Vietnam's heavy air pollution needs stronger action

Hanoi was ranked the 8th most polluted city in the world.

The latest air pollution statistics paint a troubling picture. In March, Hanoi residents experienced just one day with "moderate" air quality, and none on which the air quality was "good". Air pollution returned to pre-pandemic levels in 2023, as Vietnam saw a 9% increase in the levels of small, harmful, PM2.5 particles in the air we all breathe. On average in 2023, Vietnam’s PM2.5 readings were nearly six times the WHO recommended levels.

Poor air quality is a significant risk to health in Vietnam, and globally. Particulate matter (fine particles of various pollutants and toxins) penetrate deep into people’s lungs and cardiovascular systems. We all know about the health risks of smoking tobacco: the health risks of exposure to high levels of air pollution are very similar. Short-term health effects include breathing difficulties, respiratory infections, and exacerbation of pre-existing conditions such as asthma. Long term health risks from prolonged exposure include stroke, heart disease, lung cancer, and chronic obstructive pulmonary disease.

Smog over Thang Long Boulevard in Hanoi at 11 a.m. on March 6, 2024. Photo by VnExpress/Ngoc Thanh

Air pollution causes about 7 million deaths globally per year, and at least 70,000 deaths each year in Vietnam, shortening the average lifespan by 1.4 years. Without action to address its health impacts, air pollution could risk the significant gains in life expectancy Vietnam has achieved in recent decades.

Everyone is at risk, but some more than others, including people with lung diseases such as asthma or chronic obstructive pulmonary disease; children, especially those under five, who face higher risks of acute respiratory infections like pneumonia, impacts on lung development and function, as a result making up an estimated 7% of total deaths that can be attributed to air-pollution in Vietnam; older adults; people with cardiovascular disease and/or diabetes; people who work or exercise strenuously outdoors; and people who live or work close to sources of pollution including busy highways, demolition and construction sites, industrial areas, open burning of waste, and forest fires. Pregnant women and their babies face particular risks, with exposure during pregnancy linked to premature birth and lower birth weights. Furthermore, unhealthy air is linked with neurological disorders, childhood obesity, and mental health problems.

Indoor air pollution is also a major, though often overlooked, cause of ill-health and death. In 2020, household air pollution was responsible for nearly half of all air pollution-related deaths – an estimated 3.2 million – including, tragically, the deaths of over 237,000 children under the age of five. A new study of 15,000 children in Ho Chi Minh City demonstrates the link between respiratory symptoms and poor air quality at home from second-hand smoke, and cooking using coal, wood or kerosene. Indoor air pollution also has a differential gender impact, as women tend to be more exposed to household air pollution than men.

Just as air pollution is dangerous for health, it is also bad news for Vietnam’s communities, society and the economy. Air pollution reduces the productivity of workers, negatively impacts crop yields and livestock production, reduces domestic and international tourism revenues and international investments and damages heritage sites through acid rain, and degrades ecosystems and biodiversity. The World Bank estimates that air pollution imposes social and economic losses on Vietnam, including from premature deaths and disease, of more than US$13 billion every year, not including future clean-up costs. This is equivalent to 4% of the country’s gross domestic product (GDP).

The good news is that strengthening action to tackle air pollution and reduce its health impacts will not only be good for health: clean air and blue skies will also deliver significant benefits for Vietnam’s society and the economy. Strategies to address air pollution also contribute to meeting climate mitigation targets, enable greater access to clean energy, strengthen environmental governance, all the while making cities more liveable and sustainable. Improved health also allows for gains in educational outcomes and labor productivity. These are just a few co-benefits among many of tackling air pollution. Working towards clean air accelerates progress towards achieving the 2030 Sustainable Development Goals.

World Environment Day puts a global spotlight on the pressing environmental challenges of our times – including air pollution. It is also a call to action – to harness the power of the government, businesses and individuals to restore blue skies and clean air in Vietnam.

