In the heart of Delhi, amid the hustle and bustle, I sat sipping my daily chai. Priya, the tea vendor, began to complain about her allergies. &ldquo;This constant itch in my throat and watery eyes will never leave me,&rdquo; said Priya. The predictable seasonal pattern of her allergies made me wonder if it was a mere coincidence, especially considering we were in the most polluted city in the world.&nbsp;

Priya was no stranger to the term &lsquo;vaayu pradooshan&rsquo; (air pollution), but her belief that it was a concern only for the &lsquo;rich folks&rsquo; highlighted the immense gap in knowledge and resources. While she acknowledged that &lsquo;bad air&rsquo; played a role in her allergies, the thought of taking action to address it had never crossed her mind.

Priyas&rsquo;s experience is not unique. According to a 2019 <a href="https://www.who.int/health-topics/air-pollution#tab=tab_1">report</a> by the World Health Organization(WHO), 99% of the world&rsquo;s population lived in areas where WHO&rsquo;s air quality guidelines were not met. Air Pollution, which could either be indoor or outdoor pollution, is <a href="https://www.who.int/health-topics/air-pollution#tab=tab_1">defined</a> by the WHO as the presence of contaminants in the atmosphere that can be harmful to human health, including dust, fumes, gases, odours, and more.&nbsp;

In 2018, during the first WHO Global Conference on Air Pollution And Health, the WHO Director General, Dr. Tedros Adhanom Ghebreyesus, <a href="https://www.theguardian.com/environment/2018/oct/27/air-pollution-is-the-new-tobacco-warns-who-head">referred</a> to air pollution as a &ldquo;silent public health emergency&rdquo; and &ldquo;the new tobacco&rdquo;. This characterization is based on the sad reality that both ambient air pollution and household air pollution are <a href="https://www.who.int/news-room/fact-sheets/detail/ambient-(outdoor)-air-quality-and-health">responsible</a> for a staggering 6.7 million premature deaths annually. Nine out of ten of these deaths occur in the low-and middle-income countries, with the WHO South-East Asia and Western Pacific regions being the most heavily affected.

India has been in the spotlight for air pollution for consistently maintaining air quality levels that exceed <a href="https://www.who.int/teams/environment-climate-change-and-health/air-quality-and-health/health-impacts/types-of-pollutants">WHO recommendations</a> by a factor of ten over the past decade. However, the outdoor air pollution we often read about in the news is only a part of the problem. In a country where a significant portion of the population resides in rural areas, household air pollution is a leading contributor. The dependence on traditional cooking methods, such as chulhas, is a significant source of household air pollution.

&quot;I have been using chulhas for as long as I can remember; within 10 minutes of cooking my eyes and nose overflow,&quot; says Kamla, a resident of a basti (urban slum) in our capital city. WHO <a href="https://www.who.int/news-room/fact-sheets/detail/household-air-pollution-and-health#:~:text=Key%20facts,generates%20harmful%20household%20air%20pollution.">reports</a> that around 2.4 billion people worldwide, roughly one-third of the global population, cook using open fires or inefficient stoves, primarily fuelled by kerosene, biomass, and coal, generating harmful household air pollution. &ldquo;I try to cook whenever my family is not home, but making dinner in a 1-room house becomes difficult at night,&rdquo; said Kamla. This form of pollution contributes to the increased risk of developing diseases and even death. It particularly affects children under the age of five and women who are at risk of exposure.&nbsp;

The visible and invisible effects of air pollution are evident, as almost every organ in the human body can be impacted. &ldquo;Suresh ji, the family where I work as domestic help has difficulty in breathing and often uses that machine,&rdquo; said Kamla. On further probing Kamla it came to my knowledge that Suresh, a retired officer, had long-standing asthma. Nevertheless, air pollution was the least of his concerns as witnessed by his enthusiasm for burning crackers. &ldquo;My grandchildren bursting phuljhadi (sparklers) gives us the proper festival feel. Even if I burst or not I will have to use the machine because of the cold,&rdquo; said Suresh.

<a href="https://www.who.int/news-room/fact-sheets/detail/ambient-(outdoor)-air-quality-and-health">Air pollution</a> is responsible for a significant number of premature deaths, with heart disease, lung infections, and cancer being the common causes. Air pollution is not just a health concern; it also carries a significant <a href="https://www.who.int/news-room/feature-stories/detail/air-pollution--the-invisible-health-threat#:~:text=Air%20pollution%20is%20a%20threat,%24%208%20trillion%20in%202019).&amp;text=Put%20yourself%20in%20the%20shoes,frequently%20suffers%20from%20asthma%20attacks.">economic burden</a> due to ill health. It resulted in a global loss of over $8 trillion in 2019. While the steps have been to mitigate air pollution in India, the situation on the ground remains challenging.

Reductions in indoor emissions have been achieved through initiatives such as the <a href="https://indianexpress.com/article/governance/ujjwala-study-estimates-over-1-5-lakh-lives-saved-in-reduction-air-pollution-deaths-7825267/#:~:text=Ujjwala%20could%2C%20therefore%2C%20have%20reduced,pollutants%20and%20observed%20health%20impacts.">Ujjwala Yojana</a> which provides cooking gas cylinders to replace more polluting sources of fuel. &nbsp;However, serious efforts to reduce outdoor emissions are still lacking. Delhi and other metropolitan cities continue to face severe air quality issues. Stubble burning in surrounding states is a major contributor to Delhi and neighboring cities&rsquo; air pollution.

