In May, a WHO report revealed that 14 of the 15 most polluted cities in the world are in India. While the global health body’s finding was worrying in itself, it has acquired graver proportions in light of a new study published in The Lancet Journal of Planetary Health. Polluted air is a cause of one in eight deaths in the country, the study says. Conducted as part of the India State-Level Disease Burden Initiative, it points out that “the average life expectancy in the country would have been 1.7 years higher if the air pollution were less than the level at which health is harmed”. It notes that contrary to the popular association of pollution with respiratory diseases, poor air is responsible for heart diseases as well. These disturbing revelations underline that India’s battle against air pollution needs much more than ad-hoc reactions such as bans, fines and shutting down of power stations.
There are, however, a few silver linings. The India State-Level Disease Burden Initiative is a collaboration between the Ministry of Health and Family Welfare, Indian Council of Medical Research, Public Health Foundation of India, Institute of Health Metrics and Evaluation and experts from more than 100 institutions. This coming together of government officials and public health experts is a far cry from the times when the country’s poor performance on health and environmental indicators was treated with indifference by the government. It’s also heartening that the public health challenge of pollution has got policy focus with the Ayushman Bharat Programme emphasising the need to combat non-communicable diseases. By providing estimates of the health impact of pollution in every state, the collaborative initiative should sharpen such a focus.
However, despite the obvious links between pollution control and public health, there has been scarcely any collaboration between the ministries of health and environment. It has been known for more than a decade that the failure of public transport systems to cope with the rapid pace of urbanisation has aggravated the burden of air pollution-related diseases. But Indian cities have never had pollution control policies that draw on the combined expertise of public health professionals, transport sector specialists, environmentalists and urban planners. This shortcoming has reduced the National Clean Air Programme (NCAP) to a mere data gathering exercise with little effect on mitigating the effects of pollution. The Inter State-Level Disease Burden Initiative could meet the same fate if pollution control and public health authorities do not break their silos.