The purpose of this research: is to examine how environmental sustainability performance moderates the health impacts of pollution in sub-Saharan Africa (SSA), with a focus on the role of sanitation, environmental justice, and clean energy access in mitigating the adverse effects of particulate and methane emissions. Methodology: Drawing on the World Bank World Development Indicators for 20 SSA economies over 2000–2023, we combine trend-based diagnostics with random effects panel regressions to estimate how the interaction between the Environmental Sustainability Rating (ESR) and major pollution channels shapes aggregate health outcomes. ESR is proxied through indices of environmental sanitation, enforcement of property rights over the ecological commons (environmental justice dimension), and household access to clean cooking energy. Main Findings: The results show that higher sanitation coverage, stronger ecological property rights, and expanded clean energy access significantly mitigate the adverse health impacts of particulate and methane emissions (p < 0.01). Heterogeneity analysis revealed that Egypt, Nigeria, and South Africa face markedly elevated methane-related morbidity relative to Madagascar, Mauritania, Niger, Rwanda, Tanzania, and Uganda, after controlling for income, urbanization, and climatic variability. Scenario simulations indicate that a 10-percentage-point increase in clean cooking energy access could lower under-five mortality by 4.5 % within five years. Applications: Policy experimentation suggests that targeted household subsidies for renewable fuels, alongside nature-based solutions such as mandatory tree planting for minor environmental offenses, would yield rapid co-benefits for public health and decarbonization consistent with the One Health framework. Novelty/Originality: The study underscores the urgency of integrating environmental justice metrics into regional sustainability dashboards and of tailoring pollution control strategies to national emission profiles. These insights can inform the African Union’s Agenda 2063 and ongoing negotiations on an ambitious continent-wide methane abatement pledge in the coming decade. Keywords: Environmental sustainability rating (ESR), Pollution–health outcomes in Sub-Saharan Africa, Methane emissions risk in Africa, Clean cooking energy access, Environmental Justice and Property , Rights, Health policy implications, Renewable energy subsidies for households, Panel data analysis 2000–2023.
Henry T. Asogwa (Wed,) studied this question.