—reflect the multiple policy goals
countries have as they balance economic, environmental, and health goals. However, more than three-quarters of countries and
territories around the world are not meeting their national pollution standards or have not even set a standard.
While the AQLI Annual Report highlights where standards have not been met, and policies are failing, it’s important to also
highlight the success stories that can aid other parts of the world. Throughout history countries like the United States, Europe,
Japan, and, most recently, China have been able to significantly reduce air pollution thanks to strong policies (policies that came
only after a persistent, public call for change). China, for example, now meets its national standard and residents are living two
years longer because of the policy changes that have significantly reduced pollution since the country declared a war against it
in 2014. Building on this success, China is now aiming for a further 10 percent reduction in particulate concentrations across its
prefectures by 2025, compared to 2020 levels.
India’s national standard is similar to China’s, but only 60 percent of the population breathes air that meets this standard.
Fortunately, India is responding by implementing innovative policies. In 2019, the state of Gujarat—in collaboration with
Greenstone and colleagues—launched the world’s first market for particulate pollution. The market has since reduced pollution
by 20-30 percent in the city of Surat, and is rapidly expanding to other cities and states. These types of innovative policies
demonstrate that it is possible to achieve improvements in air quality and people’s health, without unduly impeding economic
growth (in this case, it increased economic growth).
EPIC will continue to bring data about the pollution people breathe to communities who would benefit the most through our Air
Quality Fund, effectively communicate how this pollution impacts their health through the AQLI, and work with governments
on the ground to devise and test policies that reduce this pollution at the least cost. This multi-pronged strategy aims to not just
expose the problem—that widespread pollution is causing the average person on the planet to lose 1.9 years off their life—but to
also help solve it.
Sincerely,
Michael Greenstone Christa Hasenkopf Tanushree Ganguly

Milton Friedman Director, Clean Air Program Director, AQLI
Distinguished Service Professor EPIC EPIC
Director, EPIC

At a Glance
While global pollution declined slightly in 2022, it is still the When countries enforce and meet their national standards,
greatest external threat to human life expectancy. life expectancy improves.
• The AQLI’s 2022 data reveals that permanently reducing global • Because of stringent policies, the United States and Europe have
PM2.5 pollution to meet the World Health Organization (WHO) significantly reduced pollution—now accounting for only 3.9
guideline of 5 µg/m³ would add 1.9 years onto average human life percent of the health burden from particulate pollution globally.
expectancy—or a combined 14.9 billion life years. Both regions have introduced or enacted even more stringent
standards over the last year, which if met would result in an
• The impact of PM2.5 on global life expectancy is comparable average gain in life expectancy of 1.3 months and 4 months in the
to that of smoking, 1.3 times that of childhood and maternal United States and Europe, respectively.
malnutrition, 4.4 times that of high alcohol use, 5.8 times that
of transport injuries like car crashes and unsafe water, and 6.7 • China has also succeeded in meeting its national standards.
times that of HIV/AIDS.1 Residents are now living 2 years longer because of the policy
changes that have significantly reduced pollution since the
Pollution is highly unequal around the world, and so are policy country declared a war against it in 2014.
ambitions.
• While India’s national standard is similar to China’s, only 60
• People in the most polluted areas of the world breathe air that is percent of the population breathes air that meets this standard.
six times more polluted than those in the least polluted areas. As Fortunately, India is responding by implementing innovative
a result, their life expectancy is reduced by an average of 2.7 years policies. In 2019, the state of Gujarat launched the world’s first
compared to those living in the cleanest places. market for particulate pollution. The market has since reduced
pollution by 20-30 percent in the city of Surat and is rapidly
• National air quality standards—an important tool to set strong
expanding to other cities and states.
policies—vary significantly, with some countries enforcing strict
limits as low as the WHO guideline, others setting looser limits Many countries without national standards are highly polluted
up to 50 µg/m³, and some having no standards at all. and lack critical tools.
Many countries with national standards are not meeting them, • More than half of all countries and territories around the
impacting life expectancy. world—158 out of 252—don’t have a pollution standard at all.
Those countries make up 12.4 percent of the health burden from
• Ninety-four out of 252 countries and territories globally have
particulate pollution globally. Only one-third of the countries that
national standards, making up 80 percent of the world’s
don’t have standards show evidence of government monitoring,
population.2 However, 37 of those countries aren’t meeting them,
and less than 1 percent of these countries have fully open data.
making up 30 percent of the world’s population.
With little data, it is difficult to set pollution standards and
• If all countries and territories with standards met them, the enforce them.
average person living in these regions would add 1.2 years onto
• To help confront this challenge, this year EPIC launched the
their lives.
EPIC Air Quality Fund to support local groups and organizations
in installing monitors and providing open data to communities
1 Global Burden of Disease (https://vizhub.healthdata.org/gbd-results/) level-2 that could benefit the most.
causes and risks data and WHO Life Tables (https://apps.who.int/gho/data/
node. main.LIFECOUNTRY?lang=en) were combined with the Life table method The decline in global pollution in 2022 was due almost entirely
to arrive at these results. “PM2.5 relative to WHO Guideline” bar displays the
reduction in life expectancy relative to the WHO guideline as calculated by latest
to a trend reversal in South and Southeast Asia, while pollution
AQLI (2022) data is on the rise in the Middle East and North Africa and Sub-
2 AQLI’s compilation of country-level national ambient PM2.5 standards can be Saharan Africa.
found here (Country_annual_average_pm2.5_standards_July2024 - Google
Sheets). The information in this sheet is updated to the best of our knowledge. • Global pollution declined in 2022 almost entirely due to a
We encourage readers to reach out if information provided here is incorrect,
missing, or has been updated. trend reversal in South Asia—with an 18 percent decline in
6 | 2024 Annual Update AQLI

Potential gain in
life expectancy
(in years)
≥6.0
5.0
4.0
3.0
2.0
1.0
0.5
0.1
pollution over one year (and to a lesser extent, Southeast Asia, would gain 1.3 years of life expectancy.
with a 4.8 percent decline). Though it is difficult to conclusively
determine the reasons for this decline, meteorological causes— Pollution is on par with known threats to life in local regions.
such as above normal rainfall—likely played a strong role. While
• In Central and Western Africa, air pollution is now as much of a
pollution declined slightly, the region remains the most polluted
health threat as well-known killers in the region like HIV/AIDS,
in the world, with residents set to lose 3.5 years of life expectancy
malaria and unsafe water. An average resident of this region will
if South Asia does not meet the WHO guideline.
lose 1.7 years off their lives if pollution persists at current levels.
• While pollution declined in the South and Southeast Asia,
• The health threat posed by particulate pollution is greater or
pollution levels increased across the Middle East and African
comparable to that of suicide and violence in many parts of South
continent.3 In the Middle East and North African (MENA)
America. For example, in Boliva—the most polluted country in
regions, concentrations increased by 13 percent. If pollution were
Latin America—its toll on life expectancy is nine times higher
reduced to meet the WHO guideline, people living in this region
than that of suicide and violence. In Colombia, the impact is
3 All region definitions used in this report can be found here: AQLI AR 2024 about comparable.
Regions - Google Sheets

Section 1
Global pollution levels drop, but

countries fail to meet their own
pollution standards
PARTICULATE POLLUTION DROPPED FROM PREVIOUS fairly constant over the past two decades, with pollution declining
YEARS BUT IS STILL FAR FROM SAFE: 2022 GLOBAL UPDATE in some regions and increasing in others. While China’s decline in
pollution continued in 2022—reducing its pollution by 41 percent
New and revised satellite-derived PM2.5 data show a reduction in
since it began its “war on pollution” and extending its population’s
global population-weighted PM2.5 levels—reducing from 26.6 µg/m³
average life expectancy by 2 years if sustained— South Asia made a
in 2021 to 24.2 µg/m³ in 2022. The AQLI shows that reducing global
significant trend reversal in 2022 (Figure 1.2). Instead of its pollution
PM2.5 pollution to meet the WHO guideline would add 1.9 years onto
steadily increasing as it has for at least the last two decades, the
average life expectancy, translating to a total gain of 14.9 billion
region saw a sharp decline in pollution of 18 percent from 2021 to
years—making particulate pollution the greatest threat to human
2022 (50.7 to 41.4 µg/m³) . Had the pollution levels in South Asia not
health. This burden of particulate pollution on life expectancy
declined, global pollution levels would have remained the same as
is comparable to that of tobacco use, 1.3 times that of childhood
last year.
and maternal malnutrition, 4.4 times that of high alcohol use, 5.8
times that of transport injuries or unsafe water, handwashing The South Asian decline from 2021 to 2022 is the largest single year
and sanitation, 6.7 times that of HIV/AIDS, and 26.7 times that of decline for a region in the data since the beginning of its collection
nutritional deficiencies (Figure 1.1). in 1998. If the decline is sustained, it would translate into 0.9 years
of life expectancy gained compared to 2021 levels.
PROGRESS IN SOUTH ASIA, BUT HIGHER AIR POLLUTION IN
AFRICA AND THE MIDDLE EAST With the evidence currently available, it is difficult to conclusively
determine what accounts for reduced particulate pollution levels
Global particulate pollution concentrations continue to remain
in South Asia in 2022. PM2.5 concentrations were lower in all South
Figure 1.1 · Selected major threats to life expectancy
Sources: Global Burden of Disease (https://vizhub.healthdata.org/gbd-results/) level-2 causes and risks data and WHO Life Tables (https://apps.who.int/gho/data/
node. main.LIFECOUNTRY?lang=en) were combined with the Life table method to arrive at these results. “PM2.5 relative to WHO Guideline” bar displays the reduction
in life expectancy relative to the WHO guideline as calculated by latest AQLI (2022) data

Figure 1.2 · Global and select regional annual average PM2.5 concentrations, 1998-2022
Note: South Asia is defined as the following countries: Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, Sri Lanka. Rest of the World refers to all regions
across the globe except South Asia and China. Middle East & North Africa (MENA) is defined as the following countries: Algeria, Bahrain, Egypt, Iran, Iraq, Israel, Jordan,
Kuwait, Lebanon, Libya, Morocco, Oman, Qatar, Saudi Arabia, Syria, Tunisia, United Arab Emirates, Palestine, and Yemen. Rest of the world doesn't include South Asia,
China and MENA
Asian countries except Sri Lanka. At the country level, the highest increased particulate concentrations in 2022, pollution in the region
decline was observed in Bangladesh followed by India and Nepal. has been attributed to road vehicles, municipal solid waste burning,
In some districts of Dhaka and Chittagong in Bangladesh and West agriculture and industrial processes.6 People in this region could
Bengal and Jharkhand in India, reductions in PM2.5 concentrations live 1.3 years longer than if they were to breathe air that complies
relative to 2021 are higher than 20 µg/m³. with the WHO guideline.
Recent evidence from India4 suggests that favorable meteorological WIDESPREAD DIFFERENCES IN AIR QUALITY STANDARDS AND
conditions amplified the impact of the small decreases in emissions DIFFICULTIES IN ENFORCING STANDARDS
of PM2.5 particles and PM2.5 precursors (SO2, NOx, NH3) in the country.
This coupled with the fact that the decline was region-wide, suggests Whether pollution is increasing or decreasing, it’s clear that some
that meteorology could have played a significant role in reducing regions of the world are much more polluted than other regions.
pollution levels across South Asia. Evidence also points to above People living in the most polluted places (the top quintile) breathe
normal rainfall in many parts of South Asia in 2022 5 and higher air that is six times more polluted than the air breathed by those
precipitation has been linked with lower pollution levels. While living in the least polluted places (bottom quintile) (Figure 1.3). That
it is difficult to conclusively determine what reduced PM2.5 levels means that pollution in the most polluted places is cutting 2.7
across South Asia, it is safe to posit that favorable meteorological more years off the lives of those living in them compared to those
conditions may have played a part. Moving forward, continued in the cleanest places.
observations, efforts towards policy enforcement and monitoring
While geographic terrain and meteorological factors can have an
impacts of policy interventions will be critical for understanding
influence on pollution, varying policy ambitions in the form of
and sustaining these reductions.
clean air standards or emission reduction goals—and the ability of
Despite this improvement, South Asia remains the world’s most countries to enforce them—are a primary determinant of pollution
polluted region, with residents breathing air that is eight times more levels. Policy ambitions vary significantly among countries, with
polluted than what the WHO has deemed safe. If pollution were some countries setting strict national air quality standards, others
permanently reduced to meet the WHO guideline, people living in setting weaker ones, and still others setting none (Figure 1.4a). A
this region could see 3.6 years added onto their lives. national air quality standard is critical to efforts to reduce pollution
because it allows policymakers to have a guidepost to use to set
While news from South Asia—the most widely covered region policy goals and evaluate their success. Out of the 252 countries
in the media for its air pollution challenges—was positive, PM2.5 and territories analyzed in this report, 94 countries that are home
estimates suggest that the Middle East and North Africa is emerging to more than 81 percent of the world’s population have air quality
as a pollution hotspot. PM2.5 in this region increased by 13 percent standards for PM2.5.7
compared to 2021. While difficult to conclusively determine what
Of course, countries set air quality standards to reflect multiple
4 Yuanyu Xie, Mi Zhou, Kieran M. R. Hunt, and Denise L. Mauzerall. 2024. “Recent
PM2.5 air quality improvements in India benefited from meteorological variation” 6 World Bank. 2022. “Middle East And North Africa Development Report: Blue
Nature Sustainability (2024). https://doi.org/10.1038/s41893-024-01366-y Skies, Blue Seas Air Pollution, Marine Plastics, and Coastal Erosion in the Middle
5 World Meteorological Institute. 2023. “State of Climate in Asia in 2022” https:// East and North Africa” https://openknowledge.worldbank.org/server/api/core/
wmo.int/publication-series/state-of-climate-asia-2022 https://doi.org/10.1016/j. bitstreams/9125cb69-90b8-53b0-b645-800b33e9d1ee/content
scitotenv.2024.170963 7 Refer Footnote 2

