10. Tunis, Tunisia – 57.17

Rampant pollution in Tunisia’s largest city is largely due to rapid industrialization, and an estimated 13,000 tons of industrial pollution is thought to be released into the Gulf of Gabes every year. Citizens often fall victim to pollution-related illness, and the surrounding ecosystem has suffered greatly as clean air becomes a precious commodity.

9. Pretoria, South Africa – 60.63

Though South Africa is one of the only countries on the African continent with pollution regulations on the books, it struggles to control emissions, particularly in its largest cities. The capital city of Pretoria has especially bad air pollution, due to industrial pollution, vehicle emissions, and the burning of coal. A large number of houses in the Pretoria area still do not have electricity, necessitating the use of coal for heat and cooking.

8. Johannesburg, South Africa – 62.51

Like Pretoria, Johannesburg struggles to control vehicle emissions from its 750,000 residents. Attempting to curb the amount of carbon dioxide that is released into the atmosphere, and breathed into people’s lungs isn’t so easy. Regulations have been drafted, and offenders should be receiving penalties, but it will be a long time before the problem begins to resolve itself.

7. Harare, Zimbabwe – 65.83

Zimbabwe’s capital city of Harare faces similar problems to other African metropolitan areas. Its rapid expansion has resulted in a massive outpouring of vehicle emissions and an increasingly high demand for energy. The city’s estimated 2.5 million people own approximately two thirds of all of the vehicles in Zimbabwe, many of which are not roadworthy and would not meet international standards for environmental safety.

6. Algiers, Algeria – 70.06

Algiers is the most industrialized and most densely populated city in Algeria, so it’s no surprise that it has the highest pollution rates in the country. With more than 3 million inhabitants, Algiers is home to a massive number of motor vehicles, as well as the open-air municipal landfill of Oued Smar, which remains unregulated by the government. Waste accumulates without supervision, threatening the city’s air quality and quality of life.

5. Addis Ababa, Ethiopia – 80.06

Addis Ababa has garnered much international concern for its lack of sanitation infrastructure that has contributed to an enormous pollution problem and health hazard for the city’s 4 million inhabitants. Industrial pollution and enormous diesel emissions compromise the city’s air quality, and citizens have begun to report a large number of respiratory difficulties and other health issues.

4. Alexandria, Egypt – 94.83

Alexandria suffers from similar pollution-related problems as other cities on this list, but has an added factor that only incredibly arid areas have to deal with: dust. The desert city has frequent sandstorms and dust storms that fill the air with soil particles, making it difficult to breathe. This exacerbates the air quality issues from man-made pollutants that are already present.

3. Casablanca, Morocco – 95.69

It is estimated than an incredible 50 percent of Casablanca city dwellers suffer from some type of pollution-related illness such as asthma, eye allergies, and respiratory problems. Vehicle emissions, industrial chemical pollutants, and an enormous debris-and-garbage problem have helped make Casablanca one of Africa’s most polluted cities. Even the city’s water supply, largely supplied by rainwater canals, is in jeopardy as trash and pollutants find their way into these canals as well.

2. Cairo, Egypt – 97.07

The air pollution in Cairo led the World Health Organization to liken a day spent breathing this city’s air to smoking a pack of cigarettes. Industrial plants burning low-quality fuel, seasonal sandstorms that often smother Cairo in a yellow haze, and high numbers of vehicle emissions have created a worsening problem. Little regulation is in place to enforce environmentally friendly industry processes.

1. Accra, Ghana – 111.18

Ghana’s capital city of Accra is home to some 4 million people, and its inhabitants suffer from the emissions of vehicles, industries (particularly mining activities), and landfill and garbage problems. But even worse, some areas such as the neighborhood of Agbogbloshie, have become dumping grounds for electronic goods. Recycled portions of electronics are burned to retrieve the copper inside of them, releasing toxic materials such as lead and mercury into the soil and atmosphere. Hundreds of thousands of people are forced to breathe in the fumes emitted during this process, further compromising the quality of the air in Accra and beyond.

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