Uganda is conducting its first compulsory emissions checks on vehicles after it emerged more people are dying from air pollution than HIV in the capital Kampala.

High air pollution levels in the city, where many vehicles are more than 25 years old, account for around one in five adult deaths from natural causes.

Recent exhaust pipe tests on cars, minibuses, lorries and motorcycles showed nitrogen oxide emissions more than nine times higher than European limits.

Background air pollution – primarily caused by road transport – was found to exceed World Health Organisation (WHO) limits by up to 12 times.

Alex Ndyabakira, the head of air quality monitoring at the Kampala Capital City Authority (KCCA), said: “We compared how many deaths are attributed to air pollution to how many deaths are attributable to HIV, and they were higher.

“Our highest disease burden in this city is due to coughs and respiratory tract infections with no infection. They are largely related to pollution.”

Health complications linked to high exhaust particulate levels include increased risk of asthma, chronic bronchitis, lung cancer, and pneumonia.

Mr Ndyabakira explained that most ordinary people in Kampala cannot afford to replace their high-polluting vehicles with newer, cleaner models, so they keep repairing older cars until they are impossible to drive.

It means the average age of most vehicles is more than the median average age in Uganda, around 17 years old. Many ageing cars are imported from Europe and the Far East.

“We have an ageing fleet of cars on roads that are not paved, so when that is mixed with traffic congestion it becomes much worse,” Mr Ndyabakira added.

Until now, Kampala’s ubiquitous minibus taxis, which belch out choking diesel fumes while stuck in traffic jams, were not subject to regular emissions checks as they would be for annual MOT inspections in the UK.

However, in response to the alarming data, Uganda’s government has now restarted mandatory vehicle inspections to address the bustling city’s noxious air quality.

Sheila Watson, Deputy Director at the London-based FIA Foundation, which supported the testing in Kampala, said: “Testing real vehicles on real roads shows us all just how damaging emissions are. Accurate, independent data arms policymakers, not just in Uganda but across the region, with knowledge and tools to address the toxic legacy of these vehicles.”

Efforts to curb pollution deaths in Uganda follow a recent study by the International Council on Clean Transportation (ICCT) which identified how 310 daily premature deaths from air pollution worldwide could be prevented with better traffic emission policies.

The study projected premature deaths, years of life lost, and new asthma cases in children from road transport emissions will approximately double in the least developed countries in the coming 15 years, while decreasing in high-income countries.

Separate research conducted in conjunction with two American universities found converting to less-polluting vehicles in sprawling cities in Africa, Asia and South America before 2040 would also prevent 1.4 million childhood asthma cases.

Urban areas account for two-thirds of avoidable new children’s asthma cases globally despite housing only one-third of the world’s children, with those under five years old disproportionately affected.

Only 17 per cent of people living in cities breathe air that complies with World Health Organisation safe air pollution limits, nearly all of whom are in high-income countries.

Although London’s air has been cleaned up by initiatives such as the Ultra Low Emission Zone in recent years, last year’s World Air Quality Report showed that most areas were nevertheless at least double recommended WHO limits for noxious PM2 particulates.

The densest concentration of cities with the worst air pollution are in South Asian nations like India and Pakistan, as well as China.

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