Figure 1.3 · Difference in life expectancies of the least and most polluted regions across the world
national policy goals. For example, they may perceive that the costs on ways in which standards can be better enforced.
from stricter air pollution policies in terms of industrialization and
economic prosperity may exceed the benefits in their countries. These are just a few examples of the many considerations that play
There are also a variety of distributional considerations—factors into a country's decision making around ambient air quality
related to fairness and equity—that enter countries' decision- standards, thereby, resulting in countries having different
making. standards. South Asia is a good example of these nuances. In India,
where the annual PM2.5 standard is 40 µg/m³, more than 40 percent
Countries have differing degrees of success in achieving their of the population breathes air that exceeds the standard. In 2021,
standards. The enforcement of standards requires commitment Bangladesh revised its annual PM2.5 standard from 15 µg/m³ to 35
to enforce reductions on a multitude of polluters, both mobile (e.g., µg/m³. In 2022, 96.8 percent of Bangladesh’s population breathed
vehicles) and stationary (e.g., factories and power plants). This can air that did not meet this revised standard. In Pakistan, where
be especially challenging in countries with weaker state capacity. pollution levels are like those in India and Bangladesh, the PM2.5
Indeed, countries’ track records are quite mixed. For instance, in standard is much stricter (set at 15 µg/m³), and virtually the
India, environmental regulatory institutions are often viewed as country’s entire population breathes air that doesn’t meet the
suboptimal.8 Despite similar governance structures for air and standard.
water pollution in India, their effectiveness varies significantly.
Air pollution regulations have proven more impactful compared 37 out of the 94 countries and territories with standards—home
to water pollution regulations. This discrepancy is attributed to 30 percent of global population—don't meet their national
to greater citizen engagement and judicial intervention in air standards (Figure 1.4b). If they did, an average person living in these
pollution issues compared to water pollution.9 countries could live 1.17 years longer. Iraq, Bangladesh, and Pakistan
would see the highest benefits, with life expectancies increasing
Further, environmental standards can often have unintended by 2.2 years, 1.9 years, and 2.3 years, respectively (Figure 1.4c).
consequences. In the case of tightening vehicle exhaust emission
standards in the United States, it has been found that while the However, the ability to meet standards is a problem even in regions
new standards have been effective in reducing emissions from new of the world that are cleaner and that have stronger limits. While
vehicles, they have made new cars more expensive — increasing the European Union has recently set a much stricter 2030 target
the demand for older, dirtier vehicles as an alternative. It has been of 10 µg/m³ for PM2.5, the pollution levels in the countries of Bulgaria,
estimated that more than two-thirds of pollution emissions in a Croatia, Cyprus, Czechia, Greece, Hungary, Italy, Latvia, Poland,
year can be attributed to vehicles older than 10 years.10 This makes Romania, Slovakia, and Slovenia, exceed this tighter standard. More
a case for assessing effectiveness of tighter standards and focusing than 75 percent of the population in these countries breathes air
that doesn’t meet the standard. If these countries were to meet
8 Center for policy research. 2022. “The State of India’s Pollution Control this 2030 PM2.5 limit, the life expectancy of an average resident in
Boards – A Series of Papers” https://cprindia.org/workingpapers/
these countries could go up by 4 months.
the-state-of-indias-pollution-control-boards/
9 Michael Greenstone, and Rema Hanna. 2014. “Environmental Regulations, Air
A standard—even one not quite achieved yet—is still better than
and Water Pollution, and Infant Mortality in India” American Economic Review
2014, 104(10): 3038–3072” https://www.theigc.org/sites/default/files/2016/06/ no standard at all. While 94 countries and territories have a standard,
Greenstone_Hanna.pdf even more—158—do not have a standard. Countries like the
10 Kleiman center for energy policy. 2022. “How Effective Are Vehicle Exhaust Republic of Congo, Cameroon, and Equatorial Guinea––where
Standards?” https://kleinmanenergy.upenn.edu/wp-content/uploads/2022/12/
KCEP-Digest-How-Effective-Are-Vehicle-Exhaust-Standards.pdf
pollution is among the highest in the world—do not have a pollution
standard. The fact that one-third of the countries without air quality

Figure 1.4a · Patchwork of standards
Ambient Annual
PM2.5 standard
(µg/m³)
40-50
30-40
20-30
10-20
5-10
Does not have

a standard
standards show no evidence of government monitoring, and less show that even without them, many countries still fail to meet their
than 1 percent have open data, further compounds the challenge national standards.
of setting and enforcing standards.
The remainder of this report will describe how pollution levels have changed
It's important to note that particulate concentrations used to assess over time in different parts of the world, briefly explore relevant policy measures
compliance with national air quality standards exclude that countries have implemented, and highlight how people across the globe
contributions from dust and sea salt. While these components are would live longer if they were to breathe cleaner air.
not excluded in regulatory compliance assessments, our findings
Figure 1.4b · Countries meeting and not meeting their national air quality standards
Meets Air Quality Standard?

Yes
No
No data
Does not have a standard
Figure 1.4c · Potential gain in life expectancy if countries were to meet their own PM2.5 standards1
Potential gain in
life expectancy
(in years)
4 to < 5
3 to < 4
2 to < 3
1 to < 2
0.5 to < 1
0.1 to < 0.5
0 to < 0.1
Does not have

a standard
1 Particulate concentrations used to assess compliance with national air quality standards exclude contributions from dust and sea salt

Section 2
South Asia reverses its trend

of year-on-year increase in
pollution, but continues to
breathe polluted air
After a decade of continued increase, pollution declined in South Asia in 2022.
Still, people living in the region continue to breathe polluted air—with levels
almost 8.5 times higher than the WHO guideline. Sustained exposure to such
particulate pollution is projected to reduce the life spans of South Asians by
3.5 years. The toll is even greater in the most polluted areas..
South Asia breathed cleaner air in 2022 relative to the average form of above normal precipitation and reduced number of thermal
particulate pollution levels over the last decade.11 Between 2012 inversions12 in 2022 have been found to have amplified the impact
and 2021, the PM2.5 levels in South Asia have averaged 48 µg/m³. In of the small decreases in emission controls from the residential and
2022, the PM2.5 levels were 41.4 µg/m³— an approximate 14 percent transport sectors in India. 13, 14 The decline in emissions from the
decline compared to the decade’s average—which is equivalent to residential sector in India can largely be attributed to the nation-
a potential gain in life expectancy of 7.9 months, if these reductions wide roll out of India’s clean cooking programme, the Pradhan
are sustained. Mantri Ujjwala Yojana, and the reduction in transport-related
emissions have been attributed to the decrease in use of diesel in
Relative to 2021, PM2.5 levels were lower in all South Asian countries the transport sector. In districts home to cities covered by India’s
with the exception of Sri Lanka. The decline in Bangladesh was the flagship programme on air quality management, National Clean
steepest, where annual PM2.5 concentrations were lower by more Air Programme (NCAP), PM2.5 concentrations declined by 19 percent
than 15 µg/m³. Bangladesh was followed by India and Nepal where on average and in the districts not covered by the programme stood
concentrations were lower by approximately 9 µg/m³. In Pakistan, at 16 percent. Barring Dhanbad, none of the districts with the
the concentrations were lower by 4 µg/m³. highest decline in PM2.5 concentrations are covered by the NCAP
framework.
Within Bangladesh, the highest declines were observed in districts
of Chandpur, Shariatpur, Madaripur, Gopalganj and Madira— Additionally, the World Meteorological Organisation has linked
with PM2.5 concentrations dropping by over 20 µg/m³ in each of La Niña conditions with above normal rainfall over parts of South
these districts. In India, the highest declines were observed in
the Purulia and Bankura districts of West Bengal, followed by the
Dhanbad, Purbi and Paschim Singhbhum, Paschim Medinipur, 12 A thermal inversion layer is a layer in the atmosphere in which air temperature
and Bokaro districts in Jharkhand. In each of these districts, PM2.5 increases with height -c contrary to the normal tendency of the atmosphere to
cool with increase in altitude. These inversion layers restrict upward movement
concentrations dropped by over 20 µg/m³. of air-trapping pollutants near the ground, thereby increasing ground-level
pollution concentrations.
It is difficult to precisely determine what improved South Asia’s 13 Refer Footnote 4
air quality in 2022, but favorable meteorological conditions in the 14 Gufran Beig , V Anand , N Korhale , S B Sobhana , K M Harshitha , R H Kripalani.
2024. “Triple dip La-Nina, unorthodox circulation and unusual spin in air quality
11 South Asia is defined as the following 8 countries: Afghanistan, Bangladesh, of India” Science of Total Environment , Volume 920, 10 April 2024, 170963
Bhutan, India, Maldives, Nepal, Pakistan, Sri Lanka. https://doi.org/10.1016/j.scitotenv.2024.170963

Figure 2.1 · Potential gain in life expectancy from permanently reducing PM2.5 from 2022 concentration to the WHO guideline
Potential gain in
life expectancy
(in years)
≥6.0
5.0
4.0
3.0
2.0
1.0
0.5
0.1
Asia during the summer-monsoon season.15 Pakistan was ravaged than at the turn of the century. Had pollution levels in 2000
by severe floods in August 2022. In addition to a heavy monsoon remained constant over time, the residents in these countries would
spell, Bangladesh experienced a cyclonic storm and heavy rainfall be on track to lose 2.8 years of life expectancy—not the 3.5 years that
in October 2022 and flood events in June and July. Afghanistan they stand to lose in 2022.17
experienced flood events in May.
Bangladesh has consistently emerged as the most polluted
Available evidence explaining the reduction in India’s PM2.5 levels South Asian country. Despite a 20 percent decline in particulate
and the region-wide decline in South Asia suggests favorable concentration in 2022 relative to 2021, Bangladesh’s annual average
meteorology may have contributed to the decline in South Asia’s PM2.5 level was 54.2 µg/m³ in 2022—more than 10 times the WHO
PM2.5 concentrations in 2022. These favorable conditions may not guideline. Home to 166.4 million people, the average resident
persist year to year, and especially under expected future climate in Bangladesh is likely to lose 4.8 years of life expectancy if the
changes, suggesting that these reductions may be temporary.16 pollution level persists. In Dhaka, the capital of Bangladesh and the
This reinforces the need for sustained policy measures aimed at second most polluted megacity in the world, with an annual average
emission control across the South Asian region. particulate pollution of 61.7 µg/m³—more than 12 times the WHO
guideline—an average resident would live 5.6 years longer if the
Despite having cleaner air compared to previous years, South particulate levels met the WHO guideline. In the most polluted part
Asia remains the world’s most polluted region, accounting for 45 of the country—Gazipur district in the Dhaka division—residents
percent of the total life years lost globally due to high pollution. would live 6.3 years longer if the WHO guideline was permanently
Bangladesh, India, Nepal, and Pakistan—where 23.2 percent of the met. Even in the least polluted part of the country––Sylhet district
global population lives—are among the most polluted countries in in the Sylhet division—residents are losing more years of life
the world. In each of these four countries, the impact of particulate expectancy than the global average compared to if they were to
pollution on life expectancy is substantially higher than that of permanently meet the WHO guideline (2.8 years vs. 1.8 years).
other large health threats (Figure 2.2). Tobacco use, for instance,
reduces life expectancy in these countries by as much as 2 years; Although Bangladesh is the most polluted country overall, India
unsafe water and sanitation by as much as 1 year; and alcohol use faces the highest health burden of air pollution on account of the
by half a year. large population that is exposed. Despite a 19.3 percent drop in
particulate levels in 2022 compared to 2021, an average resident
The average resident of Bangladesh, India, Nepal, and Pakistan is in India is likely to lose 3.4 years of life expectancy if pollution
exposed to particulate pollution levels that are 22.3 percent higher levels persist. The most polluted region of India is the Northern
15 Refer to Footnote 4
16 Refer to Footnote 4 17 2022 is the latest year for which AQLI satellite derived PM2.5 data is available.

Figure 2.2 · Comparison of selected major global threats to life expectancy in South Asian countries
node.main.LIFECOUNTRY?lang=en) were combined with the Life table method to arrive at these results. "PM2.5 relative to WHO Guideline” bar displays the reduction
in life expectancy relative to the WHO guideline as calculated by latest AQLI (2022) data.
Plains18, home to more than a half-billion people and almost 40 guideline. Those in Peshawar, the most polluted city in the country,
percent of the country’s population. In 2022, particulate levels in would gain 5.6 years.
this region were lower by 17.2 percent relative to 2021 levels. If these
levels are sustained in the years to come, the life expectancy in the While the South Asian region did see a decline in pollution
Northern Plains could increase by 1.2 years. Although 2022 was levels in 2022 relative to 2021, it’s too soon to see if this is the
cleaner compared to previous years, the average resident in this beginning of a larger trend. Stepping back, pollution levels have
region is still likely to lose about 5.4 years of life expectancy if the consistently increased in the region over the last two decades.
pollution level persists—which implies that there is significant Rapid industrialization, economic development, and population
scope for further strengthening mitigation efforts. growth have led to skyrocketing energy demand and fossil fuel use
across the region. In India and Pakistan, the number of vehicles
Beyond the Northern Plains, the states of Maharashtra, Madhya on the road has increased about fourfold since the early 2000s.
Pradesh and Rajasthan have the highest burden of pollution in the The number of vehicles roughly tripled in Bangladesh from 2010
country. On average, the 292.3 million people living in these states to 2020.19 In Bangladesh, India, Nepal, and Pakistan combined,
are now losing 2.9 years of life expectancy. electricity generation from fossil fuels tripled from 1998 to 2017.20
Crop burning, brick kilns, and other industrial activities have also
In Nepal, where the PM2.5 concentration was 39.2 µg/m³ in 2022 contributed to rising particulate emissions in the region.
—18.2 percent lower relative to 2021, the average resident would
live 3.4 years longer if the country met the WHO guideline. In the The increase in energy use has led to higher living standards and
most polluted parts of the country, like the districts of Mahottari economic output, which have greatly enhanced well-being. But
and Rautahat, residents stand to gain more than 5.3 years of life the concomitant rise in particulate pollution has had serious
expectancy from cleaner air. consequences. Given the energy demand in non-OECD regions is
In Pakistan, where the PM2.5 concentration was 38.9 µg/m³ in 2022

19 India Ministry of Statistics and Programme Implementation. 2017. “Motor
—10 percent lower compared to the particulate levels in 2021, vehicles – Statistical year book India 2017. Table 20.4.”; Pakistan Statistical
the average resident would gain 3.3 years from meeting the WHO Pocket Book. 2006. “Table 17.5.” and Pakistan Today. 2019. “Registered vehicles
in Pakistan increased by 9.6% in 2018.”; Bangladesh Road Transport Authority.
18 We define this region as the following seven states and union territories: Bihar, 2020. “Number of registered vehicles in the whole BD.”
Chandigarh, Delhi, Haryana, Punjab, Uttar Pradesh, and West Bengal. 20 U.S. Energy Information Administration. “International: Electricity [Data set].”

