India’s capital is in the news again for all the wrong reasons: Its lethal levels of air pollution. Just when we thought it could not get worse, it did. Air quality reached “severe plus” levels, with pollution readings up to 50 times higher than the World Health Organisation’s safe limit. Visibility has dropped dramatically, disrupting flights and train services. The Air Quality Index peaked at 491 on November 18, on a scale that tops out at 500.
Clearly, the WHO did not imagine that a day would come when any location on the planet would breach the upper limit of this scale. The numbers are so nightmarish that they verge on the incomprehensible. Humans are being exposed to sustained levels of pollution like never before and science is demonstrating what breathing such toxic air is doing to our biology.
It is worth reiterating what experts have been crying hoarse for decades: The air pollution smothering the whole of north India has profound implications for the nation. Air pollution is a leading risk factor for premature mortality and is estimated to cause two million deaths each year in India alone; the increasing risk of long-term conditions, from impairing brain development to lung and heart diseases is incalculable. Moreover, apart from sickening and shortening the lives of a third of India’s population, pollution will ultimately derail our efforts to achieve the Sustainable Development Goals. We also know the primary drivers of pollutants, notably industrial and vehicular emissions, agricultural waste burning, and the use of coal and firewood use for cooking and heating. While the cooling of air as winter sets in is a major factor in trapping these pollutants close to the ground, winter is hardly to blame for what is, essentially, a man-made disaster.
Importantly, there are known policies to reduce, and even eliminate, these drivers, such as enabling LPG for all households, enforcing regulations on the building industry and massively cutting down on fossil-fuel energy. To be fair, there have been significant wins in rolling out some strategies, notably, efforts to expand access to clean cooking fuels and transitioning New Delhi public buses from diesel to CNG but, as the events unfolding this month show us only too graphically, they are woefully inadequate. And so, all we are reduced to doing is to respond to the crisis in an emergency mode, essentially imposing restrictions on daily life reminiscent of the pandemic lockdowns, something we seem to do pretty well to tide over acute, short-term crises, but which are hopelessly inadequate for a chronic emergency which has plagued the country for decades.
What is truly scary is not that all-time global records of air pollution are being broken but that this story is like a stuck record, replaying exactly the same tune with a depressingly familiar cadence, year after year. After all, the first public interest litigations on air pollution were filed by M C Mehta in the Supreme Court over three decades ago. The fact that we are once again blanketed in poisonous air is a reminder of the sheer impotence of the state and its myriad regulatory authorities to take pre-emptive action to stall this entirely predictable catastrophe. While many of the upper and political classes can afford to mitigate the harms of air pollution by locking themselves indoors with air filtration machines cranked into full gear, the truth is that air, like water, seeps through the smallest cracks and privilege does not fully insulate you. Still, one can escape the smog altogether by boarding a flight to Goa, which so many of New Delhi’s tony classes do and, as is the case with all environmental crises, the poor and working classes suffer the most.
In short, while we have all the knowledge, we need to take action and while the solutions appear maddeningly simple, implementing them is bafflingly complex. The elephant in the room, it seems to me, is the assumption that air pollution, and other environmental challenges like depletion of water resources and climate change, are purely local issues. While much of the attention, unsurprisingly, has focused on India’s capital, the fact is that the toxic smog is engulfing an entire swathe of the Subcontinent, affecting half a billion people living in the shadows of the Himalayas, from the plains of the Punjab in Pakistan through the entire sweep of India’s northern states into Bangladesh. Our politicians should carefully study satellite images of the Subcontinent to be reminded that the air we breathe and the water we drink do not need visas and they stealthily cross the electrified fences and gun-toting soldiers at our borders. And, in this sense, the fractured polity of the region and, indeed, the country, is the monumental hurdle to addressing this recurrent nightmare.
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Air pollution, then, is a shared challenge of the entire Subcontinent and tackling it offers a unique opportunity to build bridges across the troubled waters between South Asian neighbours. Governments must set aside, even if only for a moment, the historic conflicts which cloud our relationships, and work in tandem to rapidly address the most alarming challenge to the health and development of the entire region. One thing is for certain: Without such cross-border and, within India, cross-state, solidarity, any effort to navigate this calamity will always be swimming against the current.
History is replete with accounts of sworn enemies and warring factions breaking bread with one another when faced with a more formidable foe: Could there be a more appropriate metaphor for the environmental catastrophe befalling South Asia? And, one might hope that, by focusing on a shared concern with no historical baggage, this may turn out to be an opportunity to build trust, setting the stage to tackle the thornier issues in a mutually respectful way. After all, when we sit together to solve a problem which threatens our collective well-being, we must embrace the fundamental truth that we are all one people who must breathe the same air.
The writer is the Paul Farmer Professor of Global Health at Harvard Medical School
