The popular argument in support of fossil fuel subsidies is that they make energy more accessible and affordable to consumers. In many cases this is true, but there are untold consequences that the argument leaves out and that is the impact they have on our health.

While subsidies for coal, oil and gas make consumption of these fuels cheaper for consumers, it results in an increase in carbon emissions, which are directly affecting our health in the form of air pollution. The burning of fossil fuels is one of the main contributors to air pollution, which studies show can lead to lung disease, asthma attacks, strokes and heart attacks. Air pollution kills more than 7 million people every year.

Fossil fuel subsidies also put undue pressure on our public health systems by diverting funds that could be used more efficiently for public health services. According to the European Health and Environment Alliance (HEAL), G20 governments in 2014 gave $444 billion in subsidies to fossil fuel companies, while the health costs resulting from the use of fossil fuels in those countries was estimated to be at least six times that amount.

In the UK, for example, health costs from fossil fuel-driven air pollution are almost five times higher than the subsidies paid. And in China, the impact of fossil fuels on public health through air pollution is estimated at about $1.8 trillion – this is more than 18 times what the nation pays to oil, gas and coal producers, thereby helping to fuel a public health crisis that is already causing 1.6 million premature deaths every year.

Removing the subsidies is the answer. It will lead to a reduction in fossil fuel consumption and fossil-fuel related carbon emissions, and thus significantly reduce the number of air pollution-related deaths. The removal of subsidies globally would greatly reduce global CO2 emissions each year compared to a business-as-usual scenario. Removing the subsidies will also free up much-needed funds for low-carbon alternatives such as solar, wind and hydropower, which would contribute to the reduction in the production and consumption of fossil fuels, and help prevent driving the planet far beyond the internationally agreed climate change target of limiting global temperature increases to no more than 2ºC.

Despite the urgency of transitioning to renewable energies and low-carbon societies, global fossil fuel subsidies are still significant – estimated at $373 billion a year, according to the OECD. At the same time, governments have made high-level commitments to increase public spending on working towards the UN Sustainable Development Goals (SDGs). The World Health Organization says achieving the SDG health targets would require new investments increasing over time from an initial $134 billion annually to $371 billion by 2030.

If we can remove the subsidies, funds could then be freed up to be used towards these investments and ensure healthy lives and promote well-being, as called for in SDG 3. The funds could then be used for investing in socially needed projects and policies. These could include policies aiming not just at a transition to a green economy, but also more direct health policies such as healthcare funding or poverty reduction. Making the switch to renewables and healthier energy choices could contribute to achieving higher energy security, and more importantly cleaner air.

By Chukwunonso Gerald Iheoma, Researcher, Secretariat of the Rockefeller Foundation Economic Council on Planetary Health

We are nearly two decades into the 21st century, yet nearly 2.3 billion people – one-third of the global population – still lack basic sanitation. This appalling state of affairs causes unnecessary disease and death. Poor sanitation is linked to transmission of such diseases as cholera, diarrhoea, dysentery, Hepatitis A, typhoid and polio; it also contributes to malnutrition. Poor sanitation not only affects human health, but it can also damage ecosystems and the health of our planet.

In 2010, the United Nations General Assembly recognized access to safe and clean drinking water and sanitation as a human right, and called for international efforts to help countries provide safe, clean, accessible and affordable drinking water and sanitation. Today, this call is enshrined in UN Sustainable Development Goal 6 – ensure availability and sustainable management of water and sanitation for all. Targets for the goal include achieving by 2030 access to adequate and equitable sanitation and hygiene for all and end open defecation (Target 6.2). There is also a call to expand international cooperation and capacity-building support to developing countries in water- and sanitation-related activities and programmes (Target 6.a), and to support and strengthen the participation of local communities in improving water and sanitation management (Target 6.b)

These are ambitious goals, as are most of the SDGs, but they can be achieved and in some cases are starting to be achieved.

Jennifer Cole, public health policy advisor with the Secretariat of the Rockefeller Foundation Economic Council on Planetary Health lays out in the report, Sanitation in the Context of Planetary Health, opportunities and challenges for meeting the SDGs on sanitation. By applying a planetary health approach across the triad of public health, environmental health and economic opportunities, policy-makers and environmentalists can begin to think in terms of not only the disposal of human waste, but also of resource recovery and reuse – and its potential to generate clean energy and the reduction of greenhouses gases – and recovery of nutrients for agriculture, as well as reduced exposure to disease pathogens.

One particular challenge for densely populated human settlements is how to dispose of large quantities of human waste which, if not safely managed, impact on human health, the environment and economic prosperity. The World Health Organization estimates that total global economic losses associated with inadequate water supply and sanitation to be 1.5% of GDP (US$260 billion), with poor sanitation costing some countries, especially in the developing world, as high as 7.2% of annual GDP. This reflects the cost of healthcare treatment, productivity time lost to sickness and seeking treatment, and productivity time lost to accessing sanitation facilities.

Illustrative photo of a latrine (Amy Reed)

Poorly managed sanitation can also create environmental challenges. Ill-functioning latrines and septic tanks can leak into soil and water, and untreated wastewater released directly into the environment can pollute rivers. Untreated waste flowing into our waterways can cause eutrophication – excessive plant growth due to the high concentrations of phosphates and nitrates it contains – which can severely damage freshwater and coastal marine ecosystems. And let us not forget the link between sanitation and greenhouse gas emissions. Pit latrines can produce higher greenhouse gas emissions than open defecation as more of the carbon in fecal matter forms methane rather than CO2 during breakdown, so capturing this methane for clean energy also needs to be considered.


As developing nations industrialize and urbanize, incorporating sanitation and waste management strategies into wider environmental policies can offer an array of benefits. Good waste management practices allow nutrients in waste and wastewater to be reused as agricultural fertilizer, and biogas released from the breakdown of waste can be used as fuel and generate electricity. For example, capturing methane emissions from human waste for biogas compared with losing them to the atmosphere could prevent a 6% annual increase in India’s greenhouse gas emissions. Using this biogas to provide clean energy to households that currently use traditional cooking stoves could potentially avoid more than 4% of the country’s GHGs, worth over US$1 billion on the international carbon market, and reduce black carbon – a cause of human morbidity and premature mortality – by a third.

Challenges to implementing and maintaining improved sanitation vary between locations based on economic status, rural or urban settings, and even cultural barriers. All of these need to be addressed if SDG 6 and its targets are to be achieved by their 2030 deadline. While the developed world is showing immense progress in collecting, treating and reusing waste, much more needs to be done in developing countries. But if we provide affordable and the right equipment and education in hygiene practices, we can reduce the senseless suffering from preventable diseases and loss of life.

By Mark Schulman, Editor, Secretariat of the Rockefeller Foundation Economic Council on Planetary Health