The toxic question Burnham's leadership bid cannot avoid

But for anyone looking to lead the country, there is a question that cannot be ignored: what happens when public health and political cost collide?

We saw the answer in Manchester, when a £104 million Clean Air Zone was scrapped under pressure from businesses and politicians. The 2023 Uxbridge by-election had already set a precedent for this, weaponising clean air policy and blaming ULEZ for Labour's loss - a misplaced narrative that took hold quickly.

In both cases, there is a clear pattern. The moment clean air policy generates friction, political will fades - pulled under by a divisive rhetoric that wrongly frames this as a net zero debate rather than a public health emergency.

Nonetheless, ULEZ worked. London's air quality improved rapidly. Bradford's Clean Air Zone has generated an estimated £180 million in health benefits since its introduction. The question has never been whether the policy works. The question is whether politicians are willing to see it through.

The human cost of inaction is not abstract. Toxic air contributes to up to 43,000 deaths every year - roughly 500 every week. Communities experiencing the highest levels of deprivation also face some of the highest pollution levels. The cost of inaction falls hardest on those least able to absorb it.

And the problem is no longer confined to cities or urban areas. A new ranking of pollution levels from the Healthy Air Coalition shows that areas like Cannock Chase, West Suffolk and Buckinghamshire record pollution levels comparable to those in major urban centres like Luton, Birmingham and Leeds. These local authorities encompass designated Areas of Outstanding Natural Beauty, areas where people should be able to escape high pollution levels.

This is not an isolated failure, but a wider pattern in UK politics. The original Clean Air Act - passed in the wake of the Great Smog of 1952 - was a landmark intervention that changed the country. Its seventieth anniversary falls two weeks after the Makerfield by-election. The legislative framework it created has not meaningfully moved since 2008, while WHO guidelines, medical expertise and neighbouring countries have all advanced.

Labour has shown it can act - the Tobacco and Vapes Act stands as one of the most significant pieces of public health legislation in decades. A new Clean Air Act, aligned with WHO guidelines, is the next step.

Five hundred people die every week from toxic air. Air pollution costs the UK economy an estimated £27 billion per year. These numbers will not change through ambition alone. By-elections will come and go. Toxic air will remain. The question for whoever wins is whether they bring political will or put clean air back in the box marked "too difficult," sentencing the country to continue breathing toxic air.
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Sarah Sleet is CEO of Asthma + Lung UK, the UK's lung charity and hosts of the Healthy Air Coalition.

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