This action can start at the individual level: people can take measures to protect themselves and their children against exposure to air pollution on heavily polluted days (for example, limiting prolonged or strenuous exercise outdoors, wearing a well-fitted mask that can filter out PM2.5 particles, and using air purifiers indoors if they can). But it is important to recognise that access to these "counter-measures" is not equal – for instance, many people work outdoors and can’t just stay inside till the air is clear, and effective air purifiers are expensive and thus out of reach for many of Vietnam’s citizens.

Addressing air pollution effectively – in order to bring health and other benefits for all – therefore require changes at policy, industry and sectoral level, to tackle pollution at its source. That is, cleaning up the air we breathe requires reducing Vietnam’s reliance on fossil fuels for energy and transport, moving to newer, cleaner vehicles, and better waste management such as reducing burning of crops and rubbish outdoors. Since many sources of outdoor air pollution are also sources of carbon emissions (such as fossil fuels), reducing air pollution and reducing the drivers and impacts of climate change go hand-in-hand, as part of a sound approach to sustainable development.

The Vietnam government has set ambitious targets for action on climate change, which will have significant benefits for addressing air pollution. At the 2021 United Nations Climate Change Conference (COP26), Vietnam committed to reaching zero carbon emissions by 2050. In December 2022, Vietnam and the International Partners Group announced a Just Energy Transition Partnership (JETP), which aims to unlock financing to support the country to accelerate the transition to renewable and clean energy sources. More recently, Vietnam has also joined WHO’s Alliance for Action on Climate Change and Health.

The UN welcomes these commitments, which send an important signal that addressing climate change – and improving air quality – is a priority for Vietnam. We are also happy to see progress on implementation – such as the stricter emissions standards for new cars introduced in January 2022, which, if effectively enforced, will reduce pollution generated from traffic.

However, there is scope to further strengthen action both in the short and medium/long terms, to mitigate the health impacts of air pollution and realize the dividends from doing so for Vietnam's society and economy.

For instance, strategies that have proven effective in other cities and countries include:

- Improving air quality monitoring, forecasting and information available to the public, to help inform steps individuals can take to reduce their exposure on more polluted days;

- Measures to help protect our youngest and most vulnerable, such as strengthening systems in and around schools, daycare centers, hospitals and homes to monitor air quality, improve ventilation and air filtration;

- Short-term mitigation measures that can be implemented at local level during periods of heavily pollution, such as measures to reduce the number of vehicles on the road, temporarily halting construction and industrial activity, and incentivizing switching to sustainable construction practices, such as employing low- or zero-emission equipment, and technological solutions for dust suppression and enhanced monitoring of coal-fired power plants to ensure emissions limits are strictly enforced;

- Accelerating the electrification of public transport and incentivizing people to switch to electric vehicles;

- Steps to improve waste management, in particular to end burning of rubbish and phase out burning of crop residues;

- Supporting households to access cleaner sources of energy including for cooking;

- And of course, at the macroeconomic level, accelerating action to phase out fossil fuels and transition to cleaner sources of energy.

There are several upcoming opportunities to institutionalize Vietnam's commitments to addressing climate change and air pollution in various laws and policies. For example, as the National Action Plan for Air Quality Management for 2021-2025 comes to an end and decision-makers consider how to shape the next plan, we hope to see a commitment to accelerated action to improve air quality. The next iteration of Vietnam's Nationally Determined Contribution (NDC) under the United Nations Framework Convention on Climate Change (UNFCCC), expected to be finalized by late 2025, will also be an opportunity to outline how Vietnam will meet its commitments to reducing greenhouse gas emissions.

The right to breathe clean air is one of the most fundamental rights of every adult and child on our planet. WHO, UNDP and UNICEF stand ready to support the Government of Vietnam to ensure this right is able to be enjoyed by everyone in the country – in support of the Government’s own commitments to protecting and promoting health and sustainable economic and social development, to create a brighter, healthier and fairer future.

*Dr Angela Pratt is WHO Representative in Vietnam, Ms Ramla Khalidi is UNDP Resident Representative in Vietnam, Ms Rana Flowers is UNICEF Representative in Vietnam.