projected to grow, the threat of air pollution will also grow without Nepal has instituted an Air Quality Management Action Plan
concerted policy action.21,22 for Kathmandu Valley.27 The plan uses an integrated urban air
quality management framework and calls for incorporating air
Fortunately, awareness around air pollution is increasing in these quality objectives with sectoral policies. The plan also identifies
countries, and governments are beginning to respond. transport, brick manufacturing, and construction as the most
polluting industries, and adopted measures to strengthen air quality
In Bangladesh, the most polluted country in the region and the
monitoring, develop emissions inventory, and conduct impact
world, the Ministry of the Environment, Forest and Climate Change
assessments along with specific policies for a sustainable transport
published the Air Pollution (Control) Rules 2022. These rules are
system, emissions reduction, and eco-friendly construction.28
established under the “Bangladesh Environment Conservation
Act 1995” and create the National Air Quality Control Plan and the In Pakistan, the government began installing more pollution
Air Pollution Prevention Plan, identify air pollution activities, and monitors29 and shutting down factories in highly polluted districts
establish standards for emissions from industry, automobiles, and during the winter months when energy demand for heating is
specific projects (power generation, textiles, cement, fertilizers, high.30 Similar to Bangladesh, the Government of Pakistan has
etc.).23 In Dhaka, Bangladesh, where brick kilns are responsible for also encouraged brick kiln owners to shift to cleaner technologies.
58 percent of the particulate pollution, the law governing brick kiln
production was amended in 2019 to prohibit the establishment Although inconclusive, available evidence suggests that favorable
of brick kilns near residential, commercial, agricultural, and meteorological conditions in 2022 contributed to the reduction in
environmentally sensitive areas.24 In addition, the government is PM2.5 levels across the South Asia region. Given meteorology-linked
planning to phase out the use of bricks in favor of concrete blocks improvements may be temporary, continued efforts towards policy
by 2025 in order to lessen the damage to both the quality of the enforcement and rigorous monitoring of impact of these measures
air and topsoil.25 Further, Bangladesh’s real-time air pollution will be critical to sustain these reductions.
measurements now cover eight of its cities with plans to extend
it to five more cities. 26
In India, the country with the highest health burden of pollution

in South Asia, the Government launched its National Clean Air
Programme (“NCAP”) in 2019 with the stated goal of reducing 2017
particulate pollution levels by 20 to 30 percent by the year 2024. In
2022, the Government of India revamped its NCAP goal, aiming to
achieve a 40 percent reduction in particulate pollution levels by
2026 in 131 non-attainment cities. If India were to meet this target,
the residents in the non-attainment will see their life expectancy
increase by 2 years compared to 2017. India’ national average life
expectancy will also increase by an additional 7.8 months as a result.
As of 2022, pollution in the districts with non-attainment cities has
declined by 18.8 percent relative to 2017, adding 10.8 months to the
life expectancy of 446.7 million residents of these districts, and 4
months to India’s national average life expectancy.
21 S & P Global. 2021. “Global energy demand to grow 47% by 2050, with oil
still top source: US EIA” https://www.spglobal.com/commodityinsights/en/
market-insights/latest-news/oil/100621-global-energy-demand-to-grow-47-by-
2050-with-oil-still-top-source-us-eia
27 Kathmandu Valley is defined as the following districts: Kathmandu, Lalitpur,
22 U.S. Energy Information Administration. 2023. “International Energy Outlook Bhaktapur
2023” https://www.eia.gov/outlooks/ieo/pdf/IEO2023_Narrative.pdf
28 Nepal Ministry of Populations and Environment, Department of
23 Enviliance Asia. 2022. “Bangladesh publishes Air Pollution Control Rules Environment. 2017. “Air Quality Management Action Plan for Kathmandu
including emission standards for mobile and stationary” https://enviliance.com/ Valley” https://doenv.gov.np/progressfiles/Final-Report-on-AQM-Action-
regions/south-asia/bd/report_7939 Plan-2017-42479-32168-1663670175.pdf
24 Dhaka Tribune. 2019. “Environment minister: Brick kilns responsible for 58% air 29 Hindustan Times. 2019. “Pakistan works with India to set up real-time air quality
pollution in Dhaka.” monitors” https://www.hindustantimes.com/cities/pakistan-works-with-india-
25 The Daily Star. 2019. “Checking Air Pollution: Bye bye brick!” to-get-air-quality-monitors/story-udFjR143uXVcz8Cwd2AUhI.html
26 Bangladesh Ministry of Environment, Forest and Climate Change. 2018. “Ambient 30 AlJazeera. 2021. “Pakistan’s anti-smog squads target Lahore fac-
Air Quality in Bangladesh.” The 8 cities are as follows: Dhaka, Chittagong, tories for emissions”https://www.aljazeera.com/news/2021/11/25/
Narayanganj, Gazipur, Khulna, Rajshahi, Barisal and Sylhet. The 5 cities where pakistan-anti-smog-squads-lahore-factories-pollution
expansion is planned are: Savar, Narsindhi, Comilla, Mymensingh, Rangpur

Section 3
Pollution emerging as a major

health threat in parts of Central
and West Africa
In the most polluted regions of Sub-Saharan Africa, particulate pollution
is cutting life expectancy by as much as 5.1 years. This toll is higher than
that of other health threats like HIV/AIDS, Malaria and unsafe water,
sanitation and handwashing.
Unlike the reduced pollution levels in South Asia and Southeast In the Central and West Africa region—home to 660.5 million
Asia, 2022 did not bring substantial changes to the quality of air people across 27 countries—PM2.5 levels have remained between
in the Central and West African region. The population weighted- 20 µg/m³ and 22 µg/m³ since 1998. An average resident of this
average PM2.5 concentration in 2022 was nearly identical to the region can lose 1.7 years off their lives, translating to 1.9 billion
average level in 2021, at 22.2 µg/m³—4.4 times the WHO guideline.31 total life years lost, if these levels of pollution persist. In Menoua,
Cameroon—the most polluted region—the life expectancy losses
31 Central Africa is defined as the following 11 countries: Angola, Burundi, are as high as 5.1 years (Figure 3.1), comparable to the losses in the
Cameroon, Central African Republic, Chad, Republic of the Congo, Democratic
Republic of the Congo, Equatorial Guinea, Gabon, São Tomé and Príncipe,
most polluted regions in the world.
Rwanda. West Africa is defined as the following 16 countries: Benin, Burkina
Faso, Cabo Verde, Gambia, Ghana, Guinea, Guinea-Bissau, Côte d'Ivoire, Liberia, The Democratic Republic of the Congo (DRC) was the most polluted
Mali, Mauritania, Niger, Nigeria, Senegal, Sierra Leone, Togo.
Potential gain in
life expectancy
(in years)
≥6.0
5.0
4.0
3.0
2.0
1.0
0.5
0.1

Figure 3.2 · Comparison of selected major global threats to life expectancy in the five most populous countries in Central and West Africa
node.main.LIFECOUNTRY?lang=en) were combined with the Life table method to arrive at these results. “PM2.5 relative to WHO Guideline” bar displays the reduction
country on the African continent in 2022, with an annual-average m³—5 times the WHO guideline. As a result, residents of Nigeria
particulate concentration of 34.7 µg/m³, or nearly 6.9 times the are losing 2 years off their lives compared to if air quality met the
WHO guideline. As a result, average life expectancy is 2.9 years WHO guideline. Cumulatively, Nigeria’s life years lost to pollution
lower than what it would be if the country met the WHO guideline. make up more than 20 percent of the total life years lost in all of
Africa. In the Federal Capital Territory, home to Nigeria’s capital
In Kinshasa, the capital and largest city of the DRC with 12.3 million city of Abuja and one of the most polluted regions in the country,
people, residents are losing 3.3 years of life expectancy relative to residents could gain 2.7 years of life expectancy if particulate
if the city met the WHO guideline. Further, a cluster of regions to pollution were permanently reduced to meet the WHO guideline.
the east of Kinshasa—namely, Mai-Ndombe, Kwilu, and Kasaï—
experience even higher levels of pollution, leading residents there In Lagos, Nigeria’s largest city with 21.6 million people, residents
to lose 3.7 to 3.9 years off their lives. In these regions, high air could see their life expectancy increase by 1.7 years if particulate
pollution levels have been largely attributed to waste burning, pollution were permanently reduced to meet the WHO guideline.
mining, and industrial practices such as mineral processing and Following the trend from previous years, Niger River Delta—where
cement manufacturing. Moreover, with the prevalence of dirty oil refineries are linked to the grim daily reality of air pollution—
indoor cookstoves, residents face additional exposure to high levels faces the highest health burden due to pollution in Nigeria.33 With
of air pollution indoors as well.32 an average pollution of 31.3 µg/m³, residents in these states are
losing 2.6 years of life expectancy, relative to the WHO guideline.
Following the DRC, Burundi, Rwanda, Equatorial Guinea,
Cameroon, and The Republic of the Congo were the most polluted The health discourse in Sub-Saharan Africa has largely centered
countries in Central and West Africa. These countries are also around infectious diseases, like HIV/AIDS and malaria, but
among the most polluted countries in the world. Their stories are the data show that the health impacts of particulate pollution
similar. In the Republic of the Congo’s capital city of Brazzaville, exposure are no less serious. AQLI’s analysis suggests that in
residents are losing 3.2 years; in Rwanda’s Musanze, it is 3.1 years; the Democratic Republic of the Congo and Cameroon— among
in Burundi’s capital of Gitega, it is 2.5 years; in Mezam, Cameroon, the most polluted countries in Africa—PM2.5 pollution is a more
residents are losing 4.5 years; and in Bata, Equatorial Guinea, it serious threat to life expectancy than HIV/AIDS, tropical diseases,
is 2.6 years. malaria or water, sanitation and handwashing (Figure 3.2).
Although Central African countries experience higher levels of EARLY SIGNS OF PROGRESS
pollution, the West African country of Nigeria, on account of its
large population, faces the highest health burden of air pollution in Not long ago, none of the 27 Central and West African countries
Africa. In 2022, the particulate pollution level in Nigeria was 25 µg/
33 Niger river delta is defined as the following nine states: Rivers, Delta, Akwa Ibom,
32 Interactive Country Fisches. “Democratic Republic of Congo: Pollution.” Imo, Edo, Ondo, Cross River, Abia, Bayelsa

had national standards for particulate pollution. Since 2018, Nature in 2020.43 From all around Africa, Morocco, Eswatini and
two out of the 27 countries in the region have set a standard. 34, 35 South Africa also have national level air quality legislations while
Across the entirety of Africa, 17 of 61 countries have adopted some Kenya and Ethiopia have enacted Nairobi and Addis Ababa Air
legislative instruments to monitor air quality and 13 countries Quality Management plans, respectively.
have set a national standard, including the most recent addition––
Uganda. 36, 37 Despite the progress in recent years, African countries still lack
the tools and resources to manage and mitigate air pollution.
Further, an increasing number of civil society organizations are African countries received only 5 percent of air quality funding
calling for action, and governments are beginning to respond with between 2017 and 2021.44, 45 There is also scope for significant
either some legislative instruments or air quality plans.38 augmentation of the air quality data infrastructure in this region.
With 13 government monitors across all countries in the region
Nigeria’s National Environmental Standards Regulations and sharing data openly on a data platform such as OpenAQ, the easily
Enforcement Agency (NESREA) implemented an air quality available open data provided by these government monitors is
regulation in 2021 and also established indoor and ambient quality comparable to Denmark which has pollution levels that are one-
standards. 39 The Republic of Rwanda enacted a law to preserve the third the average for this region. For people in this region to live
air quality and prevent air pollution in the country in 2016 and healthier and longer lives, more resources need to be injected.
adopted East African Standards for ambient air quality in 2018.40,41
The Ghana Environmental Protection Agency introduced a Greater
Accra Metropolitan Area (GAMA) Air Quality Management Plan
(AQMP) in 2018 with the goal of bringing GAMA in compliance
with the country’s air quality standards and maintaining the
compliance as the area grows economically. 42 Togo, in partnership
with the Climate and Clean Air Coalition, implemented a
National Plan for the Reduction of Air Pollutants and Short-Lived
Climate Pollutants with a goal of reducing particulate pollution
by 45 percent, which was formally endorsed by the Minister of
Environment, Sustainable Development and the Protection of
34 Federal Republic of Nigeria Official Gazette. 2021. https://archive.gazettes.

africa/archive/ng/2021/ng-government-gazette-supplement-dated-2021-02-
17-no-161.pdf
35 East African Community. 2021. “Draft Standards Air Quality Specification Second
Edition” https://bbnburundi.org/wp-content/uploads/2021/05/Air-quality-
Specification-DEAS-vrai.pdf
36 UN Environment Program. 2021. “Regulating Air Quality: The First Global
Assessment of Air Pollution Legislation.” Please note that only a subset of these
countries are a part of Central and West Africa. These 17 countries are as follows:
Algeria, Benin, Burkina Faso, Côte d’Ivoire, Egypt, Eswatini, Gambia, Ghana,
Kenya, Mauritius, Morocco, Mozambique, Nigeria, Rwanda, Senegal, South
Africa, and the United Republic of Tanzania.
37 New Vision. 2024. “Air quality-standards-in-2024-a landmark tool for
addressing Air quality in Uganda” https://www.newvision.co.ug/category/blogs/
air-quality-standards-in-2024-a-landmark-tool-NV_187722
38 EPIC “EPIC Clean Air Programs – Air Quality Entities Registry” https://epic.
uchicago.edu/air-quality-registry/
39 Refer Footnote 37
40 Rwanda Legal Information Institute. 2016. “Law governing the Preservation of Air
Quality and Prevention of Air Pollution in Rwanda” https://rwandalii.org/akn/rw/ 43 CCAC secretariat. 2020. “Togo’s Minister of Environment endorses first National
act/law/2016/18/eng@2016-06-06#:~:text=Any%20person%20owning%20 Plan to Reduce Air Pollutants and Short-Lived Climate Pollutants” https://www.
emission%20sources,activities%20that%20are%20considered%20as ccacoalition.org/news/togos-minister-environment-endorses-first-nation-
41 REMA. 2018. “Inventory of Sources of Air Pollution in Rwanda” https://rema.gov. al-plan-reduce-air-pollutants-and-short-lived-climate-pollutants
rw/fileadmin/templates/Documents/rema_doc/Air%20Quality/Inventory%20 44 Clean Air Fund. 2023. “The State Of Global Air Quality Funding 2023” https://
of%20Sources%20of%20Air%20Pollution%20in%20Rwanda%20Final%20 s40026.pcdn.co/wp-content/uploads/The-State-of-Global-Air-Quality-
Report..pdf Funding-2023-Clean-Air-Fund.pdf
42 EPA Ghana. 2018. “The Greater Accra Metropolitan Areas Air Quality 45 Clean Air Fund. 2023. “Philanthropic Foundation Funding For Clean Air:
Management Plan” https://www.ccacoalition.org/sites/default/files/resourc- Advancing Climate Action, Health And Social Justice“ https://s40026.pcdn.co/
es/2018_Greater-Accra-Region-Air-Quality-Management_EPA-Ghana.pdf wp-content/uploads/Clean-Air-Fund-Philanthropic-Foundation-Funding.pdf

