Title page 1

Contents 7

FOREWORD 14

ACKNOWLEDGMENTS 16

MAIN MESSAGES 18

EXECUTIVE SUMMARY 20

1. INTRODUCTION 40

1.1. THE GLOBAL COST OF AMBIENT AIR POLLUTION 42

1.2. MODELING POLICY OPTIONS FOR REDUCING AIR POLLUTION 49

1.3. THE CASE FOR INTEGRATED POLICIES 55

1.4. DEVELOPMENT CO-BENEFITS 61

2. MULTISECTORAL SOLUTIONS TO ACCELERATE ACCESS TO CLEAN AIR 68

2.1. PRIORITIZING AN INTEGRATED APPROACH 70

2.2. COOKING AND RESIDENTIAL HEATING 76

2.3. AGRICULTURE 82

2.4. INDUSTRIAL SOURCES AND POWER GENERATION 87

2.5. TRANSPORTATION 91

2.6. MUNICIPAL SOLID WASTE 96

2.7. URBAN SOLUTIONS 98

2.8. RESILIENT LANDSCAPES 103

2.9. ADAPTIVE STRATEGIES TO REDUCE THE IMPACTS OF AIR POLLUTION 108

2.10. AIR QUALITY MEASURES AND CLIMATE CHANGE MITIGATION INTERACTIONS 110

3. FINANCING FOR ACCELERATED ACCESS TO CLEAN AIR 114

3.1. THE CASE FOR AIR QUALITY FINANCING 116

3.2. THE CURRENT FINANCING LANDSCAPE 117

3.3. MOBILIZING SUSTAINABLE FINANCING FOR AIR QUALITY 119

4. STRENGTHENING AIR QUALITY MANAGEMENT FRAMEWORKS, GOVERNANCE, AND INSTITUTIONS 132

4.1. COMPREHENSIVE AIR QUALITY MANAGEMENT PLANNING 136

4.2. CREATING AN ENABLING ENVIRONMENT 138

4.3. THE AIR QUALITY MANAGEMENT IMPLEMENTATION PROCESS 143

5. CONCLUSIONS AND RECOMMENDATIONS 150

5.1. STRENGTHEN INSTITUTIONS 151

5.2. LEVERAGE INFORMATION AND PRIORITIZE MEASURES ACROSS SECTORS 154

5.3. CATALYZE INVESTMENTS 158

GLOSSARY 160

REFERENCES 162

APPENDIX A. INPUT TABLES 173

APPENDIX B. CLEAN AIR, ENERGY AND CLIMATE POLICIES AND MEASURES CONSIDERED IN THE ANALYSIS 174

APPENDIX C. DEVELOPMENT FINANCE INSTITUTION INTERVENTIONS 188

APPENDIX D. METHODOLOGY FOR QUANTIFYING AIR POLLUTION MORTALITY AND ASSOCIATED ECONOMIC DAMAGES 189

APPENDIX E. HIGHLIGHTS OF EXPOSURE UNDER DIFFERENT POLICY SCENARIOS AND KEY PRIORITY REDUCTION SECTORS UNDER THE INTEGRATED SCENARIO, BY REGION 196

PHOTO CREDITS 199

Tables 13

Table 2.1. Interactions between air quality management and climate change mitigation for policies and measures in key sectors 112

Table 3.1. System costs of achieving the air quality and greenhouse gas targets for the different modeled scenarios in Almaty 120

Table 3.2. System costs of achieving the air quality and greenhouse gas targets for the different modeled scenarios in Almaty 126

Table 5.1. Policy Package A: Strengthening institutions 152

Table 5.2. Policy Package B: Leverage information to prioritize policies and measures 155

Table 5.3. Policy Package C: Prioritizing and integrating measures across sectors 156

Table 5.4. Policy Package D: Mobilizing finance at scale 158

Figures 10

Figure ES1. Air pollution-induced mortality is higher in middle-income countries 22

Figure ES2. The main sources of pollution differ widely across regions 23

Figure ES3. Despite an overall decrease in PM2.5 concentrations, population growth will continue to drive an increase in exposure by 2040 24

Figure ES4. Low-income regions would benefit the most from implementing integrated climate/energy and air quality management policies 27

Figure ES5. Integrated policies deliver climate mitigation benefits in addition to reducing PM2.5 exposure 28

Figure ES6. Cost-effective integrated policy packages are context-specific 30

Figure ES7. The building blocks of effective air quality management systems 32

Figure ES8. Governance and institutional framework for assessing air quality management systems 33

Figure ES9. The air quality monitoring program in the Indo-Gangetic Plain focuses on 12 jurisdictions 34

Figure 1.1. The death toll of ambient air pollution continues to rise, while death rates from household air pollution decrease 44

Figure 1.2. Air pollution induced mortality is higher in middle income countries 44

Figure 1.3. Nearly 50 percent of the global population is exposed to PM2.5 concentrations above 25 μg/m³ 46

Figure 1.4. The main sources of pollution differ widely across regions 47

Figure 1.5. Dust is a significant contributor in regions with the highest PM2.5 concentrations 48

Figure 1.6. Under the current policy environment, even though the level of PM2.5 pollution is expected to decrease, by 2040 the number of people exposed is likely... 52

