The Impact of Air Pollution on Human Health in Africa: A Critical Narrative Review

Abstract

Air pollution has emerged as one of the most consequential, yet historically under-examined, environmental health threats confronting the African continent. Rapid urbanisation, continued reliance on solid biomass fuels for domestic energy, expanding vehicle fleets composed largely of imported used vehicles, gas flaring, open waste burning, and seasonal Saharan dust intrusions combine to expose hundreds of millions of Africans to concentrations of particulate matter and gaseous pollutants that routinely exceed international health-based guidelines. This critical review synthesises evidence published over the past decade on the sources, distribution and health consequences of ambient and household air pollution across Africa, with particular attention to respiratory, cardiovascular, maternal, perinatal and neurodevelopmental outcomes, as well as the disproportionate burden borne by women, children and informal-sector workers. The review further considers the continent's air quality monitoring infrastructure, the substantial economic costs associated with pollution-related morbidity and mortality, and the fragmented policy and regulatory landscape that currently governs air quality across African states. Evidence indicates that household air pollution from solid fuel combustion remains the dominant exposure pathway for the majority of the population, while ambient pollution from transport, industry and waste burning is rising sharply in urban centres. Both exposure pathways are associated with substantial burdens of lower respiratory infection, chronic obstructive pulmonary disease, cardiovascular disease, adverse pregnancy outcomes and premature mortality, with the heaviest toll falling on children under five years of age and on women engaged in domestic cooking. Air quality monitoring infrastructure remains sparse relative to other world regions, constraining both the precision of exposure assessment and the capacity of governments to design and enforce effective mitigation policy. The review concludes that integrated investment in clean energy transition, strengthened monitoring networks, and harmonised regional air quality governance represents an urgent and achievable public health priority for the continent.