Section 4
Middle East and North Africa

emerges as a new pollution
hotbed
97% of the Middle East and North Africa’s population lives in areas where
particulate pollution exceeds the WHO guideline. The impact is much larger
in the most polluted areas where residents are losing 4.1 years due to PM2.5.
particulate pollution on life expectancy is comparable to other

The latest satellite derived PM2.5 data highlights the Middle large health threats (Figure 4.2). The impact is significantly larger
East and North Africa46 as an emerging pollution hotspot. The in Babil Governorate in Iraq, the region’s most polluted area,
population-weighted average particulate pollution in 2022 was where particulate pollution is taking 4.1 years off of the life
12.9 percent higher than 2021, at 18.4 µg/m³––3.7 times the WHO expectancy of its residents.
guideline. The 466.5 million residents of this region stand to gain
1.3 years in life expectancy, translating to 612.6 million total life With a particulate pollution level of 39.1 µg/m³, or nearly 7.8
years saved, if the pollution level is reduced to meet the WHO times the WHO guideline, Qatar was not only the most polluted
guideline (Figure 4.1). In each of these countries, the impact of country in the Middle Eastern and North African region––it was
also the fourth most polluted country globally. The resulting
46 Middle East is defined as the following 13 countries: Bahrain, Iran, Iraq, Israel, average life expectancy in Qatar is 3.3 years lower than what it
Jordan, Kuwait, Lebanon, Oman, Qatar, Saudi Arabia, Syria, United Arab Emirates,
would be if the WHO guideline were met, making particulate
Yemen. North Africa is defined as the following 6 countries: Algeria, Djibouti,
Egypt, Libya, Morocco, Tunisia. pollution a larger health threat here than smoking and vehicle
Potential gain in
life expectancy
(in years)
≥6.0
5.0
4.0
3.0
2.0
1.0
0.5
0.1

injuries (Figure 4.2). In Doha, the country’s capital and largest UNEQUAL BURDEN OF PARTICULATE POLLUTION
city, home to about half its population, residents stand to lose
At the regional level, particulate pollution remains highly
3.4 years of life expectancy if the current pollution levels persist.
unequal, with annual pollution levels ranging from as little as
Particulate pollution in Qatar has largely been attributed to
6.1 µg/m³ in Algeria to as high as 39.1 µg/m³ in Qatar. Overall,
industrial emissions, and construction to support the rapid
the Middle Eastern countries have higher pollution than the
urbanization.47
North African countries. Reducing particulate pollution to meet
Although Qatar is the most polluted country, 39 out of the 50 the WHO guideline would add 10 more months onto the lives
most polluted regions of the Middle East and North Africa lie in of those living in the Middle East compared to those living
Iraq. In 2022, the annual average particulate pollution levels in in North Africa. Looking at a more granular level, particulate
Iraq were 32.4 µg/m³, making it the second most polluted country pollution in the Middle Eastern and North African countries is
of this region. Five of the country’s most polluted governorates also concentrated in certain areas––mostly in the area around
contribute more than 40 percent of the total life years lost the national capital of each country.
in Iraq. 48 In Baghdad, Iraq’s capital and its most populous
SIGNS OF POLICY ACTION TO CURB AIR POLLUTION
governorate, residents stand to lose 3.5 years of life expectancy
on average. The situation is even worse in the most polluted Until recently, none of the 19 Middle Eastern and North African
district, Al Mahawil, in the neighboring Babil governorate, where countries had any air quality management plan. Seven out
1.3 million people are losing 4.1 years of life expectancy due to of these nineteen countries have PM2.5 standards. However,
particulate pollution. Air pollution in Iraq has been attributed to air quality is getting more attention as five countries have
vehicle exhaust, electric generators, fires at oil and gas refineries, implemented air quality management plans.
and continuous military conflict in the region.49
Iran first enacted the Law on Prevention of Air Pollution in
Despite having lower average particulate pollution than Qatar 1995. Since then, it has been updated twice. The latest update
and Iraq, Egypt faces the highest health burden in the region due in 2017, called the Clean Air Law, includes stricter penalties for
to its large population. In 2022, the particulate pollution level industries or individuals that do not adhere to the pollution
in Egypt was 19.2 µg/m³—almost 4 times the WHO guideline. limits.53, 54
This means that an average resident of Egypt could live 1.4 years
longer if pollution levels in Egypt were brought down to meet The Clean Air Law of Israel came into effect in 2012. Having
the WHO guideline. This would help prevent the loss of 149.7 undergone two revisions since then, it now includes clean
million life years in the country. The city-governorate of Cairo, air requirements for industrial facilities, measures to reduce
the capital of Egypt and the largest megacity in the Middle East vehicular pollution and greenhouse gasses, and renewable fuel
and North Africa with a population of 10.1 million, experiences standards for biofuels.55
PM2.5 levels of 22.6 µg/m³––the worst in the country. With an
average resident in Cairo losing approximately 1.7 years of their The Lebanese Parliament enacted the Law on the Protection of
life, the combined life years lost due to particulate pollution the Environment. It comprises 34 articles related to air quality
in the Greater Cairo area are 23.6 million.50 In Alexandria, the monitoring and management, and prevention of air pollution.56,57
largest city in the Mediterranean and an important tourism and
In 2021, Morocco, in partnership with the Climate and Clean
industrial hub of Egypt, the condition is slightly better with
Air Coalition, finalised its national action plan to reduce short-
16.2 µg/m³ particulate pollution levels translating to 1.1 years of
lived climate pollutants. Full implementation of the plan can
reduced life expectancy. Traffic congestion and vehicle exhaust,
reduce particulate matter from the transport sector in Morocco
agriculture slash and burn practices, and coal fired power plants
are major sources of particulate pollution in Egypt.51,52
53 FAO. 2024. “FAOLEX Database” https://www.fao.org/faolex/results/details/

47 The Peninsula. 2024. “Signs of air quality improvement in Doha after major en/c/LEX-FAOC182168/
construction boom” https://thepeninsulaqatar.com/article/31/03/2024/
54 Radio free Europe. 2023. “Iran's Environmental Standards, Polluted Reality Mix
signs-of-air-quality-improvement-in-doha-after-major-construction-boom
Like Oil And Water”https://www.rferl.org/a/iran-environmental-standards-pollu-
48 The five governorates are: Al Qadisiyah, An Najaf, Babil, Baghdad, Karbala tion-smog/32385813.html#
49 Ecohubmap. 2023. “Air pollution in Baghdad, Iraq” https://www.ecohubmap. 55 Library of congress. “Regulation of Air Pollution: Israel” https://maint.loc.gov/
com/hot-spot/air-pollution-in-baghdad-iraq/nxoml7sorv56# law/help/air-pollution/israel.php#_ftn14
50 Greater Cairo is defined as: Al Qahirah governorate, Imbabah, Giza, 56 OHCHR. “Environment management in Lebanon” https://www.ohchr.org/sites/
Shubra-al-Khaymah default/files/Documents/Issues/Environment/SREnvironment/Pollution/
51 Clean Air Fund. 2023. “From pollution to solution in Africa’s cities” https://www. Lebanon.pdf
cleanairfund.org/clean-air-africas-cities/cairo/ 57 FAO. 2019. FAOLEX Database https://www.fao.org/faolex/results/details/en/c/
52 IQAir. 2024. “Air quality in Egypt” https://www.iqair.com/us/egypt LEX-FAOC176635/

Figure 4.2 · Comparison of selected major global threats to life expectancy in the five most populous countries in Middle East and North
Africa
node.main.LIFECOUNTRY?lang=en) were combined with the Life table method to arrive at these results. "PM2.5 relative to WHO Guideline” bar displays the reduction
by 51.6% from 2014 levels.58 Quality Agenda 2031 plan that was released in 2023. The latest
agenda focuses on reducing outdoor and indoor air pollution,
In 2013, the United Arab Emirates launched Vision 2021, which reducing odors, and reducing noise pollution.59, 60
initiated its air quality data collection and monitoring efforts.
This data was used to inform the targets of its National Air
59 CCAC Secretariat. 2023. “UAE Enters COP28 Leadership With

58 CCAC Secretariat. 2022. “Morocco’s National Action Plan Signals New Era in the National Air Quality Agenda” https://www.ccacoalition.org/news/
Country’s Climate and Clean Air Commitment” https://www.ccacoalition.org/ uae-enters-cop28-leadership-national-air-quality-agenda
news/moroccos-national-action-plan-signals-new-era-countrys-climate-and- 60 UAE MOCCE. 2023. “UAE National Air Quality Agenda 2031” UAE National Air
clean-air-commitment Quality Agenda 2031" https://www.moccae.gov.ae › assets › download

Section 5
Air Pollution remains a Major

Burden in Southeast Asia
Like South Asia, most parts of Southeast Asia experienced a decline in
pollution in 2022 compared to 2021. Despite the reduction, the average
pollution levels in Southeast Asia were 3.6 times higher than the WHO
guideline. With sustained exposure to such pollution levels, an average
Southeast Asian resident is likely to lose 1.2 years off their life relative to
what it would be if the WHO guideline were met.
As a whole, pollution declined across Southeast Asia in 2022. in Myanmar, average pollution levels were 27.8 and 33.8 µg/m³
The average decline in pollution levels across all Southeast Asian in 2022, respectively. If the WHO guideline were met in Yangon
countries was 4.8 percent over one year, with the highest decline and Mandalay, residents would gain 2.2 and 2.8 years, respectively.
in Myanmar (15.7 percent) and lowest decline in Malaysia (0.8
percent). Singapore and Timor-Leste were the only countries where While Indonesia’s pollution has remained largely consistent over
pollution levels increased compared to 2021. Across the region, air the past decade— fluctuating between 18 and 22 µg/m³—during
pollution reduces average life expectancy by 1.2 years, relative to dry seasons, fires in Indonesia cause sudden spikes in pollution for
what it would be if the WHO guideline of 5 µg/m³ was permanently the country and its downwind neighbors like Malaysia. The impact
met (Figure 5.1). In the 11 countries that make up this region, an of fewer fires in the region in 2022 compared to the most recent
estimated 1 billion total life years are lost due to air pollution.61 active wildfire season in 2019, a year characterized by thousands of
fires on the Indonesian islands of Sumatra and Borneo, bears out
While average pollution decreased slightly in 2022, pollution in the data.62 Indonesia saw a 17.2 percent decrease in particulate
levels in Southeast Asia have remained largely unchanged for pollution in 2022 compared to 2019, while Malaysia experienced
two decades, generally fluctuating between 17 and 22 µg/m³— a 33.9 percent decrease.
almost 3.5 times the WHO guideline. Virtually all, 99.9 percent,
of Southeast Asia’s roughly 681.3 million people breathe air that In the Indonesian island of Java, the country’s population
WHO deems polluted. Simeulue and Kepulauan Mentawai in and industrial center, pollution levels dipped slightly in 2022
Indonesia, and Turtle Islands and Kalibato Lake in Philippines compared to 2019. In the region surrounding the megacity of
are the only regions where air quality meets the WHO guideline. Jakarta (including Bogor, Depok, Bekasi, and Tangerang), the
average annual PM2.5 concentration fell roughly 6.3 percent in
In 2022, the population-weighted particulate concentration in 2022 to 28.2 µg/m³. Still, if the region met the WHO guideline,
Myanmar, the most polluted Southeast Asian country, was 28.6 the roughly 24.9 million residents would gain an average of 2.2
µg/m³—5 times the WHO guideline. Because pollution surpasses years in life expectancy. In 2022, North Sumatra––among the most
the WHO guideline, residents of Myanmar are losing 2.9 years polluted regions in Indonesia––also saw a decrease relative to
of life expectancy. This is significantly more than other health 2019. Medan, for example, experienced pollution levels of 33.0
threats in Myanmar such as child and maternal malnutrition µg/m³––significantly down from 2019 levels of 40.2 µg/m³. Here,
(1.4 years) or respiratory infections and tuberculosis (1.4 years) residents stand to gain 2.7 years of life expectancy if pollution
(Figure 5.2). In Yangon and Mandalay, the most populated regions were to be reined in to meet the WHO guideline.
61 Southeast Asia includes the following countries: Brunei, Cambodia, Indonesia, 62 Mongabay. 2024. “2023 fires increase fivefold in
Laos, Malaysia, Myanmar, The Philippines, Singapore, Thailand, Timor-Leste, Indonesia amid El Niño” https://news.mongabay.
Vietnam com/2024/01/2023-fires-increase-fivefold-in-indonesia-amid-el-nino/

Potential gain in
life expectancy
(in years)
≥6.0
5.0
4.0
3.0
2.0
1.0
0.5
0.1
Figure 5.2 · Comparison of selected major global threats to life expectancy in Southeast Asian countries
In Thailand, particulate pollution decreased 5.3 percent from 2021. In Vietnam, there are even sharper differences between regions.
The national average was 21.2 µg/m³ in 2022, a level that has been In the capital city of Hanoi, home to more than 8 million people
roughly constant since the mid-2000s. But overall, particulate and one of Vietnam’s major industrial centers, life expectancy
pollution concentrations varied widely in 2022, ranging from would increase by 3 years if air quality met the WHO guideline.
31.1 µg/m³ in Phayao in the North, to 19.1 µg/m³ in the metropolis The impacts of air pollution are much lower in many of Vietnam’s
of Bangkok, to 11.6 µg/m³ in Phuket in the South. This variation southern regions, where coastal provinces such as Phu Yen would
is partly due to fires in Thailand’s northern region (including see 0.9 years of added life expectancy if air quality met the WHO
the regions surrounding Chiang Mai, Chiang Rai, Saraburi, and guideline. Overall, the average Vietnamese citizen stands to gain
Phayao, for instance) that have increased the amount of regional 2 years in life expectancy, if pollution was permanently reduced to
air pollution, reducing life expectancy by up to 2.8 years relative the WHO guideline. This threat to life expectancy is significantly
to life expectancy under the WHO guideline. Meanwhile, in larger than other health threats in Vietnam such as diabetes (1.1
Thailand’s largest urban area, Bangkok, residents would gain 1.4 years) or respiratory infections and tuberculosis (0.84 years)
years if pollution levels met the WHO guideline. (Figure 5.2.).