India&rsquo;s installed non-fossil fuel capacity has increased 396% in the last 8.5 years and stands at more than 178.79 GW (including large Hydro), which is about 43% of the country&rsquo;s total capacity (as on May 2023). However, in 2022-23, India&#39;s coal import increased by 30% compared to the previous year. India continues to be 2nd highest consumer of coal and<a href="https://www.worldometers.info/coal/coal-consumption-by-country/"> ranks 34th</a> in per capita coal consumption globally.

The implementation of <a href="https://theicct.org/sites/default/files/publications/India%20BS%20VI%20Policy%20Update%20vF.pdf#:~:text=BS%20VI%20emission%20standards%20are%20defined%20for%20category,these%20categories%20include%20light-duty%20passenger%20and%20commercial%20vehicles">Bharat Stage VI (BS VI)</a> emission standards for vehicles and initiatives like the National Electric Mobility Mission Plan <a href="https://pib.gov.in/PressReleasePage.aspx?PRID=1576607">(NEMMP)</a> represent progress. The Revised Graded Response Action Plan <a href="https://caqm.nic.in/WriteReadData/LINKS/GRAP%20Document%20Newc57e7cc0-6165-4c40-8e8e-cc09227dc06c6e0cd339-eeef-4753-955c-3fb410de616c.pdf">(GRAP) </a>and <a href="https://cpcb.nic.in/winter-action-2021-22/">Winter Action Plan</a> for the National Capital Region (NCR) address various air quality stages and include actions to prevent the worsening of air pollution. However, the battle for clean air remains ongoing with these initiatives not leading to significant change on the ground.

China provides an example of progress in addressing air pollution. In recent years, China has made significant strides in controlling air pollution, particularly addressing concerns about acid rain and general air quality. The country&rsquo;s aggressive approach to raising funds by incorporating commercial banks <a href="https://www.worldbank.org/en/results/2020/06/21/china-fighting-air-pollution-and-climate-change-through-clean-energy-financing">(Huaxia Bank)</a> has yielded positive results. This brought in much-needed resources by mainstreaming green financing to contribute to the government&rsquo;s <a href="https://english.mee.gov.cn/News_service/news_release/201807/t20180713_446624.shtml">targets</a> as seen in their Three-Year Action Plan launched in 2018.

The Action Plan helped in shifting the government&rsquo;s priority to addressing air pollutants at their source by reducing coal consumption and increasing the use of clean and renewable energy. This approach has also generated substantial greenhouse gas emission reduction benefits. It has helped in reducing air pollution emissions through pollution abatement measures including installing equipment to remove particulate matter, advanced monitoring techniques, replacing coal with natural gas, and expanding clean energy vehicles. These focused efforts helped China in <a href="https://www.statista.com/statistics/690823/china-annual-pm25-particle-levels-beijing/">reducing</a> PM2.5 concentration from 97 &mu;g in 2014 to 31 &mu;g in 2022.

In comparison, India&rsquo;s efforts significantly lag. The <a href="https://cpcb.nic.in/about-namp/">air quality monitoring infrastructures</a> in India remain inadequate, with only 804 manual stations and limited real-time monitoring as of 2021. India&rsquo;s monitor density is far below that of other highly populated countries, such as China and the USA according to <a href="https://www.sciencedirect.com/science/article/abs/pii/S1352231019305795">research</a> from 2019. India&#39;s monitor density of ~0.14 monitors/million persons is well below that of other highly populated countries such as China (1.2 monitors/million persons). To match China, India will require at least an additional 1600 monitors.

According to the <a href="https://pib.gov.in/PressReleaseIframePage.aspx?PRID=1942953">Forest Conservation Bill 2023</a> de-reservation of reserved forests, use of forest land for non-forest purposes, and assigning forest land by way of lease or otherwise to private entities, is now possible. Urban forests are proven to <a href="https://www.nps.gov/articles/000/uerla-trees-air-pollution.htm">remove</a> multiple tons of ozone, gaseous air pollution, and particulate matter either through direct uptake of gasses or temporarily intercepting airborne particles. Therefore, having a provision in the Bill to cut them down is contradictory to what is being said and done to tackle air pollution.

According to the National Clean Air Programme <a href="https://pib.gov.in/PressReleasePage.aspx?PRID=1593056">(NCAP)</a> a target of&nbsp; 20 % - 30 % reduction in PM10 and PM2.5 concentrations by 2024 keeping 2017 as the base year for the comparison of concentration has been made. But are we really on the way to achieving our target by next year? The battle for clean air is a pressing issue in India. The situation in Delhi and many other Indian cities demands immediate attention. A &lsquo;Breath Of Concern&rsquo; hangs in the air, and we must address it collectively with a sense of urgency.&nbsp;&nbsp;

&nbsp;

Edited by Parth Sharma.

Image by Janvi Bokoliya.

&nbsp;

Air pollution in India has received a lot of attention over the past few years. However, have serious steps been taken to address this problem?

air pollution

A Breath of Concern: Are India’s Efforts Enough to Tackle Air Pollution?

Joseph Lazar is a public health physician, who currently is a PG Resident in the Department of Community Medicine at Maulana Azad Medical College, Delhi.

&nbsp;

Joseph Lazar is a public health physician, who currently is a PG Resident in the Department of Community Medicine at Maulana Azad Medical College, Delhi.

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Joseph Lazar

Joseph Lazar

A Breath of Concern: Are India’s Efforts Enough to Tackle Air Pollution?

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