新闻来源：www.nytimes.com
原文地址：Opinion | One of the World’s Biggest Health Risks Is a Philanthropic Blind Spot
新闻日期：2024-09-19
去年6月7日，纽约市及周边地区因加拿大野火烟雾笼罩而变得昏暗。州长凯瑟琳·霍库尔警告称这是一个“紧急情况”，并建议居民留在室内。在城市中，学校取消了活动，图书馆提前关闭，一场洋基队的比赛也被推迟。
这天是自1999年开始记录以来纽约市最污染的一天。空气质量指数飙升至400以上，超过300就被认为有害。尤其令人担忧的是细颗粒物含量，这些微小的颗粒物包括烟雾和焦油等污染物，深入人体肺部，在那一天创下了世界城市中最高的水平，是联邦健康标准的三倍之多。
对于纽约市而言，这是一次例外。该市的整体空气质量通常不错。但许多其他城市并非如此。对他们来说，很多天就像去年六月纽约居民所经历的一样，甚至更糟糕。
芝加哥大学的空气品质生活指数衡量了空气污染对寿命的影响，显示生活在地球上最污染地区的人民吸入的空气含有比最不污染地区人们吸入的空气多六倍的污染物——而且生活在最污染地区的人民因为空气污染而预期寿命缩短了超过两年。据健康影响研究所和卫生统计评价研究所2024年的一份报告估计，全球约有810万人在2021年死于呼吸脏空气造成的健康影响。
私人慈善捐款可以在世界上一些最污染地区取得重要进展。但据伦敦的清洁空气基金最近的一项报告显示，每年投入到空气质量领域的已知慈善资金平均只有4130万美元。这不到一家主要资助机构——全球基金一年5亿多美元支出的1%。全球基金致力于抗击疟疾、艾滋病和肺结核。
尤其是令人不安的是，空气中颗粒物已成为全球疾病负担最大的因素之一——衡量早死和疾病的指标，并且是预期寿命的最大威胁之一，超过了疟疾、艾滋病和交通事故伤害的影响总和。脏空气不仅会缩短人的寿命。据研究表明，对五岁以下的儿童而言，它还是第二高的死亡风险。
与世界其他地区相比，欧洲、美国和加拿大在空气质量对人体健康影响方面的差异微乎其微。但它们接收了约60%投入到空气质量领域的慈善资金。非洲是十大最污染国家中的五个。从2015年到2022年，整个大陆平均每年获得23.8万美元的慈善资助，用于减少空气污染。
数据——或者说，更准确地说，缺乏数据——是最紧迫的问题。数据的不足使唤动公众意见、制定政策和衡量进展变得困难。这也使得吸引资金变得更加困难。但当空气质量数据可用时，污染会下降。而当空气质量改善后，研究表明人们会活得更长、更健康。然而，全球有39%的国家未能为其公民提供空气质量数据。这些国家也是最污染的地方之一。
最近的一项研究显示，在美国大使馆的一些位置安装空气污染监测器并开始实时共享空气质量数据后，污染程度下降，并导致提前死亡人数减少，表明地方政府甚至居民得知这一信息后采取了措施以减少污染。
从我作为芝加哥大学能源政策研究所清洁空气项目主任的角度来看，最令人印象深刻的是北京的转变。美国大使馆于2008年开始每小时发布屋顶监测器记录的细颗粒物数据。据我和其他人认为，由此产生的公众对改善空气质量的压力帮助政府在2013年制定了一个改善计划。数亿美元用于全国范围内的污染减少工作，到2022年，京津冀地区的颗粒物污染下降了45%。
一些世界上最污染地区的基本空气质量监测缺乏为慈善界带来了巨大的机会。根据与当地空气品质专家和清洁空气倡导者的访谈，我们估计每个国家每年投入5万至10万美元可以支持长期的空气质量监测工作。
总计，每年只需400万到800万美元的资金就可以支持已经准备解决国别水平空气质量数据空白的本地组织。他们可以为超过十亿人提供此类数据。我们正在通过一个新基金将这些团体与慈善家联系起来，该基金将从私人捐赠者那里筹集资金，然后分发给需要的人。
即使像危地马拉这样一个拥有1800万人口的小国都能从中受益，从而最终促进空气质量有所改善，因为空气污染而生病人群的医疗成本节省下来的价值会超过全球空气质量数据投资。进展是可能实现的，并且已经在实现——在北京、东京、柏林、洛杉矶和其他城市。确立国家空气质量标准、执行这些标准并在本地层面监测进度对于减少那些城市的空气污染物至关重要。但要取得成功，就需要长期的空气质量数据。
原文摘要：
On June 7 last year, the skies across New York City and large swaths of the state turned hazy from wildfire smoke blowing in from Canada. Gov. Kathy Hochul warned of an “emergency situation” and cautioned residents to stay indoors. In the city, schools canceled activities, libraries closed early, and a Yankees game was postponed.
