By Faith Jemosop
In the early morning light of Mpumalanga, mothers cradle sick children while standing in clinic queues that grow longer by the week. In the shadows of coal-fired power plants and smouldering refineries, the air hangs heavy invisible but deadly. South Africa’s air pollution crisis has long been known. But now, we know the victims by number: at least 1,300 children die every year due to air pollution. And the world barely blinks.
PM2.5 and Child Mortality
Fine particulate matter, known as PM2.5, is less than 2.5 micrometres wide , small enough to enter the bloodstream and lodge deep in the lungs. These particles are emitted by burning coal, vehicle exhaust, industrial processes, and even household cooking fires. According to the World Health Organization (WHO), PM2.5 exposure is directly linked to pneumonia, asthma, low birth weight, and developmental delays in children.
In South Africa, where coal still provides over 80% of electricity, PM2.5 levels routinely exceed safe thresholds. A 2025 Greenpeace report revealed that towns in Mpumalanga and Gauteng rank among the world’s most polluted when it comes to PM2.5 concentrations.
Children are especially vulnerable. Their lungs are still developing. They breathe faster than adults. And they often play outdoors in the very environments that are poisoning them. The “impact of air pollution on South African children” is not just tragic, it’s systemic.
The Hidden Burden of Disease
It’s not only the children who die that we should be counting.
The Years Lived with Disability (YLDs), a global health metric that measures the years of healthy life lost due to illness, reveals a much larger tragedy. According to the Institute for Health Metrics and Evaluation (IHME), air pollution accounts for over 40,000 YLDs annually among South African children under 14. That’s tens of thousands of childhoods burdened by chronic asthma, cognitive delays, missed school days, and reduced lifelong potential.
But while data mounts, accountability does not.
Where’s the Outrage? Where’s the Accountability?
Imagine a contaminated food supply killing 1,300 children a year. Heads would roll. There would be arrests, reforms, class-action lawsuits. But when it comes to dirty air, responsibility is diffuse, laws are weak, and enforcement is nearly non-existent.
No South African corporation or government official has ever been jailed for violating air quality standards, despite repeated court rulings and health warnings. In 2022, the High Court ruled that the government had violated constitutional rights by failing to improve air quality in the so-called “Deadly Air” case. Yet emissions continue, with impunity.
“It’s environmental violence,” says Thandeka Mlambo, a public health advocate in Emalahleni. “These children are being sacrificed for energy profits.”
The Story of Sipho
Sipho was born in 2020 in eMbalenhle, a town nestled among the smokestacks of Secunda. At just eight months, he was diagnosed with severe asthma. His mother, Lerato, walks 3 kilometers to the nearest clinic twice a week to get his inhalers. Sometimes, there are none in stock.
“He wheezes all night,” she says. “I worry that one day he won’t wake up.”
Doctors confirm that Sipho’s condition is likely due to early exposure to high levels of airborne toxins. Like thousands of children in the region, his lungs were damaged before he could even speak.
What Can Be Done?
South Africa’s Air Quality Act (2004) sets standards, but implementation is weak and monitoring is often manipulated or incomplete. Eskom and Sasol, the country’s biggest polluters have repeatedly applied for and received postponements or exemptions from emission standards.
Yet solutions exist:
- Investing in clean energy would reduce emissions at the source.
- Strengthening local air monitoring and data transparency would empower communities.
- Funding public health responses could mitigate the worst effects.
- And yes holding polluters criminally accountable could send the signal that children’s lives are not negotiable.
A Public Health Emergency, Not Just an Environmental One
The “Greenpeace report South Africa air quality 2025” is a stark reminder that air pollution is not an abstract environmental concern. It is a public health emergency. When 1,300 children die annually from something entirely preventable, the silence becomes complicity.
South Africa’s Constitution guarantees everyone the right to an environment not harmful to health or well-being. But for Sipho and thousands like him, that promise feels hollow.
It’s time we stopped talking about “air pollution” in sterile terms. These are poisoned breaths. Stolen futures. And unless we act, the numbers will keep rising.