HOW CAN COUNTRIES IN THIS REGION TACKLE AIR POLLUTION? IMPROVING COMPLIANCE WITH INDUSTRIAL
EMISSION STANDARDS: EXAMPLES FROM
The countries in this region must work together to reduce INDIA
biomass, farm, forest and peatland fires. In 2023, at the 18th The Indian state of Gujarat launched the country’s first clean air
Meeting of the Committee Under the Conference of the Parties market in 2019, in the form of a large-scale pilot programme on
to ASEAN Agreement on Transboundary Haze Pollution (COM- industrial emission trading in Surat, Gujarat. The state’s pollution
regulating authority, Gujarat Pollution Control Board, is carrying
18) in Laos63, the second Roadmap on ASEAN Cooperation
out the emissions trading program with the help of a team of
towards Transboundary Haze Pollution Control with Means of researchers from the Energy Policy Institute at the University
Implementation (Haze-Free Roadmap) (2023-2030) was adopted. of Chicago (EPIC), Economic Growth Center at Yale University,
The roadmap works on implementation of actions across ASEAN and The Abdul Latif Jameel Poverty Action Lab (J-PAL). Through
member states to prevent and control land fires. The roadmap the Emission Trading Programme, the government sets a cap on
emissions and allows industries to buy and sell below the cap.
also stressed the need for satellites and applications to use for
The researchers are evaluating the program’s benefits and costs,
fire and haze monitoring, as well as the Malaysian Meteorological relative to the status quo, using a randomized controlled trial, and
Department’s refinement of the Southeast Asia Fire Danger have found that this approach has proven to be successful with
Rating System to increase the number of weather stations, pollution decreasing by 20-30 percent and industry abatement
costs declining by 11% at a constant level of emissions.1
implementation of a new fire danger code for northern the ASEAN
region, and the simulation of the 7-day forecast. Another randomized evaluation from the same state of Gujarat
finds that strengthening third-party audits of industrial emission
Alongside reducing biomass, forest and peatland fires—tighter fuel reports can reduce pollution. One way environmental regulators
emissions standards offer another area of potential improvement. monitor compliance with industrial emission standards is through
In contrast to China and India, where fuel standards are at least third party auditors. In most instances, auditors are compensated
by and accountable to the company they audit, leading to a
as stringent as those adopted by the European Union (Euro-6), the
potential conflict of interest. This arrangement might incentivize
fuel standards are much lower in Indonesia and Thailand. Vehicles auditors to manipulate or falsify their reports. And, if auditors fail
are only required to meet Euro-4 standards, which allow for up to report accurately, the regulated parties have no motivation
to 3 times more diesel NOx emissions, and 5 times more sulfur to comply with regulations, as the regulators lack the necessary
information to enforce penalties. To address this problem, Gujarat
content. The Thai government, which had plans to adopt the Euro-
Pollution Control Board (GPCB) collaborated with the same
5 standards in 2021, had delayed the adoption of the standards to group of researchers as above to help reform the audit market by
2024 due to COVID-19 restrictions and their subsequent impact improving accuracy of audit reports, thereby, improving industrial
on the private sector’s readiness to practically implement those compliance. GPCB and the researchers created a reformed
standards.64 On January 1, 2024, Thailand officially adopted the audit system in which auditors were randomly assigned to the
industrial plants they would monitor, paid from a common pool,
Euro-5 standard for diesel vehicles.65 The standard was adopted
and monitored for accuracy. The researchers found that with the
after the Thai Industrial Standards Institute accepted applications auditors working in treatment plants (reformed audit system)
from February to December 2023 and recorded 50 applications were 80 percent less likely to falsely report emission readings
from 25 automobile manufacturers. The Energy ministry plans to and average pollution from industrial units in the treatment group
dropped with highest reduction concentrated in plants that
propose EURO 6 standards by January 1, 2025. Vietnam brought
reported highest readings.2
Euro-5 standards into effect on January 1, 2022.66
Industrial emissions make up another area of potential 1 Greenstone, M., Pande, R., Sudarshan, A., & Ryan, N. (2023).
Can Pollution Markets Work in Developing Countries?
improvement. Indonesia’s coal-fired power plants—of which
Experimental Evidence from India. https://www.anantsudar-
there are around ten within a 100-kilometer radius of Jakarta67 shan.com/uploads/1/0/2/6/10267789/ets_paper.pdf
—are allowed to emit 3 to 7.5 times more particulate matter, NOx, 2 Esther Duflo, Michael Greenstone, Rohini Pande, Nicholas
and SO2 than China’s coal plants, and 2 to 4 times more than Ryan, Truth-telling by Third-party Auditors and the Response
of Polluting Firms: Experimental Evidence from India*, The
Quarterly Journal of Economics, Volume 128, Issue 4, November
63 ASEAN. 2023. “17th ASEAN Ministerial Meeting on the Environment and the
18th Meeting of the Conference of the Parties to the ASEAN Agreement on 2013, Pages 1499–1545, https://doi.org/10.1093/qje/qjt024
Transboundary Haze Pollution”
64 China Daily. 2023. “Thailand approves delay on imposing Euro 5 emission
standard on new vehicles.”
65 The Nation. 2024. “Auto industry complies with Euro 5 standard of diesel fuel” India’s plants installed between 2003 and 2016.68 NOx and SO2,
https://www.nationthailand.com/thailand/policies/40034316 once emitted into the atmosphere, can form particulate matter.
66 Transport Policy. 2022. “As of January 1, 2022, 4-wheeled light-duty vehicles in
Vietnam are regulated under the Euro 5 standard.” 68 Zhang, Xing. 2016. “International Energy Agency Clean Coal Centre – Emission
67 Reuters. 2019. “Asia’s coal addiction puts chokehold on its air-polluted cities.” standards and control of PM2.5 from coal fired power plants.”

To control industrial pollution, Indonesia will have to enforce claiming that the government had failed to deliver safe, clean air to
the country’s stationary source emission standards. In 2021, its citizens. In 2022, the grassroots organization Thailand Clean Air
Indonesia’s Ministry of Environment and Forests introduced a Network submitted the first citizen-driven draft legislation to the
new regulation towards integrating pollution control systems.69 Thai Parliament aiming to create a Thai Clean Air Act. Separately,
The new regulation requires the ten highly polluting industrial in November 2023, the Thai cabinet adopted a draft Clean Air Act
categories70 that are mandated to monitor their emissions using to put in place a legislative framework to mitigate air pollution.71
the Continuous Emissions Monitoring System to integrate their In fact, at present, Thailand has seven different drafts legislating
data into the Information on Continuous Industrial Emission for clean air, including drafts presented by the Government, the
Monitoring System no later than 1 January 2023. Beyond opposition and civil society.72 In January 2024, the Thai cabinet
continuous monitoring, there are ways to further improve voted to accept in principle all seven drafts of the Clean Air Bill.
compliance with industrial emission standards. A few of these A parliamentary committee will now be set up to consolidate the
methods are discussed in the highlight box. different efforts and make amendments to the Cabinet’s draft
before it is presented to the Parliament for further debate.73
Across the region, awareness is rising for the need for urgent clean
air action, in many cases driven by community advocates. In 2021,
for example, a Jakarta court ruled in favor of a citizen-led lawsuit 71 Reuters. 2023. “Thai cabinet approves draft clean air act to
reduce pollution” https://www.reuters.com/world/asia-pacific/
69 Ministry of Environment and Forestry. 2021. “Industrial Continuous Emission thai-cabinet-approves-draft-clean-air-act-reduce-pollution-2023-11-28/
Monitoring Information System (SISPEK)” https://ditppu.menlhk.go.id/portal/ 72 Stockholm Environment Institute. 2024. “Empowering change – Thailand’s
sispek/?token=4aSpjX66PhcYoEWi4fOB pioneering citizen-led legislation for cleaner air” https://www.sei.org/features/
70 Iron and steel smelting, pulp & paper, rayon, carbon black, oil and gas, mining, podcast-th-legislation-cleaner-air/
thermal waste processing, cement, thermal power plants, fertilizers and 73 The Nation. 2024. “Lawmakers accept unanimously all 7 drafts of Clean Air Bill”
ammonium nitrate https://www.nationthailand.com/thailand/general/40034803

Section 6
Most Latin Americans are

Breathing Air Exceeding the
WHO Guideline
The vast majority of Latin America’s 645.9 million people breathe air that
exceeds what the WHO considers safe. In the most polluted locations
in the region, air pollution is reducing people’s lives by 4 years —
comparable to some of the most polluted regions in Bangladesh, India
and Nepal.
New and revised 2022 satellite-derived PM 2.5 data reveal that comparable to other large threats to life in the region such as self-
96.3 percent of Latin America’s 645.9 million people are exposed harm and interpersonal violence (Figure 6.1). There has been a rise
to particulate pollution levels that exceed the WHO guideline in the annual average PM2.5 concentration across Latin America
of 5 µg/m³.74 The health threat posed by particulate pollution is by 4.8 percent from 2021 levels and 3 percent from 1998 levels.
Although the average gain in life expectancy from cleaning up the
74 Latin America region is defined as the following 20 countries and territory: air is relatively low—at just under 1 year on average across Latin
México, Guatemala, Honduras, El Salvador, Nicaragua, Costa Rica, Panama, America (Figure 6.2), the gain is substantially higher in regional
Colombia, Venezuela, Ecuador, Peru, Bolivia, Brazil, Paraguay, Chile, Argentina,
Uruguay, Cuba, Haiti, Dominican Republic, Puerto Rico.
hotspots—Guatemala, Bolivia and Peru (Figure 6.3). Sixty of the
Figure 6.1 · Comparison of selected major global threats to life expectancy in some of the most populous and polluted countries in
Latin America

most polluted regions in Latin America are in these three countries. cities like Bogotá, Mexico City, Santiago de Chile, and Quito have
implemented policy instruments to reduce urban air pollution
According to the latest satellite derived PM2.5 data, Bolivia is the and traffic congestion such as license plate-based restrictions on
most polluted country in Latin America, with an annual average car use,77 Bogota’s bus rapid transit (BRT) system (largest in the
particulate pollution level of 29.6 µg/m³—6 times the WHO world), dedicated bus lanes and BRT routes in Brazil’s Curitiba
guideline. The situation is much worse in the most polluted region are other examples of Latin American cities taking measures to
in Bolivia and all of Latin America—the city of Marban in the reduce vehicular pollution. Brazil's PROCONVE program, initiated
Department of Beni. There, the average particulate pollution level in 1987, also aims to reduce vehicle emissions. Vehicles are required
was 45.7 µg/m³ in 2022—or 9.1 times the WHO guideline. If the to comply with Euro VI standards, with increasingly stringent
region cleaned up its air to permanently meet the WHO guideline, requirements. PROCONVE phase L-7 standards started on January
residents could see their life expectancy increase by 4 years. 1, 2022, and phase L-8 will enforce fleet-average emissions limits
by 2025.78, 79
Rural residents in Bolivia also face high levels of particulate
pollution. For example, in Mamoré (Department of Beni)—a rural As a result of these measures, pollution levels in most of these cities
region containing some of the country’s worst air quality—the (except Santiago de Chile) have either declined or remained stable
average level of particulate pollution in 2022 was 41.8 µg/m³. over the past 15 years, indicating a positive trend in managing air
Residents there are losing 3.6 years of life expectancy due to this quality. For instance, residents of Brazil’s Sao Paulo are breathing air
unclean air, relative to if the WHO guideline was met. with particulate concentrations that are 5 percent lower compared
to the average of the past 15 years. In Colombia’s capital city of
In Guatemala, which is one of the countries in the Central American
Bogota, particulate levels have remained between 19 µg/m³ and 20
Volcanic arc, particulate pollution is one of the greatest threats to
human health. The average life expectancy in Guatemala is 2.1
years lower than what it would be if the WHO guideline were
met—making particulate pollution a larger health threat than Figure 6.2 · Potential gain in life expectancy from permanently
reducing PM2.5 from 2022 concentration to the WHO guideline
interpersonal violence, tuberculosis and tobacco use (Figure 6.3).
Mixco, Guatemala, is the country’s most polluted city, where
residents are losing 3.8 years off their lives. Latin America’s air
pollution is not only limited to its cities. In Brazil, Latin America’s
most populous country, 216.9 million people could gain 8.4 months
of life expectancy—or a total of 151.8 million life years gained—if
particulate pollution were reduced to meet the WHO guideline.
The situation is significantly worse in the Rondônia state—one Potential gain in
life expectancy
of the Amazonian states of Brazil where 1.7 million residents are (in years)
losing 3.2 years of life expectancy to polluted air. In the state of

≥6.0
Amazonas, particulate pollution levels are 6.4 times the WHO 5.0
guideline, primarily due to the burning of the rainforests. The fires 4.0
are a result of deforestation and illegal fires set to clear land for 3.0
2.0
farming and cattle grazing. The 4.1 million residents of the area
75
1.0
could gain 2.7 years of life expectancy if pollution was reduced to 0.5
0.1
permanently meet the WHO guideline. 0
PROGRESS TOWARDS REDUCING AIR POLLUTION
Vehicle emissions are primarily responsible for poor air quality in

