Cities That Breathe: How urban planning is becoming a public health strategy

In cities across the globe, the air is becoming harder to breathe. Pollution from traffic, industry, and waste is not just clouding the skyline; it’s filling lungs, weakening hearts, and shortening lives.

According to the World Health Organization, ambient air pollution causes approximately seven million premature deaths globally each year, with a growing share occurring in low- and middle-income countries.

In Africa, where rapid urbanization is placing extraordinary pressure on infrastructure, air pollution has become a quiet but deadly epidemic.

Poor communities bear the brunt of exposure, yet many cities lack even the most basic monitoring systems to track or manage the crisis.

Recognizing this global health threat, Bloomberg Philanthropies is working to change how cities approach air pollution.

Through investments in data infrastructure, city partnerships, and policy support, the foundation is helping urban governments prioritize air quality as a central part of public health and planning.

“In more than 50 cities, we are helping mayors and city governments use data to track air pollution and clean up their air,” states the Bloomberg Philanthropies Annual Report 2024–2025.

One of the foundation’s leading platforms for this work is the Breathe Cities initiative.

Launched by Bloomberg Philanthropies in partnership with C40 Cities and the Clean Air Fund, the program aims to reduce air pollution by 30% in participating cities by 2030.

It combines technical assistance, community engagement, policy design, and financial support to drive measurable change.

The 2023 Expansion: African Cities Join Breathe Cities

In December 2023, during the United Nations Climate Change Conference (COP28) in Dubai, Bloomberg Philanthropies announced the expansion of Breathe Cities to include 11 new cities worldwide.

The expansion brought the total number of participating cities to 14.

Three African cities joined the program in this phase: Accra in Ghana, Johannesburg in South Africa, and Nairobi in Kenya.

These cities were selected based on a mix of population vulnerability, political readiness, and opportunities for scalable impact.

Bloomberg committed $30 million to support this global expansion. According to the Clean Air Fund’s official press release:

“These cities will benefit from technical assistance, funding, and peer-to-peer collaboration to develop and implement ambitious clean air policies that reduce pollution and protect public health.” (Clean Air Fund, 2023)

While the specific interventions vary by city, the overarching goal is to give local governments the tools and knowledge to turn air quality data into actionable policy.

Nairobi: Building a Real-Time Pollution Map

In Nairobi, air pollution has long been a challenge.

Emissions from traffic congestion, informal waste burning, and unregulated industrial activities contribute to dangerously high concentrations of particulate matter, especially in densely populated informal settlements.

Under the Breathe Cities initiative, Nairobi has begun installing a network of air quality sensors throughout the city.

These sensors are being placed in schools, clinics, and traffic corridors, providing real-time data that city officials can use to identify pollution hotspots and prioritize mitigation measures.

Clean Air Fund reports that this support will help Nairobi’s county government develop targeted responses and improve public communication around health risks associated with pollution.

The local government’s engagement signals a strong political will to integrate environmental health into broader urban policy, a shift that Breathe Cities is designed to encourage and reinforce.

Accra: From Monitoring to Policy

In Ghana’s capital, the groundwork for a clean air policy has already been laid.

Accra has previously partnered with the Ghana Environmental Protection Agency and international organizations to install air quality monitoring equipment and raise public awareness.

Bloomberg Philanthropies’ earlier support helped establish some of these foundational efforts.

Now, under Breathe Cities, Accra is receiving additional technical assistance to move beyond data collection and into formal policy action.

This includes incorporating pollution data into transportation planning and zoning decisions, improving communication campaigns to inform citizens of air quality threats, and co-designing clean air policies with local stakeholders.

Accra’s trajectory represents a critical next step for African cities: from recognizing the problem to building institutional structures that address it at scale.

Johannesburg: Linking Air Quality to Climate Resilience

In Johannesburg, air pollution is shaped by a complex mix of industrial emissions, traffic congestion, and seasonal variations in weather that trap smog over the city.

The municipality also faces a legacy of spatial inequality, with historically marginalized communities living near major pollution sources.

With the support of Breathe Cities, Johannesburg is developing a Clean Air Action Plan that aligns with its broader climate resilience strategies.

While specific activities are still underway, Clean Air Fund confirms that the initiative is helping the city integrate pollution control into climate adaptation efforts.

This city-level alignment, where clean air becomes part of broader resilience planning, reflects the multifaceted value of air quality investments.

Not only do they improve health, but they also reduce greenhouse gas emissions, increase urban livability, and make infrastructure more inclusive.

Why Air Quality Data Matters

One of the major obstacles facing African cities is the absence of reliable air quality data.

In many places, monitoring is sporadic, outdated, or absent.

Without data, policymakers struggle to understand the scale of the problem, let alone justify targeted interventions.

Breathe Cities responds to this gap by funding low-cost sensor networks, helping local authorities build open-data platforms, and providing technical training on interpreting and using air quality data.

As the Bloomberg report explains:

“Reliable data is essential to help policymakers understand the scale of the problem and target the most effective interventions.” (Bloomberg Philanthropies Annual Report 2024–2025)

This approach ensures that air pollution control strategies are not based on guesswork but are grounded in real-time environmental monitoring and epidemiological evidence.

Urban Design and Public Health: A Shared Future

Beyond data and sensors, Breathe Cities encourages a deeper transformation: treating urban planning as a public health intervention.

The initiative promotes the integration of clean air considerations into transport, housing, and waste management.

For instance, cities are encouraged to rethink traffic patterns to reduce congestion, improve public transport options, expand green spaces that trap pollutants, and discourage open waste burning.

These interventions have broad ripple effects.

Reducing air pollution leads to fewer hospital visits, improved cognitive performance in children, increased worker productivity, and lower healthcare costs.

It also contributes to the mitigation of noncommunicable diseases such as asthma, heart disease, and stroke.

Bloomberg Philanthropies’ broader health portfolio, which includes global initiatives on tobacco control, obesity prevention, and road safety, complements the clean air effort by targeting common risk factors.

Long-Term Vision and Measurable Impact

Because the African cities joined Breathe Cities only recently, measurable impacts from these efforts are not yet fully available.

However, in other cities globally, Breathe Cities has already helped enact vehicle emissions regulations, establish low-emission zones, and expand public access to air quality information.

What sets this model apart is its emphasis on sustained engagement.

Rather than one-off projects, Breathe Cities fosters long-term partnerships between global funders and local governments.

By doing so, it builds institutional capacity that remains even after external funding concludes. Importantly, the program encourages peer learning.

Participating cities share experiences and best practices through C40’s urban network, enabling African cities like Nairobi, Accra, and Johannesburg to learn from counterparts in Warsaw, Jakarta, and London.

Breathing Room for the Future

As Africa’s urban population continues to grow, the stakes for clean air are only getting higher.

Projections show that by 2050, over 60% of Africans will live in cities.

Without deliberate investments in clean air policies today, millions more could face avoidable health risks tomorrow.

The Breathe Cities initiative offers a model for what effective, city-led air pollution control can look like: data-driven, politically supported, locally grounded, and globally networked.

“Our work in cities is focused on data-driven, health-centered strategies that can be scaled,” the Bloomberg Philanthropies report affirms.

In an era of compounding health and climate crises, cities that prioritize clean air aren’t just protecting their skies; they’re protecting their people.

Sources: Bloomberg Philanthropies Annual Report 2024–2025, Clean Air Fund press release: Breathe Cities expands to 11 new cities; WHO Global Air Quality Database (2023)