It was the most polluted day in the city since record-keeping began in 1999. The air quality index, a composite of five pollutants, skyrocketed to over 400; above 300 is considered hazardous. Most alarming, the level of fine particulate matter, which is an especially dangerous component of the index because the tiny particles of smoke, soot and other pollutants penetrate deep into the lungs, was the highest recorded in any city in the world on that day and three times as much as the federal health standard.
For New York City, this was an anomaly. The city’s air quality is generally pretty good. But that is not the case for hundreds of cities around the world. For them, many days are like what New York City residents experienced that day last June. Or often worse.
The Air Quality Life Index at the University of Chicago, which measures the impact of air pollution on life expectancy, shows that people living in the most polluted places on Earth breathe air that has six times as much pollution as the air breathed by people in the least polluted places — and those in the most polluted places are seeing their lives cut short by more than two years because of it. An estimated 8.1 million people globally died in 2021 from the health impacts of breathing dirty air, according to a 2024 report by Health Effects Institute and the Institute for Health Metrics and Evaluation.
Private philanthropy could do much to turn the corner on this problem in some of the most polluted parts of the planet. But just an average $41.3 million in known philanthropic funds are devoted to air pollution each year, according to a recent report by the Clean Air Fund, a philanthropic group based in London. That is less than 1 percent of the more than $5 billion spent annually by one major funder, the Global Fund, to combat malaria, H.I.V./AIDS and tuberculosis.
This is especially disconcerting because particulate matter in air pollution has become the world’s largest contributor to the global disease burden — a metric quantifying premature death and sickness — and one of the greatest threats to life expectancy, outstripping the impacts of malaria, H.I.V./AIDS and transportation injuries combined. Polluted air does not just cut off a few years at the end of a long life. It is the second highest risk of death for children 5 and under.
Europe, the United States and Canada are barely affected by the health impacts of air pollution when compared with the rest of the world. But they receive roughly 60 percent of the philanthropic funds devoted to combating it. Africa is home to five of the top 10 most polluted countries. From 2015 through 2022, the entire continent received an average of $238,000 per year in philanthropic grants aimed at reducing air pollution.
Data — or, more precisely, a lack of data — is the most immediate problem. The paucity of data makes it difficult to stir public opinion, develop policy or measure progress. It also makes it hard to attract funding. But when air quality data is available, pollution declines. And when air quality improves, decades of research make clear that people live longer, healthier lives. Yet, 39 percent of the world’s countries aren’t producing air quality data for their citizens. Those countries are also some of the most polluted.
A recent study showed that when American embassies installed air pollution monitors at some of their locations and began sharing the real-time air quality data publicly, pollution declined and led to decreases in premature mortality, suggesting that local governments and perhaps residents took steps to reduce pollution once they learned of it.
From my perspective as the director of the clean air program at the University of Chicago’s Energy Policy Institute, perhaps the most impressive turnaround was in Beijing, where the United States Embassy, in 2008, began tweeting hourly levels of fine particulates from a monitor on the embassy’s roof. I and others believe the resulting public pressure to reduce air pollution helped lead the government to lay out a plan to do so in 2013. Billions of dollars were spent to reduce pollution countrywide, and by 2022, particulate pollution in the Beijing-Tianjin-Hebei region had declined by 45 percent.
The lack of basic air quality monitoring in some of the world’s most polluted places presents a huge philanthropic opportunity. From interviews with local air quality experts and clean air advocates, we estimate that annual investments of $50,000 to $100,000 per country could support long-term air quality monitoring efforts.
In total, it would take a global investment of a mere $4 million to $8 million a year to support local organizations already poised to address country-level air quality data gaps. Together, they could provide a billion people with access to such data. We are working to connect those groups to philanthropies through a new fund we have created that will raise money from private donors and then dispense it.
If even one relatively small country like Guatemala, home to 18 million people, were to benefit from such data infrastructure support, eventually spurring even a modest reduction in pollution levels, the avoided costs of caring for people sickened by breathing dirty air would outweigh the global investment in air quality data.
Progress can be made, and it has — in Beijing, Tokyo, Berlin, Los Angeles and other cities. Establishing national air quality standards, enforcing those standards and monitoring progress at the local level was crucial to reducing air pollutants at their source in those cities. Achieving that success, though, requires air quality data over long periods.
Few global health issues can be alleviated with an investment of just a few million dollars a year. But gathering air quality data in some of the world’s most polluted countries is one of them.
