Sadiq Khan's asthma epiphany on cleaner air rules

After a court ruling that expansion of the ultra-low emission zone was lawful, an extract from the mayor's new book reveals what made him first face up to the 'invisible killer' on the streets of London

A coroner concluded that air pollution from the congested South Circular Road, above, near the home of Ella Roberta Adoo-Kissi-Debrah contributed to the death of the nine year old in 2013. PA
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I ran for London before I actually ran for London. But the marathon wasn’t just the beginning of my journey as a runner. It was the beginning of my journey as a climate activist.

As I got more into jogging, I found myself wheezing, struggling to breathe. After tests, I received the diagnosis of 'adult-onset asthma'. I was incredulous. I was 43. I’d never had any respiratory issues. I’d just run a marathon, for goodness’ sake. My GP said it wasn’t uncommon now, largely due to poor air quality. I had almost certainly developed it from training on London’s roads.

Until then, I’d never been particularly ‘green’. Climate change had seemed a ‘tomorrow’ issue. Asthma made me think again. Environmental problems weren’t just ‘out there’; they had given me asthma, in London. This wasn’t just a climate crisis, it was a health crisis.

Having an asthma attack is scary. I can’t imagine how frightening it must be for a child. There is no better way to demonstrate why our toxic air matters than the story of Ella Roberta Adoo-Kissi-Debrah.

Like me, Ella was born in south London. She loved to dance and sing, enjoyed sports and science, and dreamed of becoming a pilot. Just before her seventh birthday, Ella developed a cough.

In the 28 months following her diagnosis with a unique, severe form of asthma, Ella’s mum, Rosamund, resuscitated her on over 20 occasions. She was treated in five hospitals by numerous specialists. On Valentine’s Day 2013, Ella stopped breathing and died in the early hours of 15 February. She was nine.

The pathologist who carried out her post-mortem said Ella suffered from ‘one of the worst cases of asthma ever recorded in the UK’, and the coroner concluded she died due to a severe asthma attack followed by a seizure, ‘possibly caused by a reaction to something in the air’. But what?

Months later a neighbour mentioned to Rosamund that Lewisham often had poor air quality, due to its location near the South Circular Road. So began the journey to find the truth.

Eight years after Ella’s death, Coroner Philip Barlow concluded that toxic air had indeed played a role. She became the first person in the UK to have ‘air pollution’ listed as a cause of death. Above all, the verdict hammered home that Londoners were being harmed by the very act that keeps us alive: breathing.

The main causes of poor air quality also cause climate breakdown: greenhouse gases, particularly from transport, industry and power generation. This means the solutions are often the same. Tackle one, you tackle both.

Climate change isn’t political kryptonite. The case for tough action is one that concerned citizens, activists and politicians can win. Once it’s won, we can start to make things better.

Ella humanised why the environment matters. Her short life forced people to face up to an invisible killer. We cannot wait to clean up our air. That is why we keep going, further and faster. For Ella.

This is an edited extract from 'Breathe: Tackling the Climate Emergency', by Sadiq Khan, (Hutchinson Heinemann, £16.99) which is available now.

Published: August 02, 2023, 5:00 AM