By Jemosop Faith
On a chilly winter morning in Mpumalanga, 10-year-old Thandiwe clutches her inhaler before heading to school. She’s one of thousands of South African children growing up with chronic respiratory issues. Her mother, Sindi, has never smoked a day in her life, yet she was recently diagnosed with bronchitis and early signs of COPD. The culprit? Not a virus, not genetics, but the very air they breathe.
Air pollution in South Africa is not new. But what’s shocking is just how deadly it has become killing over 42,000 people every year, according to data from the Global Burden of Disease.
And this is not just a one-year crisis. It’s a persistent, systemic issue made worse by policy loopholes, poor enforcement, and long-standing dependence on coal. While Eskom South Africa’s power utility is often in the hot seat, the truth is more complex, and far more alarming.
What Is PM2.5?
PM2.5 refers to fine particulate matter that is 2.5 micrometres or smaller in diameter so tiny, it can penetrate deep into your lungs and even enter your bloodstream. These particles are mostly produced from burning coal, vehicle emissions, industrial processes, and even domestic wood-burning.
According to the World Health Organization (WHO), the safe annual average for PM2.5 is 5 µg/m³. In parts of Mpumalanga, where some of Eskom’s largest coal-fired power stations are located, PM2.5 levels have reached more than 40 µg/m³ eight times the recommended limit.
The Health Toll
The health impact of PM2.5 in South Africa includes:
- Respiratory diseases like asthma, bronchitis, and lung cancer
- Cardiovascular issues including strokes and heart disease
- Low birth weight and developmental issues in children
- Increased COVID-19 vulnerability and other infectious diseases
Greenpeace’s air quality South Africa report has repeatedly ranked Mpumalanga as one of the world’s worst pollution hotspots, comparable to Beijing and Delhi.
Eskom’s Emissions and Exemptions
Let’s be clear Eskom is a major polluter. The utility runs 15 coal-fired power stations, many of which are operating well beyond their intended lifespan. According to Centre for Environmental Rights, Eskom emits more SO₂ than any single power company on Earth.
In 2023, Eskom sought and received pollution exemptions from the government arguing it could not meet minimum emission standards without risking blackouts. The Eskom pollution exemptions controversy sparked outrage among health advocates and environmentalists. It raised a grim question: Should keeping the lights on come at the cost of public health?
The Industrial and Transport Sectors
But to pin the entire blame on Eskom is to miss the forest for the trees. Industries such as steel, cement, and petrochemicals release their own toxic loads into the air. Vehicle emissions in urban centers like Johannesburg and Cape Town contribute heavily to nitrogen dioxide and ground-level ozone pollution.
South Africa also has lenient pollution enforcement. The National Air Quality Officer rarely exercises their full regulatory powers, and the Air Quality Act, though progressive on paper, is undermined by poor implementation.
The cost of air pollution to South Africa economy is staggering.
- A 2021 study by the World Bank estimated that air pollution cost South Africa up to 6% of its GDP through healthcare costs, lost productivity, and premature deaths.
- In purely financial terms, that’s more than R270 billion annually more than the entire national education budget.
- For context, air pollution kills more people in South Africa each year than traffic accidents, homicides, and diabetes combined.
Also read: Is Climate Change Threatening the Global Energy Sector?
This is not just an environmental issue. It’s an economic emergency and a human rights crisis.
Sindi and the Price of Survival
Back in Mpumalanga, Sindi spends close to R1,000 a month on medication for her daughter and herself nearly half her salary. When asked what she wishes the government would do, she doesn’t hesitate:
“Just clean the air. We don’t want compensation. We want our lungs back.”
She’s not alone. Across South Africa, particularly in low-income, Black communities, air pollution has become a silent pandemic. They live closest to the refineries, the coal plants, and the highways but furthest from decision-making power.
What Needs to Change?
Policy, Transparency, and Alternatives
The path forward is clear, if politically inconvenient:
- Tighten emissions standards and remove the option for blanket exemptions.
- Invest in renewables and accelerate the Just Energy Transition.
- Equip the Department of Environment, Forestry and Fisheries (DEFF) with real enforcement teeth.
- Increase public air quality monitoring and make the data accessible to citizens.
These are not radical ideas they’re overdue necessities.
We often measure progress by how brightly our cities shine at night, but what if that light comes shrouded in a deadly haze?
The fact that 42,000 South Africans die each year from air pollution should shake us to the core. It’s not a future problem. It’s happening now in our lungs, our hospitals, our wallets. And unless South Africa rethinks its energy priorities and environmental governance, Thandiwe’s generation will inherit a country they can’t breathe in.
Clean air is not a luxury. It’s a right. And every delay in action is a death sentence for someone like Sindi or Thandiwe.
