In 1952 in London, the onset of a severe air pollution event that is referred to as the Great Smog, caused an estimated 12,000 deaths. In recent memory, there has been one other event when a major global economic and political centre has been blanketed with thick smog as a result of cold weather, an atmospheric temperature inversion, and an array of pollutants emitted from various sources. This happened in Delhi after Diwali last year, and continued in the subsequent weeks.

London’s Great Smog led to the implementation of the Clean Air Act and several changes in common practice around cooking, heating and transport in the UK.

In Delhi, the severe smog resulted in widespread outrage by the public, but there was little meaningful action from the government. With the indignation over the air quality emergency dying down, the pressure on the political class to take action has also waned as was evident from Union Environment Minister Anil Madhav Dave’s somewhat incoherent remarks in the Rajya Sabha earlier this week.

In a written reply to a question in the Upper House, Dave said that, “There is no conclusive data available in the country to establish direct correlationship [sic] of death exclusively with air pollution”.

He subsequently observed that,

“Health effects of air pollution are a synergistic manifestation of factors which include food habits, occupational habits, socio-economic status, medical history, immunity, heredity etc. of the individuals. Air pollution could be one of the triggering factors for respiratory associated ailments and diseases”.

Dave’s contradictory statements disregard the wealth of data that scientists have generated over several decades on short- and long-term exposure to air pollution and its association with mortality and morbidity.

Health professional bodies such as the American Heart Association and the American Lung Association have made statements attributing deaths from respiratory and cardiovascular diseases to exposure to short- and long-term air pollution. Systematic reviews of dozens of studies conducted globally have captured these links, as well as the physiological processes that leads to such respiratory and cardiovascular distress.

The evidence

Work carried out by the Ministry of Health and Family Welfare’s Steering Committee on Air Pollution in 2014-’15 also catalogued the best available Indian evidence linking air pollution exposure and health impacts, citing several dozen studies that have been carried out since the early 1980s. The report, released by the government in August 2015, laid out a framework for multi-sectoral action to address the associated burden of disease.

The Global Burden of Disease comparative risk assessment goes one step further, bringing together several hundred scientists from India and around the world to collate the best available evidence on a range of risk factors. It estimated that outdoor and indoor air pollution together constitute one of the top risk factors for ill health, and contribute to 1.8 million deaths and 49 million healthy life years lost in India in the year 2015. These estimates also have their basis in government-generated data, so denial of this evidence reflects either a lack of awareness, or a belief that the lungs of Indians are somehow more resistant to these deadly particles than the lungs of the Chinese or residents of western countries.

A report released by the World Bank and the Institute of Health Metrics and Evaluation in September estimated that air pollution-linked premature mortality cost the Indian economy $560 billion or 8.5% of its gross domestic product in 2013. This alarming figure, itself an underestimate, only served to reinforce the truly devastating cost that India’s polluted air imposes on its citizens, and makes the need for strong and sustained action even more urgent.

The institute’s latest report, the State of Global Air, finds that India rivals China for the most number of air pollution deaths in the world.

DALY: Disability-Adjusted Life Years.
DALY: Disability-Adjusted Life Years.

The Supreme Court and the National Green Tribunal, taking heed of the mounting evidence and public outcry, directed central and state governments to take decisive action on the issue on more than one occasion. Their calls for action were echoed earlier this month by the Health and Environment Leadership Platform ­– appropriately abbreviated to HELP – a group representing over 5,000 healthcare institutions and several thousand physicians from around the country. The statement from the platform noted that “if India is to realise the value of its demographic dividend, it will need to tackle the growing menace of air pollution” immediately and effectively.

Food for thought

The unanimity of outlook among the health community, the judiciary and the general public should give the Union Environment Ministry much food for thought.

Air pollution is a huge stain on a rapidly changing global socio-economic landscape in which India boasts of building smart cities in a Swachh Bharat and is investing heavily in renewable energy. At the same time, the incomprehensible and somewhat contradictory stand taken by the Environment Ministry through its recent actions to remove polluting sectors such as the construction industry from the purview of the Environment Protection Act reflects a regressive viewpoint, completely out of step with the needs of a developing country.

Dave’s predecessor Prakash Javadekar once said that clean air is a birthright for all. If this statement is to have any meaning or relevance, then radical and systemic actions need to be taken immediately to reverse these regressive measures on pollution. The need of the hour is to move from perplexing denials to proactive policy making.

The writer manages the Centre for Environmental Health at the Public Health Foundation of India, and is co-founder of Care for Air.