Latin America’s major hotspot cities in Guatemala, Bolivia, and
Peru among others.76 In recent decades, several Latin American
77 Boso, À., Oltra, C., Garrido, J. et al., 2023. “Understanding Public Acceptance
of Automobile Restriction Policies: A Qualitative Study in Four Latin American
75 Rainforest Foundation US. 2024. “Amazon Rainforest Fires” https://rainforest- Cities.”
foundation.org/engage/brazil-amazon-fires/ 78 Brazilian Institute of Environment and Renewable Natural Resources. 2011.
76 Guatemala: International Women’s Media Foundation. 2018. “How Outdated “Air Pollution Control Program by Motor Vehicles” https://www.ibama.gov.br/pho-
Cars Live On in a Smoggy Afterlife.”; Bolivia: Mardoñez, V., Uzu, G., Andrade, M., cadownload/veiculosautomotores/manual%20proconve%20promot_english.
Borlaza, L. J. S., Pandolfi, M., Weber, S., Moreno, I., Jaffrezo, J.-L., Besombes, J.-L., pdf
Alastuey, A., Perez, N., Močnik, G., and Laj, P., 2022; Peru: Pinedo-Jáuregui, C., 79 Climate and Clean Air Coalition (CCAC). 2024. “Brazil” https://www.ccacoalition.
Verano-Cachay, J., Barrantes-Santos, V., 2020. org/partners/brazil

µg/m³ over the last 15 years. In Ecuador's capital Quito, particulate guidelines, an average resident in each of these cities would live
levels have remained between 17 µg/m³ and 18 µg/m³. In 2021, the over a year longer.
pollution levels dropped to 15.6 µg/m³ but increased to 17.4 µg/m³
in 2022.
While these cities have managed to plateau their increasing

pollution levels, there is significant scope for reducing their
pollution. If pollution were reduced to permanently meet the WHO
Figure 6.3 · Potential gain in life expectancy from permanently reducing PM2.5 from 2022 levels to the WHO guideline in the 15 most polluted
regions of Latin America

Section 7
China continues to make

progress in reducing pollution
While China has substantially reduced its pollution in recent years,
there continue to be regions in the country where air pollution is taking
off more than 4 years from people’s lives.
Home to almost 18 percent of the world’s population, China specific targets to improve air quality by the end of 2017, including a
accounts for 20 percent of air pollution related health burden. But, USD 270 billion initiative to reduce pollution in densely populated
thanks to stringent policy action, China has managed to reduce regions.
its air pollution by 41 percent between 2013 and 2022. Within
the country, Beijing province experienced the largest decline in To meet the goals laid out in its National Air Quality Action Plan,
pollution, dropping 54.1 percent in just nine years (Figure 7.1). the government began to restrict the number of cars on the road
Because of these air quality improvements, the average Chinese in large cities such as Beijing, Shanghai, and Guangzhou. In the
citizen can expect to live 2 years longer, provided the reductions industrial sector, iron and steel making capacity was reduced.
are sustained. In Beijing, the average person can expect to live 3.9 New coal plants were banned in the Beijing-Tianjin-Hebei (BTH),
years longer. In Shanghai, where PM2.5 fell from 45.3 to 23.0 µg/m³, Pearl River Delta (PRD) and Yangtze River Delta (YRD) regions.
the average person could expect to live 2.2 years longer (Figure 7.2). Existing plants were mandated to reduce their emissions or switch
to natural gas and renewable energy sources, while others were
China has had such success in reducing pollution because of strict closed or relocated. In addition, coal-fired boilers used for heating
public policies. After China reached its highest pollution levels in homes in the north were replaced with gas or electric heaters.
2013, the public began to call for change. China responded with
a National Air Quality Action Plan in the fall of 2013, laying out Thanks to these and other strict pollution policies, China’s annual
Figure 7.1 · Annual average PM2.5 concentrations in major regions in Mainland China, 1998-2022
Note: PRD stands for Pearl River Delta, and it includes the dense network of cities that covers nine prefectures of the province of Guangdong, namely Dongguan,
Foshan, Guangzhou, Huizhou, Jiangmen, Shenzhen, Zhaoqing, Zhongshan and Zhuhai and the Special Administrative Regions of Hong Kong and Macau. YRD stands
for Yangtze River Delta, and it includes Shanghai, Jiangsu and Zhejiang. BTH stands for Beijing-Tianjin-Hebei. It is important to note that our definition of the YRD
region includes all regions in the Jiangsu and Zhejiang provinces. Others may define the YRD region differently than how we have defined it in this report.

than they were when China began its war on pollution. Reducing
Figure 7.2 · Improvements in life expectancy due to reduced
pollution to meet the WHO guideline can add 1.5 years to the
pollution between 2014 and 2022 in China
life expectancy of 29.7 million residents in these prefectures.
These prefectures are distributed across the provinces of Gansu,
Heilongjiang, Nei Mongol, Ningxia Hui, Qinghai, Xinjiang Uygur.
Among these provinces, Hebei, Xinjiang Uygur, and Sichuan also
face the most unequal burden of air pollution, with the potential
gain in life expectancy in China ranging between 2.4 months to 4.4
years across them (outlined in black in Figure 7.2).
While China has made significant improvements in reducing

its pollution, there is more to be done. In November 2023, China
published its third pollution control plan.80 The plan sets a
2025 target of reducing particulate pollution in all cities at the
prefecture level and above by 10 percent compared to 2020. It
targets a 20 percent reduction in the PM2.5 level of the BTH region
Change in life
expectancy -2 to -0.5 to -0.1 to 0 to 0.1 to 0.5 to >=2 and a 15 percent reduction in the pollution level of the Fenwei
(years) < (-0.5) < (-0.1) <0 < 0.1 < 0.5 <2
Plain compared to its 2020 level. If the pollution reductions are

successful, they will add 10 months to the average life expectancy
Note: Virtually all Chinese residents are projected to see their life
in the BTH region and 6.9 months in the Fenwei Plain.81 Time will
expectancy improve (blue) due to recent reductions in particulate pollution
since 2014, if those reductions persist tell how China responds to these new targets in the coming years. .
Figure 7.3 · Top 5 threats to life expectancy in China

average pollution level now meets the national standard of 35 µg/
m³. However, the pollution in China is still 5.6 times higher than
the WHO guideline and remains one of the top threats to life
expectancy in the country. If China were able to reduce its pollution
from 2022 level to meet the WHO guideline, and those reductions
were permanently sustained, the average person in China would
see their life expectancy increase further by 2.3 years. This threat
falls just behind the threat from tobacco and high blood pressure
in the country, which takes 3 years of life expectancy (Figure 7.3).
UNEQUAL BURDEN OF AIR POLLUTION
While the overall pollution level in the country has declined since
2013, residents in the more heavily polluted provinces of Hebei,
Tianjin, Henan, and Shandong stand to gain between 3 and 3.4
additional years of life expectancy if pollution levels in these Source: Global Burden of Disease (https://vizhub.healthdata.org/
gbd-results/) level-2 causes and risks data and WHO Life Tables (https://
regions were brought down to meet the WHO guidelines. The apps.who.int/gho/data/node.main.LIFECOUNTRY?lang=en) were combined
health threat is even larger in the 54 prefectures that do not meet with the Life table method to arrive at these results. "PM2.5 relative to WHO
China’s national standard of 35 µg/m³. With an annual average Guideline” bar displays the reduction in life expectancy relative to the WHO
guideline as calculated by latest AQLI (2022) data.
particulate pollution of 40.5 µg/m³, 318.1 million residents in these
54 prefectures would live 3.5 years longer if the WHO guideline
was permanently met. Additionally, 33 out of these 54 prefectures
experienced an increase in particulate pollution in 2022 compared
80 Dialogue earth. 2023. “New air pollution control plan released” https://dialogue.
to 2021. earth/en/digest/new-air-pollution-control-plan-released/
81 Fenwei Plain is defined as the following prefectures: Xi’an, Baoji, Xianyang,
Across the entire country, 112 prefectures reported an increase in Weinan, Tongchuan in Shaanxi province; Jinzhong, Luliang, Linfen, Yuncheng in
particulate pollution from 2021 to 2022. Out of these, 24 prefectures Shanxi province; Luoyang, Sanmenxia in Henan province. Source: Liu, S.; Ju, T.;
Pan, B.; Li, M.; Peng, S. 2022 “Aerosol Analysis of China’s Fenwei Plain from 2012
in northern and western China reported an increase compared
to 2020 Based on OMI Satellite Data.” Atmosphere 13(10): 1728. https://www.
to 2013. In other words, these prefectures are more polluted now mdpi.com/2073-4433/13/10/1728

Section 8
Stricter air pollution standards

reveal air pollution inequalities
in the United States and Europe
Both the United States and Europe have further tightened their pollution
standards but several regions are unable to meet them. If pollution levels
in these regions were to meet the new standards, Europe and the US could
respectively gain an additional 7.2 months and 2.4 months of life expectancy.
Both the United States and Europe have been largely successful in United States and Europe today. With this new evidence now built
creating and enforcing stringent pollution control measures after into the WHO’s guideline, the 2022 data reveal that 94 and 96.8
decades of breathing polluted air. In the United States, legislative percent of people in the United States and Europe, respectively,
measures like the Clean Air Act have helped to reduce pollution by live in areas with pollution levels greater than 5 µg/m³––deemed
67.2 percent since 1970, extending the average lifespan by 1.5 years. unsafe by the WHO.
Only one county––Pierce County in Washington state––experiences
pollution levels that are higher in 2022 than their estimated levels in In the United States, average pollution was 6.9 µg/m³ in 2022,
1970 (Figure 8.1).82 In Europe, policies such as the European Union’s slightly above the WHO guideline of 5 µg/m³ , but meeting the
Air Quality Framework Directive have helped reduce pollution by newly revised national annual-PM2.5 standard of 9 µg/m³. At this
30.2 percent since 1998, helping residents gain 5.6 months (Figure level, residents could expect to gain roughly 2.2 months if the air
8.2).83 Barring some residents living in Andorra, Greece, Italy, they breathed permanently met the WHO guideline, or 62.6 million
Malta, and Spain, most European residents have seen air quality total life years.
improvements that have extended their life expectancy. Primarily
The average European resident in 2022 was exposed to a particulate
due to these pollution reductions, the United States and Europe—
pollution concentration of 11.1 µg/m³, meeting the European Union’s
which make up 15.3 percent of the world’s population—account
annual PM2.5 limit of 25 µg/m³ and the stage 2 limit of 20 µg/m³,
for only about 3.9 percent of the health burden from particulate
but falling short of the revised WHO guideline as well as the newly
pollution.84
adopted EU 2030 limit of 10 µg/m³.85,86 If particulate pollution were
But, the latest scientific evidence suggests that pollution is harmful to meet the revised WHO guideline, average life expectancy across
to human health at even the low levels that exist in much of the Europe would improve by 7.2 months, or 515.9 million total life years.
UNEQUAL BURDEN OF AIR POLLUTION

82 Our 1970 US estimates are based on only 237 US counties for which 1970
PM2.5 concentrations could be approximated. It should be noted that not all
Specific areas of the United States and Europe face much higher
states include counties with data available from 1970. Here we are comparing
1970s imputed PM2.5 data for those 237 counties with 2021 PM2.5 data, levels of pollution than the average, having a significant impact
which are available for all 3,136 US counties. For further information, see the on life expectancy.
Technical Appendix available at https://aqli.epic.uchicago.edu/policy-impacts/
united-states-clean-air-act/. 85 Although the EU PM2.5 standard only applies to a subset of the countries in
83 European Commission. 2008. “DIRECTIVE 2008/50/EC OF THE EUROPEAN Europe that are in the EU, we use it as a reference point for all of Europe’s 53
PARLIAMENT AND OF THE COUNCIL on ambient air quality and cleaner air for countries, in this report.
Europe.” 86 Council of the Europen Union. 2024. “Air quality: Council and Parliament strike
84 Europe is defined as the 53 countries listed in the following file: https:// deal to strengthen standards in the EU” https://www.consilium.europa.eu/en/
drive.google.com/file/d/1CpDGkKu96HcKr5xCZ3QozIdnozJMetrH/ press/press-releases/2024/02/20/air-quality-council-and-parliament-strike-
view?usp=drive_link deal-to-strengthen-standards-in-the-eu/

Figure 8.1 · Change in life expectancy due to change in PM2.5 concentration in 235 counties in the United States between 1970 and 2022
Note: Only one county (in yellow) is losing life years due to particulate pollution increasing in 2022 compared to 1970—Pierce (Washington).
This comparison can only be made for the 237 US counties for which 1970 PM2.5 concentrations could be estimated from available data. The two counties of
Anchorage (Alaska) and Honolulu (Hawaii) were excluded in this figure due to limited space; however, they also experienced declines in particulate pollution in 2022
relative to 1970 resulting in gains of 7.2 months and 3.1 months respectively. For further information, see the Technical Appendix available at https://aqli.epic.uchicago.
edu/policy-impacts/united-states-clean-air-act/.
In recent years, rising wildfires in the Western United States high levels of particulate pollution, comparable to the wildfire
have caused air pollution levels to rise in the region. Residents ravaged Brazilian Amazonas. If pollution were reduced to meet
of California’s Central Valley are now exposed to average the WHO guideline, residents in Tuzla, the most polluted region
particulate pollution levels above both the WHO guideline and
the nation’s own air quality standard. In 2022, while Fairbanks
North Star Borough in Alaska was the most polluted county- Figure 8.2 · Change in life expectancy due to change in PM2.5
concentration in Europe between 1998 and 2022
equivalent where residents stand to gain 10 months if WHO
guideline was met, nine out of ten most polluted counties were
in California. There, average pollution concentrations ranged
from 4.3 µg/m³ in Del Norte County to 11.6 µg/m³ in Kern County.
(Figure 8.3).
Like the United States, the burden of air pollution is unequal

in Europe as well, with the eastern portions of the continent
reporting higher pollution levels (Figure 8.4). If both Eastern
and Western Europe were to meet the WHO guideline, Eastern
Europe would gain 4.8 months more on to their life expectancy
compared to Western Europe.87 The East European nation of
Bosnia and Herzegovina is the most polluted country in Europe,
and virtually all of Poland, Belarus, Slovakia, Hungary, Lithuania,
and Armenia exceed the WHO guideline. If particulate pollution Change in life
expectancy -2 to -0.5 to -0.1 to 0 to 0.1 to 0.5 to >=2
was reduced to meet the WHO guideline, an average resident (years) < (-0.5) < (-0.1) <0 < 0.1 < 0.5 <2
of these countries would gain an additional 10.2 months of

life expectancy—equivalent to the addition of 61.3 million Note: Virtually all European residents will see their life expectancy improve
(blue) due to reductions in particulate pollution, if those reductions persist.1,2
life years. The cities of Tuzla and Zenica-Doboj in Bosnia and
Herzegovina and their surrounding areas see particularly
1 Refer Footnote 72
2 This map excludes the regions of Islas Canarias (in Spain), and Azores
87 The definition of Eastern v/s Western Europe can be found here. This definition and Madeira (in Portugal) due to space limitations. But all underlying
is used only when comparing Eastern and Western Europe in this report (both in calculations include these regions. See Footnote 4 for the definition of
text and figure 8.4). All other types of calculations follow the original definition of Eastern vs Western Europe
Europe (which includes a couple more countries) as listed in this sheet

