Prepared for the report, Air pollution and child health: prescribing clean air. Published in The Lancet Global Health, 12 November 2018.
"Lower respiratory tract infections, by which we usually mean pneumonia, are the second leading cause of death in under-5s worldwide, and the leading cause in Africa. Air pollution is just one of many poverty-linked risk factors, others being undernutrition, poor hygiene, limited or no breastfeeding, and lack of access to vaccines. In turn, death rates in those who succumb to infection are much higher in impoverished regions than in higher-income ones owing to slow care seeking (stemming from poor health education or geographical or financial barriers to care), diagnostic failure, and inappropriate treatment.
The WHO report recognises that the issue of air pollution, particularly ambient air pollution, is largely a high-level issue for governments and regions, and its recommendations for health professionals centre around awareness-raising, research, advocacy, and prescribing of household-level solutions (such as switching to cleaner fuels, where possible). But what about the other, potentially more tractable, risk factors and system failures that contribute to pneumonia’s standing as a barely surpassed killer of children?"