Accounting for Pollution: Greening the SDGs

What is the first thing you think of when you hear the word pollution?

Billowing dark clouds rising out of a smokestack at a local factory. Thousands of cars on a highway adding to the smog layer above. Or maybe the iridescent shine of an oil spill as it meets fresh water?

The typical images we tend to think about – and consequently work to address – are usually the most visible.  But it’s what we can’t see that poses the biggest threat to our health and livelihoods. The tiny, all-but-invisible particles that form those billowing clouds can enter our lungs causing respiratory or cardiovascular disease. Unseen, highly toxic chemicals leaching into our soil and eventually our food affect brain functioning and children’s development.

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In the photo: Atop Black Mountain in Kabwe, Zambia: More than 6 million metric tonnes of lead slag form Black Mountain, a 30-meter pile of toxic lead waste that still contains a sizable quantity of lead, copper, manganese and zinc.  Photo Credit: Larry C. Price

Toxic processes surround almost all products we use every day.  Miners extract gold using mercury or cyanide processing for earrings we find in big-name jewelry stores.  The leather used for many wallets, belts, and other goods may have been tanned in factories with no enforced safety precautions, let alone any regard for the local waterways it dumps it’s chemical waste into. Landfills and other less formal waste sites are full of old TVs, appliances, phones, and computers leaching toxic chemicals into groundwater. These processes and their ultimate effects are often invisible to us.


The reality is that pollution, the contamination of our environment caused by human activities that have­ an adverse effect on human health, comes in many forms –air, water, soil, chemical and workplace exposure. Because pollution permeates every aspect of our lives, it’s urgent to detect, prevent and limit its harmful effects.

Including Pollution in the SDG Framework

Incorporating pollution in efforts to achieve the Sustainable Development Goals (SDGs) framework is a crucial new way to target pollution.  Key human, financial, and material resources are being funneled towards what the public health community actively chooses to measure. The Millennium Development Goals (MDGs) were the first worldwide effort to define and set global targets for progress in development. During the 15-year MDG period there was a lot of debate about issues being overlooked due to their lack of explicit inclusion in the framework.  A more rigorous consultative process during the formation of the new SDGs led to a broader mandate and more comprehensive framework for measuring progress. As part of this process, Pure Earth and more than 40 institutional members of the Global Commission of Health and Pollution (GAHP) successfully campaigned for the inclusion of an explicit target under SDG 3, “Ensure Healthy Lives and Promote Well-Being for All,” that addresses all forms of pollution. Today, SDG Target 3.9 seeks to “substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination” by 2030.

But it’s what we can’t see that poses the biggest threat to our health and livelihoods.

Pollution’s inclusion in the SDG framework will undoubtedly lead to meaningful progress to mitigate its concerning effects worldwide. Perhaps even more exciting are the many opportunities to improve pollution control and mitigation through multi-sectoral programs and policies now being evaluated and funded based on their relation to all of the SDGs. By understanding and beginning to measure exactly how pollution relates to each SDG, countries will not only improve health and livelihood outcomes directly related to pollution, but also increase positive outcomes across other targets.


Photo Credit: Larry C. Price

How Pollution is Affecting Disability, Chronic Illnesses, and Death

Pollution in all its forms (air, water, soil, and workplace) is one of the largest threats to health on the planet – especially in low and middle-income countries (LMICs). In 2015, diseases caused by pollution led to an estimated 9 million premature deaths – more than those caused by tobacco, and three times more than those caused by AIDS, tuberculosis and malaria combined. This amounts to about one in every six deaths on the planet being related to pollution – with much higher burdens – 92% –  in LMICs. In Africa, there are countries where pollution kills as many as one in four people.

The enormity of deaths caused by pollution is staggering, but these numbers do not even include those who experience pollution-related illness or disability.  Using a metric known as a Disability-Adjusted Life Year (DALY), we can gain a better sense of the impact of pollution beyond mortality statistics. DALYs essentially measure the number of years of good health an individual loses due to a particular disease or health condition. The Global Burden of Disease study coordinated by the Institute of Health Metrics and Evaluation (IHME) and the World Health Organization (WHO) estimates that in 2015 all forms of pollution were responsible for 268 million DALYS. Many of this premature loss of health is due to the fact that children are particularly susceptible to the effects of pollution. This means that if a child is exposed to pollution that harms their health, or in the worst cases leads to death, they have more years of health lost than an adult.

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In the photo: Sekotong, Lombok, Indonesia. Three-year-old Zaskia plays in the living room of her home. Zaikai was born with a congenital deformity and is missing several fingers and toes. Doctors suspect the birth defect is related to high levels of mercury Zaikai’s mother was exposed to during pregnancy. Photo Credit: Larry C. Price

Pollution-related illness, disability, and death are not separate from the other health issues included in SDG 3. It is often the direct cause of or exacerbates existing health issues, including maternal and child mortality, sexual and reproductive health, and non-communicable diseases such as respiratory disease and cancer. There is now a need for multi-sectoral and integrated efforts with a scope of evaluation across the entire SDG framework to explicitly consider pollution.

Any effort that seeks to improve health in these other areas without considering and responding to pollution will be incomplete.

Broadening the Lens: Pollution Across the SDGs

Pollution must always be considered when implementing the rest of the SDG framework. Because pollution impacts the health of individuals, it also causes economic productivity loss, serves as a barrier to education, and inflates health care costs. One study found that in 2013, China lost as much as 10% of its GDP to pollution-related costs.  Other countries – such as India, Sri Lanka, and Cambodia – faced similar burdens. The lost revenue due to premature death in some highly developed countries can easily surpass billions of dollars.

