Pulse

Public health in times of environmental pollution

Bhargav Krishna / K Srinath Reddy | Updated on May 11, 2018

Killer kitchen: It is time to use clean energy for cooking and heating   -  iSTOCK

The draft National Clean Air Programme has lofty goals, but falls short on three key counts

The World Health Organization recently released its updated Ambient Air Pollution database, noting that over 90 per cent of the global population lives in areas with poor air quality. Unsurprisingly, India figures prominently on the list with 14 of the top 15 cities showing the highest levels of annual average PM2.5 (particulates smaller than 2.5 microns) in the world.

The WHO also released updated numbers on the burden of disease attributable to air pollution, observing that 7 million people die prematurely each year due to air pollution-induced disease (mostly in developing countries of the global south). While the reaction to this biennial release in years past has been reflexively defensive with denials and distortions, the call from the Environment Minister this year for concerted action to reduce air pollution and ameliorate its harmful health effects is highly encouraging.

Two key issues flagged

This year’s report sheds light on two important issues, the first being that India’s air pollution problem is not restricted by geography, with Kanpur, Patna, Jaipur, Srinagar, Lucknow, Agra, and Faridabad all featuring in the top 20. The lack of adequate monitoring capacity in these and other tier 2&3 cities is also highlighted in the report.

The second issue raised is the importance of transitioning to clean energy for cooking and heating. Over 65 per cent of Indian households (76 per cent in rural areas) continue to use solid fuels like wood, dung, coal or charcoal for cooking and heating. The contribution of household smoke to the ambient PM2.5 load is 13-35 per cent in many of these cities, and over 50 per cent in rural areas.

Recognising the multi-faceted and Pan-India nature of the problem, the Ministry of Environment released a draft of its National Clean Air Programme (NCAP) recently. The draft NCAP appropriately sets lofty goals with the right rhetoric, and a reasonable budget allocation for source-specific emissions reductions across sectors.

It is deficient on three counts, however, with no time-bound pollution-reduction targets set, no clear mechanism for participatory engagement with relevant stakeholders, and little articulation on how it aims to operationalise multi-sectoral action. The approach articulated continues the existing command-and-control mode of source reductions which has delivered sluggish progress till date.

An alternative, multi-sectoral approach to action on air pollution has already been laid out in the Ministry of Health’s Steering Committee report on air pollution released in 2015. The committee’s membership reflected the diverse stakeholder group required to address air pollution, and emphasised the need to implement an exposure-driven intervention strategy.

This prioritised action on sources that people are most exposed to and are proximate to, such as cooking stove, vehicular and industrial emissions.

The actions proposed by this committee are reflected in interventions the government has subsequently taken, such as the Pradhan Mantri Ujjwala Yojana (PMUY), which has garnered praise from the WHO. The PMUY was conceptualised primarily as a health and energy access intervention. Its progress till date in providing LPG connections to 37 million low-income families serves as a suitable example of health-driven environmental policy-making.

The raison d’etre of the Air Act and Environment Protection Act is the protection of public health. In this age of multi-modal exposure and multi-sectoral challenges that public health faces, it is essential that the health sector be a key stakeholder in driving policy on environmental exposures where it often picks up the burden of poor policy-making across other sectors.

Adopting such an approach is essential, going forward, and would be the purest expression of what the sustainable development goals lay out so eloquently as a pathway for development in the next 15 years.

The writers are with the Public Health Foundation of India. Views expressed are personal. Disclosure: Reddy was Co-chair and Bhargav was a co-author of the Ministry of Health Steering Committee report

Published on May 11, 2018

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