At COP28, a Growing Sense of Alarm Over the Harms of Air Pollution

In one home video, Ella Adoo-Kissi-Debrah bops to a choreographed Beyoncé dance. In another, she looks at the camera, and her mom and plants a big kiss on her lips. Then there is a photo of her mid-laugh when she told her mom she could not climb any more steps at a monument. And in some of the final images taken of Ella as she neared the end of her all-too-brief life, the 9-year-old lies in a London hospital room struggling to breathe, an oxygen mask covering nearly all of her tiny, oval face.

When she died in 2013, after years of seizures and a long struggle with asthma, Ella’s death marked a grim milestone in the planet’s battle against climate change: She is believed to be the first person for whom “air pollution” was listed as her official cause of death.

“Not only do you have to grieve, but to carry this and to fight this is huge,” Ella’s mother, Rosamond Adoo-Kissi-Debrah, said of her work as an advocate for clean air during the decade since her daughter’s death. “You do have to thank God for His mercy. But I think it’s the injustice of it all, seeing it all continue. I think that’s also quite heartbreaking.”

If, in the years since her death, Ella Adoo-Kissi-Debrah has emerged as a symbol of the fight against air pollution, then this year’s COP28 conference on climate change in Dubai stands as a reminder of how the crisis continues to worsen.

On the eve of the conference, a peer-reviewed study in the British Medical Journal found that there were more than 8 million deaths each year that are attributable to air pollution and fine particulate matter. Roughly 5 million of those deaths, the scientists said, could be directly traced to the air pollution caused by fossil fuels.

“I think it’s easy when we hear these statistics to let them wash over us,” said Jane Burston, chief executive officer and founder of the Clean Air Fund, during the conference’s first ever “Health Day” on Sunday. “They’re big, big numbers; we listen to them, and then we forget. But the people that don’t forget are the families who are absolutely devastated by the quality of life of their loved one’s deteriorating, and ultimately their death.”

Burston noted that deaths from air pollution are rising—a 2020 study cited 6.6 million related deaths in 2019— and are expected to double by 2050.

Those deaths are also expected to disproportionately affect low-income communities and people of color, who, researchers say, because of limited economic opportunities, bias and other systemic factors are often compelled to live in areas where air quality is worse than their wealthier and white counterparts.

With that in mind, many attended the conference, which began Nov. 30 and ends on Dec. 13, with environmental justice and equity as issues at the top of mind.

Robert Bullard, a distinguished professor of sociology at Texas Southern University who is regarded as the father of the environmental justice movement, was in attendance at the conference and said in an interview that he was disappointed by the relative dearth of attention paid to addressing systemic inequities.

Bullard said that he was also discouraged by comments from Sultan al-Jaber, the president of the conference, who said last week that there was “no science” to support the contention that phasing out the use of fossil fuels could slow global warming.

“It’s almost like ignoring the facts, ignoring the data and ignoring all of the studies that are showing the health benefits of getting off of fossil fuels,” Bullard said. “This is not some low-level bureaucrat. This is the person over this whole thing. And if that’s the framing, then it means that going forward, there’s probably less of a chance of taking health as seriously. It’s as if you were going to keep doing the same thing.” 

Bullard noted that the handling of environmental justice issues contrasts sharply with what he experienced at last year’s gathering in Egypt, an event where organizers seemed determined to “bring the world’s climate justice, environmental justice, organizations and institutions and friendly governments under one big umbrella and one big tent.”

This year?

“This COP seems to be taken over by the oil and gas, fossil fuel entities,” he said. “And it’s to the point where it’s really a bit disturbing given the urgency in which we need to move away from that type of energy.”

Given that this year’s meeting was held in the United Arab Emirates—which produces about 2.8 million barrels of oil a day—Bullard said that he expected a significant presence from industry officials.

“But to have it come forward in such an in-your-face way is a bit disturbing,” he said. 

Many researchers were encouraged by a declaration on climate and health that was signed by over 100 countries recognizing “the urgency of taking action on climate change” and noting “the benefits for health from deep, rapid, and sustained reductions in greenhouse gas emissions, including from just transitions, lower air pollution, active mobility, and shifts to sustainable healthy diets.” 

In addition to concerns about air pollution, the conference also focused attention on other ways that climate change is affecting public health—from weather changes to the spread of illnesses and pathogens.

“I think it just bears reminding that the evidence abounds showing that rising temperatures and sea levels, more frequent and intense extreme weather events, the heavy rains and typhoons, cyclones, heat waves, floods,” said Avril Benoît, executive director of Doctors Without Borders. “In addition to all these events, we’re seeing altered patterns of infectious diseases, malaria, dengue, shifting to new zones.” 

Benoît said she hopes that this COP will highlight these issues and drive home the important link between the environment and our health. 

“You need concrete political action to implement all those solutions that we know are out there to limit climate change, to limit the devastating impacts of it on humanitarian crises,” she said.

Cecilia Sorensen, a physician and director of the Global Consortium on Climate and Health Education at Columbia University, said that researchers have found evidence of air pollution in placentas. 

“It gets into this very, very, fragile, delicate developing child system,” Sorensen said. “And this is why the World Health Organization predicts something like 90 percent of health impacts are going to be on this next generation because they start experiencing these exposures even before they’re born.”

Sorensen said those impacts are amplified throughout the life of the child.

“There’s been really good data looking at when you’re able to shut down fossil fuel producing facilities and in neighborhoods where there’s populations who are pregnant, that birth outcomes improve,” she said. “You can think about the benefits of that to the health and longevity of those individuals, but also about the avoided health costs and the benefits to the economy and to society. It’s huge.”

Mitigating those crises in her own small way is now Rosamond Adoo-Kissi-Debrah’s mission. She continues to work to keep other families from experiencing the pain that has endured for her family since Ella’s death.

Adoo-Kissi-Debrah, who frequently posts moments like Ella’s Beyoncé dance and her struggles in the hospital to her social media account as a way to raise awareness about the perils of polluted air, said she is frequently contacted by families who complain about the conditions near their homes.

“Someone writes to you and they say they live near a landfill and they can smell things,” she said. “You know sooner or later it’s going to impact their health. So these are quite heavy things to live with. If your breathing dirty air is linked to cancers and all sorts of things, it’s not a great life. And I’m not sure how we found ourselves in this situation, but poor people, they get a lot of pollution dumped on them.”

Adoo-Kissi-Debrah, who is of African descent, said that a multiplicity of factors, including race and class likely play a role in those who suffer most from air pollution.

“I’m sure if I came to America, where I will find poor people—it doesn’t matter the race—the air pollution will be worse there, and I don’t know when justice is going to come,” she said. “That’s what bothers me.”

Although she was not in attendance at the conference in Dubai, Rosamond Adoo-Kissi-Debrah’s name was invoked there. During her Health Day presentation, Burston reminded the audience of Ella’s story and her mother’s continuing work.

“I hope Ella will one day get justice,” she said. “Oh God, I have got to think that for all she suffered. I think one has to be hopeful.”