Premature death from pollution costs the UK $7.6B, Germany $18B, and the U.S $45B in lost revenue each year.

It’s clear then that the common opinion that pollution is unavoidable for economic growth is simply incorrect when government expenditure on health care is factored in. While there are practical considerations in implementation, economies are impeded by toxic pollution. Together, the economic impacts of pollution have distinct implications for achieving SDG 1 (No Poverty), SDG 4 (Quality Education), and SDG 8 (Decent Work and Economic Growth).


Photo Credit: Larry C. Price

Beyond health issues, pollution also affects access to life-sustaining resources such as food and water and destroys natural and man-made environments. It impacts livability, makes cities inhospitable, discourages investment and encourages migration. Most evident of all, pollution has certainly had a direct effect on global climate change. Pollution reduction is a central aspect of the circular or green economy. Clean energy solutions will save lives as we take steps such as moving away from coal and diesel to batteries and renewables. Considering the higher burden of pollution faced by many LMICs, as well as weak regulatory infrastructure and unstable political climates, LMICs experience the negative effects of pollution disproportionally. Within countries, certain populations – such as women, children, and other groups marginalized by society – also are more likely to experience the negative effects of pollution. For this reason, addressing pollution is also central to SDG 5 (Gender Equality) and SDG 10 (Reduced Inequalities).

Within the SDG framework, the targets lay a foundation for progress in the fight against pollution. For example, Target 3.8 to achieve universal health care, which will help individuals suffering from the health effects of pollution, and Target 11.6 to reduce the adverse per capita environmental impact of cities, which will decrease solid waste and harmful particulate matter. Several of the SDGs go further to more explicitly call for action that directly relates to pollution prevention and mitigation. These include SDG 7 (Affordable and Clean Energy), SDG 11 (Sustainable Cities and Communities), and SDG 12 (Responsible Consumption and Production).

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In the Photo: Battery Breaking in Tegal, Indonesia Photo Credit: Larry C. Price

Given the immensity of the world’s pollution problem, it’s surprising that attention to pollution in research, programming, and funding falls so far short of other public health areas. The pollution-related mortality estimate of 9 million deaths in 2015 does not even include data relating to most diseases from chemical toxins found in soil and water. We also know that the available data is incomplete – especially in LMICs where both demand and capacity for data collection are low. Overall, impacts of pollution are undercounted and solutions are underfunded. Even some of the more well-studied areas of pollution are lacking funding. Urban air pollution is just gaining traction as a key public health area while addressing soil pollution is currently only partially funded.  This is why the comprehensive pollution target in SDG 3.9 and partnerships across all of the SDG sectors are so critical.

Key stakeholders are already mobilizing around efforts to strengthen responses to pollution. In Fall 2017, the publication of a landmark report by The Lancet Commission on Pollution & Health, a collaboration between The Lancet, GAHP, and the Icahn School of Medicine at Mt. Sinai, will help to galvanize action towards combatting pollution. The report will include research explaining key sources and impacts of pollution in addition to highlighting effective interventions. By raising awareness and taking a comprehensive approach to explaining the problem of pollution, the report will increase understanding, prioritization, and investment in pollution prevention and mitigation.

Some of the solutions related to chemicals and soil contamination contained in the report are currently being implemented by Pure Earth and our partners. Through community-based initiatives around the world, Pure Earth is working to promote safe e-waste recycling, toxic site clean-up, mercury-free gold from artisanal miners, and more.


These projects can save millions of lives and have proven feasibility.  In Agbogbloshie Ghana, infamous for billowing black clouds of toxicants from e-waste burning, Pure Earth opened an e-waste recycling center with mechanized wire strippers giving workers an alternative to burning.  In Peru, Indonesia, Bolivia and Mongolia, Pure Earth is training small-scale gold miners in mercury-free techniques.  In Senegal, Zambia, Dominican Republic, Vietnam and Indonesia Pure Earth has cleaned up communities with very high levels of lead in soil that had been causing mass lead poisoning for decades.

We hope that the publication of the Commission report will contribute to knowledge sharing and uptake of pollution prevention and mitigation interventions.


Photo Credit: Larry C. Price

GAHP will continue bringing governments and international agencies together to focus on solutions and coordinating efforts. Governments in particular need to lead action against pollution and integrate pollution mitigation into national development plans undertaking interventions across relevant ministries (Health, Environment, Transport, Infrastructure, etc.) that have measurable outcomes. These actions can be raising resources for clean-up or ensuring appropriate pollution control regulations. The civil sector can call for action and support government programs, and the private sector can promote pollution prevention and develop clean industries and technologies. Multilateral and bilateral donor community must provide active support through technical assistance, training, and financing appropriate to solutions.  Dedicated funding for pollution mitigation activities needs to be established. Coalition building and knowledge sharing activities such as an annual conference on pollution would help reinforce demand for action, establish platforms to support the collection of data and measure country progress, and coordinate national and international efforts.

As the global community works together to achieve the SDGs in the coming years, we must remain committed to undertaking quality research, implementing cross-sectoral programs, and crafting policy that comprehensively addresses pollution.

It is important not to think of the SDGs as competing priorities but rather a framework for evaluating highly interrelated health and development issues that will benefit from overlapping strategic efforts by the global community. Millions of lives depend on it.

About the Author /

Richard Fuller, is an Australian-born, U.S.-based engineer, entrepreneur and environmentalist best known for his work in global pollution remediation. In 1999, he founded Pure Earth, non-profit solving pollution problems in developing countries. He is also the President of Great Forest, a leading sustainability consultancy. In 2015, Fuller published “The Brown Agenda: My Mission To Clean Up The World’s Most Life-Threatening Pollution”.

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