Our most vulnerable are also our most valuable. ARNEC was mentioned in The Straits Times’ OpEd on 24 June – Tiny Lungs, Hefty Price: Air pollution’s unequal burden on young children.

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Tiny Lungs, hefty price: Air pollution's unequal burden on young children

My daughter was four when we moved from Kathmandu to Kuala Lumpur in 2019 to escape air pollution.

We were living in Nepal's capital due to my husband’s job.

With the Air Quality Index (AQI) hovering close to 500 at times, we discovered firsthand why Kathmandu was ranked among the top 10 most polluted cities in the world at that time.

I decided to relocate back to my home country Malaysia with our little one while my husband continued to work in Kathmandu.

Little did we know that we would face a similar issue back in Kuala Lumpur. The deadly transboundary haze had returned to blanket South-east Asian countries with Indonesia declaring states of emergency across six provinces.

Schools and childcares suspended classes due to health concerns. This affected at least 1.7 million children in Indonesia and Malaysia.

A 2022 global report by Swiss air quality technology company IQAir showed that only 13 countries had healthy air quality levels and none of them were from Asia.

Of the 296 South-east Asian cities in the report, only eight met the World Health Organization's (WHO) PM2.5 limit. Air quality has continued to worsen over the decades since 1998.

Average PM2.5 Concentrations in Southeast Asia, 1998 to 2020

Source: Air Quality Life Index (AQLI), University of Chicago

Impact on young children

The urgency to address this global problem becomes more apparent in the region when it's hit by the haze.

Just within Malaysia between 2000 and 2007, there was a 41 per cent excess risk of natural deaths due to haze affecting children less than 14 years old, based on a 2021 UNICEF Malaysia study on Environment and Climate.

The study also found that health effects among young children below the age of five are more acute when haze occurs over a longer period of time with greater intensity.

The ultrafine particulate matter (more than 700 times thinner than the width of a single strand of human hair) found in polluted air poses a greater threat to children.

It can easily enter the bloodstream and make its way to the brain - causing inflammation, harming neurons and brain cells.  Inhaled toxic air can cause neuro-degenerative diseases, often found in people living in areas where urban air pollution is high.

Fetuses during pregnancy and infants are at greater risk compared to older children and adults.

During pregnancy, inhaled air pollutants can cross the placenta and affect the developing brain of a fetus, damage cognitive abilities, with potential lifelong neurological effects during adulthood with an increased risk of cognitive decline.

Almost a million stillbirths in low- and middle-income countries were also linked to air pollution, according to a study released last year, and they were attributed to PM2.5 particulate matter which is dominant during the haze.

Infants breathe three times faster than adults and their bodies absorb more pollutants given their body size.

During infancy, 80 per cent of tiny air sacs critical to oxygen-blood transfer is developed, making this a vulnerable period to air pollution as it can lead to harmful respiratory disease such as asthma and pneumonia.

Pneumonia is among the biggest child killers as it accounts for almost one in 10 under-five deaths, according to UNICEF.

Climate change brings new challenges

There is a fundamental issue of children's rights when it comes to the environment.

The UN Convention of the Rights of the Child (CRC) recently adopted General Comment 26 as official guidance on children’s rights to a clean, healthy and sustainable environment, with a special focus on climate change. This is significant as children – particularly infants and toddlers – are often forgotten in the current climate and environmental discourse.

The final texts, which will be released in July, include a reference to the threat air pollution poses to children  and state that under-five mortality can be prevented through the reduction of air pollution.

The effects of climate change, intensification of air pollution as well as physical and psychological trauma linked to these events, are disproportionately borne by children.

But even as the global wheels are in motion in highlighting the issue, the problem of air pollution can potentially get worse.

The next five years will be the warmest five-year period recorded, the World Meteorological Organization has warned. Joint occurrence of heatwaves and air pollution can lead to worse air quality.

Studies have shown that excess heat exposure compounded by air pollution can increase risks of pre-term birth and increase incidence of hospitalisation related to childhood asthma.

The effects of climate change can also exacerbate the levels of air pollution. For instance, droughts can lead to wildfires which increase carbon emission.

Young children need support to strengthen their resilience and adaptive capacities. This was highlighted in a joint scoping study by the Asia Pacific Regional Network for Early Childhood (ARNEC).

Efforts need more urgency

Singapore hosted talks on transboundary haze cooperation during the Ecosperity Week conference recently with ASEAN members Brunei, Indonesia, Malaysia, and Thailand.

We have the assurance from the Indonesian minister that transboundary haze originating from Indonesia will not be an issue anymore despite an anticipated dry and hot season ahead.

Regionally, there are legal instruments and commitments.

There is the ASEAN Agreement on Transboundary Haze Pollution (AATHP), commitment of ASEAN to meet globally agreed climate targets as part of the UN Sustainable Development Goals, Framework for Circular Economy, and ASEAN Carbon Neutrality Strategy. Singapore has its Transboundary Haze Pollution Act 2014.

Even with these instruments in place, the coming months are not expected to be free from haze, according to the Singapore Institute of International Affairs.

Its recently released Haze Outlook report pointed to a high risk in 2023 of severe transboundary haze in Indonesia, Malaysia, Singapore and the surrounding region with hotter and drier weather predicted, especially as the warmer El Nino is expected to return.

The imperative is clear for concrete collective action.

"The world has turned the corner on tobacco. Now it must do the same for the 'new tobacco' - the toxic air that billions breathe every day," said Tedros Adhanom Ghebreyesus, WHO’s Director General in 2018.

As young children bear the brunt of climate change, we owe it to them to do everything we can to make things better, sooner.

Our most vulnerable are also our most valuable.