Figure 8.3 · Wildfire ravaged California is home to 9 of the 10 most polluted counties in the US
in the country, would gain 2.5 years in life expectancy. countries of the EU exceed the 2030 stricter limit. If these 12
countries were to reduce their pollution levels to meet the
Outside of Eastern Europe, pollution remains high in areas such limit, the average citizen living in these countries would gain
as Italy’s Po Valley. In Milan, the city with the highest pollution 4 months of life expectancy on average, which is equivalent to
in Western Europe, residents would gain 1.7 years if particulate gaining 55.8 million total life years for the population of those
pollution levels were reduced to meet the WHO guideline. 12 countries.91
ACTION TOWARDS STRENGTHENING AIR QUALITY STANDARDS
In the wake of the revised WHO guideline in 2021, both the 91 Twelve countries exceeding the proposed stricter standard: Bulgaria, Croatia,
Cyprus, Czechia, Greece, Hungary, Italy, Latvia, Poland, Romania, Slovakia,
United States and European Union have been taking steps to Slovenia.
strengthen their PM2.5 standards. As of May 6, 2024, the United
States Environmental Protection Agency implemented a new
annual PM2.5 standard of 9 µg/m³, replacing its standard of 12 µg/ Figure 8.4 · Potential gain in life expectancy from permanently
reducing PM2.5 from 2022 concentration to the WHO guideline,
m³.88 In 2022, all states in the US met the old standard. Despite comparing Eastern Europe versus Western Europe (demarcated
the more stringent standard, the pollution levels in only 13 out of by heavy black line)1
the 3,142 counties in the United States were higher than the new
standard. Nine of these counties are in the state of California. If
these counties were to meet the revised standards, an average
resident in these parts of the US would gain an additional 1.3
months of life expectancy, adding 1.9 million life years nationally.
Meanwhile, in late 2022, the European Commission proposed

ratcheting down the European Union’s current PM2.5 standard of
25 µg/m³ to 10 µg/m³ by 2030.89 In February 2024 the European
parliament struck a provisional agreement with EU countries in
this regard.90 As per the latest AQLI data, 12 of the 27 member
88 USEPA. 2024. “Final Rule to Strengthen the National Air Quality Health Standard
for Particulate Matter” https://www.epa.gov/system/files/documents/2024-02/
pm-naaqs-overview.pdf
Potential gain in
89 European Commission. 2022. “DIRECTIVE OF THE EUROPEAN PARLIAMENT life expectancy 0 to 0.1 to 0.5 to 1 to 2 to
AND OF THE COUNCIL on ambient air quality and cleaner air for Europe (recast).” (in years) < 0.1 < 0.5 <1 <2 <3
90 European parliament news. 2024. “Air pollution: Deal

with Council to improve air quality” https://www.europarl.
1 Refer Footnotes 72 and 79
europa.eu/news/en/press-room/20240219IPR17816/
air-pollution-deal-with-council-to-improve-air-quality

Conclusion
In 2022, global pollution levels declined, including in South Asia National standards are an important tool to improve air
where air pollution has been on the rise for almost a decade. quality. If countries adopt more ambitious air quality targets
Despite this decline, people worldwide are losing an average and implement policies to achieve these targets, life expectancy
of 1.9 years of life expectancy due to polluted air. In the most would significantly improve. Yet, more than 30 percent of the
polluted regions, individuals are losing more than 5 years of life world’s population lives in regions that don’t meet their country’s
expectancy. national standard. But if those countries did meet their own
benchmarks, it would add more than 3 billion life-years globally.
The impacts of air pollution are highly unequal, with South Asia Further, almost half of all countries around the world don’t have
and Sub-Saharan Africa bearing the brunt. Significant disparities a pollution standard at all, and many of them are among the
also exist within regions. For instance, while China has reduced most polluted countries in the world. The latest AQLI report
its particulate pollution levels by over 40 percent since 2013, emphasizes the disparity of air pollution around the world, the
more than 20 percent of China's population still breathes air impacts on human health, and the policies helping to reverse
that does not meet the country’s standard. these disparities.

Appendix I: Methodology
The life expectancy calculations made by the AQLI are based on a over certain ranges of PM2.5 concentrations and/or that there is a
pair of peer-reviewed studies, Chen et al. (2013) and Ebenstein et threshold below which PM2.5 has no effect, we are unaware of
al. (2017), co-authored by Michael Greenstone, that exploit a unique credible empirical evidence that would cause a rejection of the
natural experiment in China. By comparing two subgroups of the linearity assumption.
population that experienced prolonged exposure to different levels
of particulate air pollution, the studies were able to plausibly isolate Ebenstein et al. (2017) found that sustained exposure to an additional
the effect of particulate air pollution from other factors that affect 10 µg/m³ of PM10 reduces life expectancy by 0.64 years. In terms of
health. Although the study was based solely on a Chinese setting, PM2.5, this translates to the relationship that an additional 10 µg/
together, the regions and years covered in the study saw a wide range m³ of PM2.5 reduces life expectancy by 0.98 years. This metric is then
of pollution levels - spanning 27-307 μg/m³ of PM10 (approximately combined with sea-salt and mineral dust removed satellite-derived
equivalent to 18-200 µg/m³ of PM2.5). Thus, the relationship between PM2.5 data. All 2022 annual average PM2.5 values are population-
life expectancy and particulate pollution that underlies the AQLI weighted and AQLI’s source of population data is https://landscan.
is derived from a PM2.5 distribution similar to the observed global ornl.gov/. We are grateful to the Atmospheric Composition Analysis
distribution, providing a credible basis for generalizing the measured Group, based at the Washington University in St. Louis for providing
pollution-life expectancy relationship from Ebenstein et al. (2017). us with the satellite data. The original dataset can be found here:
https://sites.wustl.edu/acag/datasets/surface-pm2-5/.
We’d like to note that the global PM2.5 annual average measurements
in this AQLI update range from less than 1 µg/m³ to 84 µg/m³. For life To learn more deeply about the methodology used by the AQLI,
expectancy estimates for regions with particulate concentrations visit: aqli.epic.uchicago.edu/about/methodology
lower than those in Ebenstein et al. (2017) - home to approximately
40 percent of the world population, the AQLI assumes the same
linear relationship between long-term exposure to PM2.5 and life
expectancy, as the rest of the concentration range. Though it is
possible that the pollution-life expectancy relationship is nonlinear

Appendix Table · 2022 Annual Average PM 2.5 Pollution Concentrations by Country and Corresponding Potential
Life Expectancy Gains, if WHO Guideline or National Standard Were Met
Life Expectancy Life Expectancy
Gains (in years) Life Expectancy Gains (in years) Life Expectancy
from reducing Gains (in years) from from reducing Gains (in years) from
PM2.5 from 2022 reducing PM2.5 from PM2.5 from 2022 reducing PM2.5 from
PM2.5 National Concentrations to 2022 Concentrations PM2.5 National Concentrations to 2022 Concentrations
concentration Standard the WHO Guideline to the National concentration Standard the WHO Guideline to the National
Country 2022 (in µg/m³) (in µg/m³) of 5 µg/m³ Standard Country 2022 (in µg/m³) (in µg/m³) of 5 µg/m³ Standard
Afghanistan 17 35 1.2 0 Chad 11.3 * 0.6

Akrotiri and Dhekelia 13.4 * 0.8 Chile 22.8 20 1.7 0.28
Åland 4 * 0 China 28.2 35 2.3 0
Albania 12.6 10 0.7 0.25 Christmas Island 2.9 * 0
Algeria 6.1 * 0.1 Clipperton Island * * *
American Samoa 1.4 9 0 0 Cocos Islands 1.7 * 0
Andorra 8.7 25 0.4 0 Colombia 16.2 20 1.1 0
Angola 21.1 * 1.6 Comoros 7 * 0.2
Anguilla 1.7 * 0 Cook Islands 1.1 * 0
Antigua and Barbuda 1.8 * 0 Costa Rica 12.6 * 0.7
Argentina 12.5 * 0.7 Côte d'Ivoire 10.4 * 0.5
Armenia 19.5 * 1.4 Croatia 14.1 10 0.9 0.41
Aruba 3.4 * 0 Cuba 6.3 * 0.1
Australia 3.4 8 0 0 Curaçao 3.7 * 0
Austria 9.5 10 0.4 0 Cyprus 14.7 10 1 0.46
Azerbaijan 11.9 * 0.7 Czechia 11.5 10 0.6 0.15
Bahamas 3.1 * 0 Democratic Republic of
34.7 * 2.9
the Congo
Bahrain 22.8 25 1.7 0
Denmark 7.1 10 0.2 0
Bangladesh 54.2 35 4.8 1.88
Djibouti 18.4 * 1.3
Barbados 2 10 0 0
Dominica 2.3 * 0
Belarus 9.8 15 0.5 0
Dominican Republic 7.9 15 0.3 0
Belgium 8.8 10 0.4 0
Ecuador 18.3 15 1.3 0.33
Belize 9.9 * 0.5
Egypt 19.2 50 1.4 0
Benin 17.3 * 1.2
El Salvador 27.4 15 2.2 1.22
Bermuda 2.8 * 0
Equatorial Guinea 32.9 * 2.7
Bhutan 22.8 * 1.7
Eritrea 14.4 * 0.9
Bolivia 29.6 * 2.4
Estonia 5.6 10 0.1 0
Bonaire, Sint Eustatius
3.3 * 0 Ethiopia 16.9 * 1.2
and Saba
Bosnia and Herzegovina 23.9 20 1.9 0.39 Falkland Islands 2.6 * 0
Botswana 12.5 * 0.7 Faroe Islands 2.6 * 0
Bouvet Island * 5 * Fiji 3.2 * 0
Brazil 12.1 10 0.7 0.2 Finland 4.4 10 0 0
British Indian Ocean France 8.4 10 0.3 0
* * *
Territory
French Guiana 5.5 * 0
British Virgin Islands 1.5 * 0
French Polynesia 1.5 * 0
Brunei 6.3 * 0.1
French Southern
Bulgaria 18.8 10 1.4 0.87 * * *
Territories
Burkina Faso 8.7 * 0.4 Gabon 25.7 * 2
Burundi 34 * 2.8 Gambia 6.9 * 0.2
Cabo Verde 2.2 * 0 Georgia 13.7 20 0.9 0
Cambodia 16.9 25 1.2 0 Germany 8.5 10 0.3 0
Cameroon 32.6 * 2.7 Ghana 13.7 * 0.9
Canada 6 8.8 0.1 0 Gibraltar 7.3 * 0.2
Cayman Islands 8 * 0.3 Greece 12.6 10 0.7 0.25
Central African Greenland 1.1 * 0
25 * 2
Republic
* No national standard specified and/or data not available.

Grenada 2.2 * 0 Mali 6.6 * 0.2

Guadeloupe 2.3 * 0 Malta 7.2 10 0.2 0
Guam 1.2 9 0 0 Marshall Islands 1 * 0
Guatemala 25.1 * 2 Martinique 2.7 * 0
Guernsey 6.9 * 0.2 Mauritania 3.5 * 0
Guinea 9.8 * 0.5 Mauritius 5.7 * 0.1
Guinea-Bissau 7.9 * 0.3 Mayotte 8.1 * 0.3
Guyana 7.2 * 0.2 México 15.6 12 1 0.36
Haiti 9.9 * 0.5 Micronesia 0.9 * 0
Heard Island and Moldova 11.5 25 0.6 0
* * *
McDonald Island
Monaco 9.9 * 0.5
Honduras 24.5 * 1.9
Mongolia 30.1 25 2.5 0.5
Hungary 11.9 10 0.7 0.19
Montenegro 15.1 25 1 0
Iceland 2.9 10 0 0
Montserrat 2.3 * 0
India 41.4 40 3.6 0.14
Morocco 7.1 * 0.2
Indonesia 18.3 15 1.3 0.32
Mozambique 12.7 * 0.8
Iran 18.8 12 1.4 0.67
Myanmar 28.6 * 2.3
Iraq 32.4 10 2.7 2.2
Namibia 14.5 * 0.9
Ireland 5.4 10 0 0
Nauru 1.2 * 0
Isle of Man 5.4 * 0
Nepal 39.2 * 3.4
Israel 14.3 25 0.9 0
Netherlands 8.5 10 0.3 0
Italy 13.1 10 0.8 0.3
New Caledonia 4.3 * 0
Jamaica 13.2 12 0.8 0.11
New Zealand 3.7 10 0 0
Japan 11.3 15 0.6 0
Nicaragua 14.6 * 0.9
Jersey 6.9 * 0.2
Niger 10.6 * 0.5
Jordan 19.7 15 1.4 0.46
Nigeria 25 20 2 0.49
Kazakhstan 12 * 0.7
Niue 1.2 * 0
Kenya 16.5 35 1.1 0
Norfolk Island 1.6 * 0
Kiribati 0.9 * 0
North Korea 18.6 * 1.3
Kosovo 15.5 * 1
Northern Cyprus 14.5 * 0.9
Kuwait 21.7 * 1.6
Northern Mariana
Kyrgyzstan 12.1 * 0.7 1.1 9 0 0
Islands
Laos 23.5 * 1.8 Norway 4.9 5 0 0
Latvia 12.2 10 0.7 0.21 Oman 13.4 * 0.8
Lebanon 18.6 * 1.3 Pakistan 38.9 15 3.3 2.34
Lesotho 27.9 * 2.2 Palau 2.4 12 0 0
Liberia 9.4 * 0.4 Palestine 14 * 0.9
Libya 8.9 * 0.4 Panama 9.7 15 0.5 0
Liechtenstein 10.8 * 0.6 Papua New Guinea 14.5 * 0.9
Lithuania 9.6 10 0.5 0 Paracel Islands 4 * 0
Luxembourg 8 10 0.3 0 Paraguay 13.2 15 0.8 0
Macedonia 19 * 1.4 Peru 25.5 25 2 0.05
Madagascar 9.7 * 0.5 Philippines 19.2 25 1.4 0
Malawi 17.6 * 1.2 Pitcairn Islands 2.5 * 0
Malaysia 13.3 15 0.8 0 Poland 14.1 10 0.9 0.4
Maldives 8.2 * 0.3 Portugal 5.7 10 0.1 0

