Speech – Upon accepting the 2014 European Lung Foundation award on behalf of WHO for its outdoor air quality guidelines

6 September 2014, Munich, Germany

Dear Ms Fletcher, Professor Barnes,

Ladies and gentlemen,

It is a great pleasure and honour to accept the 2014 Annual European Lung Foundation Award on behalf of the World Health Organization (WHO) for our efforts in improving the health and well-being of people by addressing the key determinants of respiratory health.

There is no doubt that healthy lungs are essential for quality of life. Yet respiratory diseases still remain a leading cause of death and disability in Europe and across the world.

Prevention and control of respiratory diseases are important elements of the WHO European health policy framework, Health 2020, and the Action Plan for Implementation of the European Strategy for the Prevention and Control of Noncommunicable Diseases 2012−2016, including the measures to strengthen the response to chronic diseases, combat indoor and outdoor air pollution, and efforts to implement effectively the WHO Framework Convention on Tobacco Control.

In the field of communicable diseases, our focus on respiratory diseases has been on the prevention and control of infectious diseases including influenza, tuberculosis and multidrug-resistant tuberculosis. In 2011, the WHO Regional Committee for Europe unanimously adopted the Consolidated Action Plan to Prevent and Combat Multidrug- and Extensively Drug-resistant Tuberculosis in the WHO European Region 2011–2015, which was developed through a consultative and iterative process with our Member States and partners like the European Respiratory Society and civil society. We are now in the process of developing, through a similar consultative process, the regional tuberculosis action plan 2016–2020, to implement the global strategy and targets for TB prevention, care and control after 2015. I have appointed a Special Representative of the Regional Director to Prevent and Combat multidrug and extensively drug-resistant TB in the WHO European Region as a sign of my personal commitment to lung health, and the fight against MDR-TB and respiratory diseases. We have been working very closely with our 53 Member States in the WHO European Region and key partners, particularly the European Respiratory Society, to monitor the health indicators, build scientific evidence for intervention, and facilitate country capacity building to address the health inequalities through health systems’ lens and people-centred approaches. However, as you are aware, a great deal more is needed to achieve better protection of lung health in Europe.

Let me speak about one of the most important public health challenges. At least six hundred thousand people die as a consequence of indoor and outdoor air pollution in the WHO European Region every year. Seven million people die from the same cause globally.

Science provides convincing arguments for decisive action to improve air quality and reduce related deaths and diseases in Europe.

The leading sources of harmful pollution – transport, burning of coal in power plants and households, burning of biomass and industry – cause over 80% of the population of the European Union to live in cities with particulate matter levels exceeding the WHO air quality guidelines. This pollution creates a substantial burden of disease, reducing life expectancy by almost 9 months on average.

An evidence review conducted by the WHO Regional Office for Europe last year indicated that health effects occur at air pollution concentrations even lower than the existing guideline levels. Results from recent scientific projects indicate that average life expectancy in the most polluted cities could be increased by approximately 20 months if the long-term particulate matter concentration was reduced to the WHO annual guideline level. In line with those findings, the WHO Regional Office for Europe has initiated the revision of the air quality guidelines, which should be completed in the coming two years.

There is also consistent evidence that lower air pollution levels resulting from sustained, long-term interventions result in health benefits for the population, with improvements in population health occurring within a few years after the reduction in pollution. Decreased levels of particulate air pollution can substantially diminish total, respiratory and cardiovascular death rates. Benefits can be expected at almost any reduction in levels of air pollution, suggesting that any good policy intervention is likely to have continuing favourable effects on public health.

Interventions and policies that improve air quality often have significant co-benefits in addressing other important and urgent public health concerns of our times. Cleaner energy production often reduces greenhouse gas emissions as well, mitigating climate change. Improved transport policies and systems not only reduce air pollution but also stimulate active transportation and physical activity and, therefore, contribute to addressing obesity.

It is a fundamental public health responsibility of governments to ensure safe living conditions for all people. Issues like air quality are a perfect example of why health is the business of the whole government. While the health sector should be able to observe, measure and understand common threats to people’s health and guide the design and implementation of effective standards and policies, it is the other sectors, such as transport, energy, agriculture, urban and land management that have to act appropriately.

In the WHO European Region, this was understood a long time ago. The European environment and health process, initiated in 1989, developed into a perfect example of intersectoral governance at the international level. It addresses environmental health determinants from a wide perspective of societal priorities of improving health, preserving the environment, developing sustainable societies and economies while promoting environmental and societal justice. In that context, the WHO Regional Office for Europe exercises its core functions of normative guidance and public health policy leadership on the leading health issues of our times.

The WHO air quality guidelines led to the adoption of national air quality standards and of the clean-air directive in the European Union. They are also the basis for the implementation of the Convention on Long-range Transboundary Air Pollution. Together with the current revision of those guidelines in the context of the new evidence, this is a prime example of our role in international public health, of which we are very proud. I therefore thank you wholeheartedly for the recognition of our role in international public health and of our contribution to the better health and well-being of our citizens.

Thank you.