Global health benefits of policies to reduce on-road vehicle pollution through 2040

Abstract Air pollution from road transport-related tailpipe emissions is a well-documented risk to human health. This study assesses the health impacts of these emissions under business-as-usual and various policy scenarios across 186 countries and territories, including 13 135 urban areas, until 2040, at a 1 km resolution. We evaluate emissions for 15 scenarios based on different combinations of key emission control measures. We use Goddard Earth Observing System -Chem Adjoint v35n for pollutant concentration modeling. We estimate PM 2.5 and ozone-attributable premature mortalities following global burden of disease 2019 methodology, and an epidemiologically-derived concentration-response model for NO 2 -attributable new paediatric asthma cases. Implementing all measures identified in this study is projected to avoid 1.9 million (95% confidence interval 1.3 million-2.4 million) premature deaths and 1.4 million (95% confidence interval 0.7 million-1.7 million) new cases of paediatric asthma cumulatively from 2023 to 2040. These health benefits differ by region and age group. Adults aged 65 and older account for 70% of global avoidable years of life lost, and children under 5 represent 50% of global avoidable new paediatric asthma cases. In countries without Euro 6/VI-equivalent standards, implementing such standards could achieve 56% and 63% of the total benefits of all identified measures combined for avoidable premature deaths and new paediatric asthma cases respectively. Regional disparities in road transport-attributable air pollution and health burdens are projected to widen without additional policies. Less developed countries are projected to experience more adverse impacts. Developing countries and urban areas show substantial potential in reducing new paediatric asthma cases. Stronger policies are needed to mitigate these health impacts, particularly for vulnerable groups such as children and older adults, and to address the growing inequities in air pollution exposure and related health impacts across regions. This evidence is valuable to policymakers to identify and prioritize actions to protect public health.