Puerto Rico 2.2 9 0 0 Tanzania 18.2 * 1.3

Qatar 39.1 * 3.3 Thailand 21.2 15 1.6 0.6
Republic of the Congo 31.9 * 2.6 Timor-Leste 11 * 0.6
Réunion 2.7 * 0 Togo 15.6 * 1
Romania 13.7 10 0.9 0.36 Tokelau 1.6 * 0
Russia 9.3 25 0.4 0 Tonga 2 * 0
Rwanda 33.4 35 2.8 0 Trinidad and Tobago 3.9 15 0 0
Saint Helena, Ascension Tunisia 10.2 * 0.5
2.7 * 0
and Tris
Turkey 21.1 * 1.6
Saint Kitts and Nevis 2.4 * 0
Turkmenistan 10.4 * 0.5
Saint Lucia 2 * 0
Turks and Caicos
Saint Pierre and 2.7 * 0
3.4 * 0 Islands
Miquelon
Tuvalu 1.5 * 0
Saint Vincent and the
2.1 * 0
Grenadines Uganda 27.8 25 2.2 0.28
Saint-Barthélemy 2 * 0 Ukraine 10.8 25 0.6 0
Saint-Martin 1.8 * 0 United Arab Emirates 20.7 * 1.5
Samoa 1.7 * 0 United Kingdom 8.3 20 0.3 0
San Marino 13.5 * 0.8 United States 6.9 9 0.2 0
São Tomé and Príncipe 10.3 * 0.5 United States Minor
3.2 * 0
Outlying Islands
Saudi Arabia 27.5 15 2.2 1.23
Uruguay 9.1 * 0.4
Senegal 5.7 * 0.1
Uzbekistan 18.6 * 1.3
Serbia 16.9 25 1.2 0
Vanuatu 5.1 * 0
Seychelles 5 * 0
Vatican City 11.1 * 0.6
Sierra Leone 9.9 * 0.5
Venezuela 12 * 0.7
Singapore 13.9 10 0.9 0.38
Vietnam 23.6 25 1.8 0
Sint Maarten 2 * 0
Virgin Islands, U.S. 1.8 9 0 0
Slovakia 12.1 10 0.7 0.21
Wallis and Futuna 1.8 * 0
Slovenia 12.3 10 0.7 0.23
Western Sahara 4.9 * 0
Solomon Islands 7 * 0.2
Yemen 16.8 * 1.2
Somalia 8.9 * 0.4
Zambia 22.2 * 1.7
South Africa 23.3 20 1.8 0.32
Zimbabwe 16 * 1.1 *
South Georgia and the
* * *
South Sand
South Korea 20.8 15 1.5 0.57
South Sudan 16 * 1.1
Spain 7.5 10 0.2 0
Spratly Islands 0 * 0
Sri Lanka 19.1 25 1.4 0
Sudan 10.2 10 0.5 0.02
Suriname 6.1 * 0.1
Svalbard and Jan Mayen * * *
Swaziland 16.4 * 1.1
Sweden 4.9 10 0 0
Switzerland 8.7 10 0.4 0
Syria 22.8 * 1.7
Taiwan 17.3 * 1.2
Tajikistan 17.1 * 1.2

Appendix II: The Evolution of Satellite-Derived PM2.5 Data
Reliable, geographically extensive pollution measurements are 27.2 µg/m³) relative to the 2021 dataset used in our 2023 AQLI update
critical to understanding the extent of air pollution and its health (Figure A.1)
impacts. Unfortunately, many areas around the world either lack
extensive pollution monitoring systems or did not begin monitoring According to van Donkelaar et al. (2021), satellite-derived PM2.5 data
PM2.5 until recently, making it impossible to track long-term global were constructed by converting measurements of aerosol optical
trends. To construct a single dataset of particulate pollution and depth (AOD) over each grid cell into PM2.5 measurements using a
its health impacts that is global in coverage, local in resolution, chemical transport model called GEOS-Chem. These estimates were
consistent in methodology, and that spans many years to reveal then subsequently calibrated to regional ground-based observations
pollution trends over time, the latest AQLI data incorporates of both total and compositional mass using a Geographically
satellite-derived annual ambient PM2.5 concentration estimates Weighted Regression (GWR). Over time, improvements in the model
spanning 25 years from 1998-2022 by the Atmospheric Composition and calibration inputs, alongside growing ground level monitoring
Analysis Group at the University of Washington (methodology coverage necessitate periodic updates to the historical PM2.5 dataset.
described in van Donkelaar et al. (2021) and Donkelaar et al. (2024).
In Figure A.1, we plot and compare the global population-weighted
The latest raw dataset (version: V6.GL.01) is publicly accessible at: PM2.5-time trends using various years’ versions of the annual average
https://sites.wustl.edu/acag/datasets/surface-pm2-5/#V6.GL.02. PM2.5 dataset. Although the new and revised PM2.5 dataset yields
The AQLI uses a version of this data that excludes sea salt and dust. global average concentration levels that are lower on average than
those estimated using the 2020 and 2021 datasets and higher on
There are differences between the satellite-derived PM2.5 dataset average than the 2016 reference datasets, the overall picture remains
used in this report and those used in previous AQLI reports. For the same. The global annual average PM2.5 level has shifted between
example, in the new and revised 2022 dataset used this year, the 3.8 to 7.2 times the WHO guideline, making air pollution the greatest
estimated global population-weighted average PM2.5 concentration external threat to human health globally.
for the year 2019 has been revised downwards (from 28.5 µg/m³ to
Figure A.1 · Comparing latest (2022 reference dataset) global annual average PM2.5 concentration time series with various historical
reference datasets
Note: The “2022 dataset” line plots the global population-weighted annual average PM2.5 trend using data accessible from https://sites.wustl.edu/acag/datasets/
surface-pm2-5/#V6.GL.02 and methodology described in van Donkelaar et al. (2021) and Donkelaar et al. (2024). The “2021 dataset” line plots the global population-
weighted average PM2.5 trend using data from van Donkelaar et al. (2021). The “2020 dataset” line plots the analogous trend using data from Hammer et al. (2020).
The “2016 dataset” plots the trend using data from van Donkelaar et al. (2016). Note that the AQLI uses a version of all datasets that excludes sea salt and dust. To
learn more about these versions, visit: https://sites.wustl.edu/acag/datasets/surface-pm2-5/.

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About the Authors
Michael Greenstone
Michael Greenstone is the Milton Friedman Distinguished Service Professor in Economics,
the College, and the Harris School, as well as the interdisciplinary Energy Policy Institute
at the University of Chicago. Greenstone’s research, which has influenced policy globally,
is largely focused on uncovering the benefits and costs of environmental quality and
society’s energy choices. As the Chief Economist for President Obama’s Council of
Economic Advisers, he co-led the development of the United States Government’s social
cost of carbon. Additionally, he has been researching the impacts of particulate pollution
on human well-being for more than two decades, including work that plausibly quantified
the causal relationship between long-term human exposure to particulate pollution and
life expectancy. This work is the basis of the Air Quality Life Index.
Tanushree Ganguly
Tanushree Ganguly is the Director of Air Quality Life Index programme at EPIC. Her career
efforts focus on strengthening data-driven air quality decision making, and unpacking
challenges in implementing national-level policies at local levels. She has worked as air
quality consultant and researcher in the US and India. Prior to joining AQLI, Tanushree led
the Clean Air Programme at the Council on Energy, Environment and Water, and supported
multiple states and municipalities in charting pathways towards meeting their clean air
ambitions. Tanushree has a graduate degree in Environmental Engineering from the Georgia
Institute of Technology, Atlanta, and an undergraduate degree in civil engineering from
Nirma University, Ahmedabad.
Christa Hasenkopf
Christa Hasenkopf is the Director of the Clean Air Programme at EPIC. Her career focuses
on efforts that open information, resources, and networks so that more people in more
places can help make the air they breathe healthier. Previously, she co-founded and was
the CEO of OpenAQ, an environmental tech non-profit, which fosters a global community
around the world’s largest open database of air quality information. She has also served as
the Chief Air Pollution Advisor to the Office of Medical Services at the US Department of
State and in multiple positions at the US Agency for International Development. Hasenkopf
received a PhD in Atmospheric & Oceanic Sciences from the University of Colorado and a
BS in Astronomy & Astrophysics from The Pennsylvania State University& Astrophysics
from The Pennsylvania State University.

Nishka Sharma
Nishka Sharma is the Research & Policy Manager of Air Quality Life Index (AQLI) and Air
Quality Programs at EPIC. She has over five years of experience in research and policy in a
variety of subject areas including interaction between social welfare and income inequality,
the social cost of carbon, climate policy and air quality. Her research interests lie at the
intersection of climate change and economic development, and the impact of open data
practices on policy action. She graduated with a Master’s in International and Development
Economics from Yale University and a Bachelor’s in Economics from Shiv Nadar University.
Hrishikesh Gautam
Hrishikesh Chandra Gautam is a Data Specialist of Air Quality Life Index (AQLI) at EPIC.
Prior to joining EPIC, he worked as a senior associate at Center for study of Science,
Technology and Policy (CSTEP) where he worked on statistical model development for
satellite data analysis, calibration of low-cost sensors, reduced complexity model and
Emission Inventory development. He holds a Ph.D. in Environmental Engineering from
Indian Institute of Technology Madras (IITM) where he worked on ANN-based air quality
forecasting, and Fuzzy AQI development. He has a master’s in environmental engineering
from National Institute of Technology Karnataka (NITK).

ABOUT THE AIR QUALITY LIFE INDEX
The AQLI is a pollution index that translates particulate air pollution into perhaps the most important
metric that exists: its impact on life expectancy. Developed by the University of Chicago’s Milton Friedman
Distinguished Service Professor in Economics Michael Greenstone and his team at the Energy Policy Institute
at the University of Chicago (EPIC), the AQLI is rooted in recent research that quantifies the causal relationship
between long-term human exposure to air pollution and life expectancy. The Index then combines this
research with hyper-localized, global particulate measurements, yielding unprecedented insight into the true
cost of particulate pollution in communities around the world. The Index also illustrates how air pollution
policies can increase life expectancy when they meet the World Health Organization’s guideline for what
is considered a safe level of exposure, existing national air quality standards, or user-defined air quality
levels. This information can help to inform local communities and policymakers about the importance of
air pollution policies in concrete terms.
aqli.epic.uchicago.edu aqli-info@uchicago.edu @UChiAir #AQLI
ABOUT EPIC
The Energy Policy Institute at the University of Chicago (EPIC) is confronting the global energy challenge
by working to ensure that energy markets provide access to reliable, affordable energy, while limiting
environmental and social damages. We do this using a unique interdisciplinary approach that translates
robust, data-driven research into real-world impacts through strategic outreach and training for the next
generation of global energy leaders.
The EPIC Clean Air Program is working to bring actionable information about the quality of the air we breathe
and its impact on our health to every corner of the globe in order to motivate action and lay guideposts
for efficient air pollution policies. This work includes an Air Quality Fund to bring high quality and high
frequency air pollution monitoring and data access to the places of the world where it is needed most; the Air
Quality Life Index (AQLI), which uses air pollution data to translate the impact of pollution on a person’s life
expectancy; and several particulate pollution trading markets being piloted in Indian cities in coordination
with state governments.
epic.uchicago.edu @UChiEnergy /UChicagoEnergy /UChicagoEnergy @UChiEnergy

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Index®

AIR QUALITY LIFE INDEX® | 2024

AQLI 2024 Annual Update | 3

Michael Greenstone Christa Hasenkopf Tanushree Ganguly

AQLI 2024 Annual Update | 5

6 | 2024 Annual Update AQLI

AQLI 2024 Annual Update | 7

Global pollution levels drop, but

Figure 1.1 · Selected major threats to life expectancy

8 | 2024 Annual Update AQLI

AQLI 2024 Annual Update | 9

10 | 2024 Annual Update AQLI

Does not have

Meets Air Quality Standard?

Does not have a standard

0.1 to < 0.5

Does not have

AQLI 2024 Annual Update | 11

South Asia reverses its trend

12 | 2024 Annual Update AQLI

AQLI 2024 Annual Update | 13

In Pakistan, where the PM2.5 concentration was 38.9 µg/m³ in 2022

14 | 2024 Annual Update AQLI

In India, the country with the highest health burden of pollution

AQLI 2024 Annual Update | 15

Pollution emerging as a major

16 | 2024 Annual Update AQLI

AQLI 2024 Annual Update | 17

34 Federal Republic of Nigeria Official Gazette. 2021. https://archive.gazettes.

18 | 2024 Annual Update AQLI

Middle East and North Africa

particulate pollution on life expectancy is comparable to other

AQLI 2024 Annual Update | 19

53 FAO. 2024. “FAOLEX Database” https://www.fao.org/faolex/results/details/

20 | 2024 Annual Update AQLI

59 CCAC Secretariat. 2023. “UAE Enters COP28 Leadership With

AQLI 2024 Annual Update | 21

Air Pollution remains a Major

22 | 2024 Annual Update AQLI

AQLI 2024 Annual Update | 23

24 | 2024 Annual Update AQLI

AQLI 2024 Annual Update | 25

Most Latin Americans are

26 | 2024 Annual Update AQLI

losing 3.2 years of life expectancy to polluted air. In the state of

PROGRESS TOWARDS REDUCING AIR POLLUTION

Vehicle emissions are primarily responsible for poor air quality in

AQLI 2024 Annual Update | 27

While these cities have managed to plateau their increasing

28 | 2024 Annual Update AQLI

China continues to make

AQLI 2024 Annual Update | 29

While China has made significant improvements in reducing

Plain compared to its 2020 level. If the pollution reductions are

Figure 7.3 · Top 5 threats to life expectancy in China

UNEQUAL BURDEN OF AIR POLLUTION

30 | 2024 Annual Update AQLI

Stricter air pollution standards

UNEQUAL BURDEN OF AIR POLLUTION

AQLI 2024 Annual Update | 31