Figure 1.7. Stated policies are likely to see lower income regions experience further growth in PM2.5 exposure 53

Figure 1.8. The rise in anthropogenic emissions will drive the increase in air pollution exposure in the worst affected regions 54

Figure 1.9. Integrated policies could cut attributable mortality by up to 35 percent against the Stated Policies scenario 56

Figure 1.10. Low-income regions would benefit the most from implementing integrated climate/energy and air quality management policies 57

Figure 1.11. The Integrated Policies scenario could cut attributable mortality by about 35 percent against the Stated Polices scenario 58

Figure 1.12. Aspirational "32 by 35" target for the Indo-Gangetic Plain and Himalayan Foothills 60

Figure 1.13. Integrated policies deliver climate mitigation benefits while reducing PM2.5 exposure 63

Figure 1.14. Modeled PM2.5 concentrations from anthropogenic sources in 2040 in the Stated Policies scenario (top) and the Integrated Policies scenario (bottom) 67

Figure 2.1. Reducing air pollution exposure will require policy instruments tailored to the specificities of sectors and regions 71

Figure 2.2. Comparison of annual PM2.5. exposure between Stated Policies scenario and Integrated Policies scenario in 2040, by sector and regions 72

Figure 2.3. Sectoral breakdown of additional exposure reductions needed to achieve the Clean Air Targets through integrated policies, by region 74

Figure 2.4. Cross-sector interventions would enable the Clean Air Targets to be achieved in a cost-effective fashion 75

Figure 2.5. More than 80 percent of space heating in East and Central Asia derives from fossil fuel 79

Figure 2.6. East and Central Asia's heating sector is a significant source of air pollutants 80

Figure 2.7. Overlap between pollution and wealth in Johannesburg, South Africa 99

Figure 2.8. Cities in low- and middle-income countries have worse air pollution than cities in high-income countries 99

Figure 2.9. Urban compactness reduces pollution 100

Figure 4.1. Comprehensive air quality management planning 137

Figure 4.2. Governance and institutional framework for assessing air quality management systems 138

Figure 4.3. The air quality management cycle 143

Figure 4.4. The five steps of an integrated air quality and climate change policy process 146

Boxes 9

Box ES1. Modeling scenarios and World Health Organization Air Quality Guidelines used in this report 26

Box ES2. Key interventions in different parts of the Indo-Gangetic Plain and Himalayan Foothills region 34

Box 1.1. World Health Organization Air Quality Guidelines 43

Box 1.2. Modeling scenarios and World Health Organization Air Quality Guidelines used in this report 50

Box 1.3. Case study: A "35-by-35" aspirational goal for South Asia 59

Box 1.4. PM2.5 and greenhouse gas emissions: Common issues and sources 66

Box 2.1. The true cost of heating in regions with cold winters 79

Box 2.2. Case study: Burning crop residues in India 83

Box 2.3. Chinese cities: An early focus on industry 90

Box 2.4. Mexico City: An early focus on transport 93

Box 2.5. The Complementarity of Standards and Fiscal Incentives in Improving the Quality of Used Vehicles in Mauritius 94

Box 2.6. Public-private partnership and an innovative leasing scheme promote adoption of electric buses in Chile 95

Box 2.7. Cities taking steps to improve urban air quality 102

Box 2.8. How innovation in urban forestry in Korea enhances air quality for city dwellers 104

Box 2.9. Drawing on nature to reduce air pollution from dust storms 105

Box 2.10. Indonesia's forest fires: Raising awareness by analyzing the cost 106

Box 2.11. Innovative productive landscape restoration strategies in Central Asia 107

Box 3.1. Assessing integrated air quality management and climate change mitigation policies in Kazakhstan 120

Box 3.2. Leveraging priority sector lending in India 122

Box 3.3. The Kyrgyz Republic Air Quality Improvement Project 128

Box 3.4.The Bangladesh Environmental Sustainability and Transformation project 129

Box 4.1. Country illustrations of various air quality management framework development strategies 134

Box 4.2. AQMx: Defining comprehensive air quality management planning 136

Box 4.3. Air quality management governance: enabling conditions and emerging trends across countries 141

Box 4.4. Integrated air quality and climate change process 145

Box 4.5. South Asia regional program on air quality: shifting to airshed approach 147

Box 4.6. Common features across collaborative watershed management and airshed management 148

Appendix Tables 13

Table A.1. Population growth trends by region assumed for the scenarios 173

Table A.2. Real GDP average growth assumptions by region 174

Table B.1.Energy policies and measures assumed in the International Energy Agency's Stated Policies (STEPS) scenario (2021) andincluded in this report's Stated... 175

Table B.2. Air quality policies and measures assumed in the Stated Policies scenario (2040) 178

Table B.3. Examples of cost effective energy and climate policy and AQM measures to achieve the Clean Air Targets 185

Table B.4. Diffuse and small-scale sources of pollution and corresponding control measures 187

Table D.1. Estimated GEMM function parameters 192

Appendix Figures 13

Figure D1. Reduction in ambient air pollution-attributable mortality compared to the Stated Policies scenario in 2040 190

Figure D2. GEMM hazard ratio predictions, group of persons aged 60 to 64 193

Figure D3. Comparison between Burnett et al. (2018) and GBD 2021 relative risk values 195