The prospect of a second, even deadlier wave of COVID-19 reinforces the need to act on alerts about diseases linked to air pollution and global warming. The Philippines is acutely vulnerable to airborne illnesses given the country’s high population density, ecological fragility, and lack of preparedness to health crises. The decline in air pollution triggered by the COVID-19 lockdown—by a third in parts of Metro Manila—should be a powerful motivation to avert a return to the polluting ways of growing the economy.
Recent studies show a strong relation between air pollution and the impact of COVID-19. In China, the avoided number of early deaths from better air quality in recent months exceeded the number of those who have died from COVID-19. And there were 11,000 fewer deaths due to air pollution in Europe in the weeks of the lockdown. Southeast Asian cities like Jakarta, Bangkok, and Manila have some of the world’s highest levels of urban air pollution.
The Philippines was 57th out of 98 in IQAir’s list of countries ranked on air pollution last year. Fine particulate matter, known as PM 2.5, is the major air pollutant whose concentration in Metro Manila was 175 percent above the World Health Organization’s safety limit last year. Air pollution in the Philippines is responsible for 45 deaths for every 100,000 people, the third highest in the world, according to a 2018 WHO study.
The lockdown has provided a respite from the heavy pollution hanging over the city, but this is likely to be short-lived. Traffic accounts for some 70 percent of air pollution in the skies of Manila. There is an urgent need to modernize urban transportation, encourage public transportation in place of the 3 million vehicles, expand railways, introduce electric buses, and provide interconnectivity between the metro and buses.
Adding to the noxious cocktail of PM 2.5 are greenhouse gases (GHG), notably carbon dioxide and methane, that are causing global warming and damaging human health. Slowing global warming would have a direct impact on health—for example, by reducing the incidence of heat waves that can worsen respiratory illnesses. There is also a link between global warming and new diseases, for example, mosquito-borne illnesses. Europe reported its first local transmissions of dengue in 2010. Global warming also has an indirect impact on health, for example, by hurting food security.
Spending on climate change prevention and adaption, by one estimate, provides health benefits of 1.4 to 2.5 times more than the financial cost of these actions. A green energy transition in Southeast Asia could reduce premature deaths by 70 percent. Southeast Asia, including the Philippines, needs to prioritize clean energy, reverse its plans to boost the use of fossil fuels, and make a drastic shift to renewable energy sources.
In managing health risks, emission reduction should be coupled with investments in a stronger public health system. Health care is too underfunded across Southeast Asia, including the Philippines, to be effective. Out-of-pocket health care expenses, estimated at 55 percent of the total in the Philippines, reflect the inequities of the system and the poverty impacts of epidemics and health emergencies. The Philippines has made progress with the universal health care act, but government and private spending on health, and the efficiency of spending, need to improve. Most countries, including the Philippines, fail the test of readiness for health disasters, according to the 2019 Global Health Security Index.
Scientific warnings do not indicate the exact time and place of calamities, but they signal that, in the absence of strong defenses, air pollution and global warming will aggravate health calamities. What’s needed is a marked increase in investments in health care and health systems, government and private, to enable a better response to the next health emergency that is surely going to happen.
Vinod Thomas (Twitter @vthomas14) is a distinguished Fellow in Development Management at the Asian Institute of Management, Manila.