Extreme weather patterns resulting from climate change have a direct impact on our health. Sharp fluctuations in our body temperature can cause heart and vascular disease, and the increased frequency and severity of natural disasters can result in serious injury and even death. Our health is indirectly affected as well by climate-induced shortages of food, potable water, and clean air.
The burning of fossil fuels is the number one cause of climate change and the direct cause of air pollution. Despite the close relationship between these two things and their direct and indirect adverse effects on our health, we are not incorporating policies to reduce air pollutant emissions into our climate policies, but continue to address each issue separately.
Climate action is focused on two parallel paths: reducing carbon emissions and adapting to new climate patterns and their impacts. Because Egypt is not a country that has historically been responsible for carbon emissions &mdash; our contribution to global emissions does not exceed 1% (Climate Watch, n.d.) &mdash; reducing carbon emissions is not a priority on our agenda. The irony here is that Egyptian cities, particularly Greater Cairo, suffer from severe air pollution, which means that we must indeed address emissions in urban areas.&nbsp;
Measures to limit air pollution will yield health, social, and economic benefits, specifically measures designed to reduce emissions in sectors that rely mainly on fossil fuels, like the industrial, energy, and transport sectors.&nbsp;&nbsp;
<h3>Pollution is hazardous to public health</h3>
Air pollution poses a direct threat to public health. It shortens the life expectancy of Egyptians by two years on average due to morbidity or disability (Apte et al., 2018). Air pollution was the cause of 90,559 premature deaths in Egypt in 2019 (United Nations Environment Program, n.d.), and more than 12% of all deaths in 2017 (Institute for Health Metrics and Evaluation, 2019). According to the World Health Organization database, air pollution-related illnesses responsible for premature mortality in Egypt in 2016 included heart disease (57.9%), stroke (17.7%), and pulmonary and lower respiratory diseases and cancer (24.4%) (WHO, 2018). Noncommunicable diseases are the number one cause of death in Egypt, responsible for 82% of deaths and 67% of premature deaths (WHO, n.d.).&nbsp;
<h3>Economic burden of poor health due to climate change and air pollution</h3>
The health burden associated with air pollution was estimated at EGP47 billion in 2016-17 in Greater Cairo alone, or 1.35% of GDP, according to the World Bank (Larsen, 2019). The cost of the toll on health due to air pollution resulting from the burning of fossil fuels was estimated at more than EGP100 billion in 2018, or 2.8% of GDP (Greenpeace, 2020).&nbsp;
<h3>The social impact of deficient health expenditure&nbsp;</h3>
Egyptians pay nearly double the global average for out-of-pocket spending on health, or 62% of all health spending, while households spend some 10% of their monthly income on health (Ministry of Planning and Economic Development, 2021). At the same time, government health spending does not exceed 1.5% of GDP, which is about half the percentage explicitly defined in the constitution (Gad, 2021).&nbsp;
The Egyptian government is striving to improve air quality with programs targeting the most polluting sectors, such as programs to regulate industrial emissions, collect and recycle rice straw, and convert vehicles to run on natural gas. These programs rely on economic feasibility as a prime motivator for air quality improvement. The government also relies on partnerships with donor entities to devise programs that encourage polluting sectors to improve their environmental performance.&nbsp;&nbsp;
Programs to improve environmental performance can be an effective solution when they are part of a package of environmental policies, but they are no replacement for a holistic strategy to limit air pollution in Egypt. Such a strategy would have well-defined goals and responsibilities and integrate policies to reduce air and climate pollution in various sectors with existing policies governing priorities for health and environmental spending and social support programs, to serve as a general reference for public service and investment projects.&nbsp;&nbsp;
In 2013, the World Bank described policies to reduce air pollution in Egypt as &ldquo;limited, and activities related to air pollution planning management and control are carried out in a piecemeal fashion through the adoption of ad hoc projects and solutions rather than the proper combination of policy measures that would yield economic and health benefits.&rdquo;&nbsp;
Research that shows the detrimental impact of environmental degradation on the economy and health can be an important tool for influencing environmental policy. Currently, however, all such research relies on a partnership with the World Bank, which itself has published four reports about the health and economic costs of air pollution in Egypt. At the same time, there is no local, regularly updated database of indicators on air pollution, the resulting health burden, or various sectors&rsquo; contribution to overall pollution in Egypt. This dearth of easily accessible data means that public policy rarely incorporates environmental and health considerations as a matter of course.&nbsp;
