• Climate change
• air quality
• pollution

Ignorance, allied with power, is the most ferocious enemy justice can have. James Baldwin

On the eve of President Trump’s inauguration in 2017, we published an editorial setting out the threat that climate change poses to lung health. We urged the incoming President to face up to his responsibilities and take steps to address this growing existential threat.1 We drew a parallel with the actions of two conservative leaders in the 1980s, Ronald Reagan and Margaret Thatcher who, faced with unequivocal scientific evidence, led the decisive steps necessary to avert the destruction of the ozone layer.2 3 Rather than being contrary to his stated goals, acting on climate change, we wrote ‘is one way in which President Trump can make good on his promises to improve the wellbeing of Americans, increase America’s energy independence, and act with fiscal prudence. Investing in green infrastructure creates jobs. It reduces healthcare costs, as 1/4 - 1/3 of the costs of decarbonising come straight back as health economic gains’.4

Sadly, 2 years on our worst fears have been realised. The USA is experiencing an unprecedented wave of natural disasters attributable to climate change, including widespread wildfires, destructive storms and temperature swings. However, rather than providing global leadership, the Trump administration has not merely abdicated responsibility but is actively sabotaging efforts to mitigate climate change by announcing plans to withdraw from the Paris Climate accords.5 Clear evidence in the most recent Intergovernmental Panel on Climate Change report sets …