Transforming air pollution and health research into action in low- and middle-income countries

This commentary highlights the need for actionable and context-appropriate research on air pollution and health that will continue to drive policies to reduce exposures and disease burden. Research on air pollution and health has been substantial in high-income countries (HIC), leading to causal conclusions on the adverse effects of air pollution. Despite bearing the greatest disease burden from air pollution, low- and middle-income countries (LMICs) have had scant research funding, a trend that may well be aggravated due to changing political priorities in some HICs. High-quality data from LMICs is urgently needed to help motivate local, subnational, and national policies to raise awareness and identify priority actions to improve health. The new evidence will also provide a more complete understanding of air pollution and health globally. We highlight a framework for moving from research to action and address how this framework differs in HIC and LMIC contexts. We propose a hierarchy of research needs that begins with having the necessary air pollution monitoring and health data, and the capacity to use the data for informative analytics, risk assessment, valuation, and policy formulation. Building technical capacity may be needed for this purpose, as will development of a functioning regulatory system in parallel. We call for greater emphasis on surveillance studies to demonstrate the benefits of action and address barriers to action. The global community would benefit from a broad research agenda with priorities and adequate funding dedicated to building evidence that leads to positive policy change. We urge priority for advancing actionable research and improving research capacity in LMICs, including investments in routine collection of relevant data, emphasizing the foundation of risk monitoring and health data systems, and building a cadre of researchers and informed policy-makers.