<h3>Examples of poor policy integration</h3>
Trees&nbsp;
Trees are an obvious means of reducing air- and climate-polluting emissions and adapting to global warming, particularly in large metropolitan areas, but we continue to witness repeated encroachments on mature trees in Egyptian cities and suburbs. Ironically, most of these encroachments were the result of centrally planned national projects undertaken as part of the government&rsquo;s sustainable development plans, such as the expansion of the road network or works to line canals, both of which required razing trees to implement (Salah, 2021). Yet while lining canals is ostensibly part of efforts to adapt to climate change, there was no study of the environmental and social impacts of tree loss. Similarly, road projects give no consideration to trees&rsquo; role in absorbing carbon emissions.&nbsp;
Coal
Egypt&rsquo;s 2035 energy strategy originally relied on coal for one-third of its electricity generation. While it officially backtracked on this goal and pledged to gradually eliminate coal at the Glasgow climate conference (UN Climate Change Conference, 2021), the state continues to permit its use in polluting cement factories located in residential areas, even as the cement industry is responsible for more than half of all industrial carbon emissions (Egyptian Environmental Affairs Agency, 2018). Currently, there are no plans to ban coal use in industries. This has entailed adverse health consequences for residents of areas like Wadi al-Qamar in Alexandria, who live with the pollutants and dust produced by the nearby Titan Cement plant (Egyptian Initiative for Personal Rights, 2018).&nbsp;
&nbsp;The quality of diesel fuel
Emissions in cities come largely from the burning of fossil fuels in means of transport. Measures to produce cleaner transport emissions focus primarily on the quality and type of fuel used, and the Egyptian government is developing and upgrading its mass transit fleet to reduce pollution loads, for example, through programs that aim to shift to natural gas-powered or electric vehicles. But we have developed no standards for the quality of the main fuel used to power heavy transport vehicles: diesel. Accounting for the brunt of pollution loads in the transport sector, diesel emissions are classified as carcinogenic by the WHO. Ironically, even as we are pouring investments of USD19 billion into the petrochemical industry, we have drafted no legislation that would require the production of diesel that meets the Euro 5 standard, which would cost only USD508-660 million. Absent such a measure, it is impossible to clean up the air in cities and protect public health (Younes, 2021).&nbsp;
The Egyptian government is investing in economic solutions to reduce air-polluting emissions, but the pattern of economic-driven interventions to address the problem of local air pollution is considered a biased measure that prioritizes the economy at the expense of public health and the local environment. These policies are based on the same profit-driven capitalist logic that has produced the current imbalance in our ecosystems to the detriment of natural resources.&nbsp;&nbsp;
Legal protection for public health and the environment has been noticeably lacking. The legislative agenda on the environment included no parallel improvements to tighten up lax air pollution standards, enact Egyptian standards for air quality, or develop fuel quality specifications. Inadequate legal protection is reflected in the rarity of environmental legal cases, given poor environmental inspection and regulation and the difficulty of accessing information.&nbsp;&nbsp;
Citizens&rsquo; health must be a priority for state public policy. Article 46 of the 2014 constitution states, &ldquo;Every person has the right to a sound, healthy environment, and the protection of the environment is a national duty. The state shall take necessary measures to protect it and avoid harm to it, and ensure a rational use of national resources to achieve sustainable development and secure the rights of future generations.&rdquo;&nbsp;
This year Egypt will host the 27th climate summit in Sharm el-Sheikh. This presents an opportunity for us all to focus on the inconsistencies in environmental actions and to strive for domestic policy integration by integrating environmental dimensions, reviewing development plans, and defining national objectives to gradually reduce air pollution levels. We must craft a holistic strategy to improve air quality as part of climate-mitigation efforts, update legislation on local emissions standards, and designate responsibilities to a specific body given the necessary prerogatives and adequate funding.&nbsp;
<hr>
References
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</ul>

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