Estimation of pollution impacts on health is critical for guiding policy to improve health outcomes. Estimation is challenging, however, because economic activity can worsen pollution but also independently improve health outcomes, confounding pollution–health estimates. We show that future climate change driven changes in Saharan rainfall—a control on dust export—could generate large child health impacts, and that seemingly exotic proposals to pump and apply groundwater to Saharan locations to reduce dust emission could be cost competitive with leading child health interventions.