Leading regional and international public health and environmental scientists gathered in Kathmandu to push for progress in global pollution hotspots. India alone could save up to $1.3trillion in health benefits by 2030 by meeting air quality standards. Pakistan is estimated to lose $1bn a year in environmental degradation chiefly due to air pollution.

Kathmandu-headquartered regional organisation the International Centre for Integrated Mountain Development (ICIMOD) has partnered with US-based Health Effects Institute (HEI), to drive action that tackles hazardous air pollution in Bangladesh, Bhutan, India, Nepal, Pakistan, and Sri Lanka, to improve public health across the region.

The two organizations have come together to strengthen the skills of early-career researchers in air pollution and health in this global pollution hotspot and to raise awareness about the air quality crisis and accelerate action by convening regional medical experts, scientists, government decision-makers, and global thought leaders, with a specific focus on health and inequality.

The Indo-Gangetic Plain and Himalayan Foothills (IGP-HF) region airshed includes some of the world’s most polluted countries, and air pollution in South Asia has risen more than 50 per cent since the start of this century. The average lifespan in South Asia is cut short by five years, compared to four months in America.

“Air pollution costs the global economy $8 trillion a year, and in South Asia wipes out more than 10 per cent of gross domestic product per annum,” said Izabella Koziell, Deputy Director General of ICIMOD. “The longer-term health and productivity costs, and the fall-out from the temperature rises that air pollution accelerates, will be higher still. These are costs that low- and middle-income countries in this region can ill afford. Stakeholders from across the region simply have to come together to shift the dial on dirty air.”

The poverty link

While populations across the region are exposed to polluted air, exposure and vulnerability are greatest among those living in poverty – including those working long hours outdoors, communities living close to landfills or factories, or families unable to afford clean alternatives to solid fuels for cooking, lighting, or heating.

“The moral and social case for action on clean air has long been clear, but the economic cost of this public health crisis is perhaps evenly striking,” Michal Krzyzanowski, Visiting Professor at Imperial College London said at a launch event for the new partnership in Kathmandu this week. “Studies in Europe find that for every euro invested in improving air quality, economies get €10 back in productivity and health.”

India alone could save up to $1.3trillion in health benefits by 2030 by meeting air quality standards. Pakistan is estimated to lose $1bn a year in environmental degradation chiefly due to air pollution.

Rapid industrialisation and population growth are key drivers of declining air quality in South Asia, with sources including transport, industry, agriculture, waste burning, and domestic solid fuel use.

In the launch, HEI and ICIMOD brought together representatives from regional ministries of health, forest and environment, and medical research councils to explore the nexus between air pollution, health and social exclusion; with a particular focus on the role of physicians in building support for faster action among publics and policymakers. The event is supported by the United Kingdom Foreign, Commonwealth and Development Office (FCDO) under the Climate Action for Resilient Asia (CARA) initiative.

A pernicious challenge

A session on gaps in research on the nexus between pollution, health and social exclusion featured presentations from Ahsan Habib, from Dhaka University’s Department of Chemistry; Leki Dorji, from Bhutan’s Medical and Health Professionals Council; Ankit Viramgami, from India Council of Medical Research; and Meghnath Dhimal, from Nepal Health Research Council.

Speakers included Michal Krzyzanowski, Visiting Professor at Imperial College London; Jill Baumgartner, Professor at McGill University; Om Kurmi, Associate Professor at Coventry University; and Narayan Babu Dhital, Assistant Professor at Tribhuvan University.

Speaking at the opening of the event, Baumgartner said, “You look at the dramatic decrease in pollution in China over the last decade – where pollution has fallen 42 per cent – to see what’s possible with the right political will and public support. While pollution is a pernicious challenge, it is one that is eminently fixable, is hugely popular with the public, and where the long-term benefits of action far outweigh the upfront investments.”

Kurmi, who has started a major family-cohort study of the health impacts of air pollution on children in two regions of Nepal, following similar research conducted in China, said, “Poverty is a huge driver of exposure to air pollution in South Asia. People working in polluting industries or with pesticides lack personal protective gear and are unable to afford the more drastic measures that more affluent families are adopting, such as buying air purifiers, moving out of urban centres, or sending children to schools outside cities. This lack of economic means further exacerbates existing inequalities – with early exposure resulting in health issues that ricochet down a child’s entire life-course and determine long-term socioeconomic outcomes.”

South Asia: Two million deaths

The HEI and ICIMOD partnership on inequalities, health and air pollution follows a high-level dialogue with key policymakers from both national and state and municipal governments across the IGP-HF in Bhutan this June, convened by ICIMOD and World Bank, which brought together development partners, and donors and ministries of energy and natural resources, environment, forests and climate change, science technology and environment and pollution control boards.

Pallavi Pant, Head of Global Health at the Health Effects Institute and a co-organizer of the event said, “Global progress towards clean air shows that sustained, evidence-based programs can achieve clean air and improve health for all. However, in South Asia, more than two million deaths were linked to air pollution in 2021 alone, with many more people living with chronic diseases. In hopeful news, the research on the link between air pollution and health in the region has grown significantly, and the workshop will showcase some of the data that is available to inform action.”

HEI has also recently developed a public database of peer-reviewed research on air pollution and health in South Asia (DoSAAH). It features more than 1000 studies from across the region and can be used by decision makers to inform policy action.

The sustained focus on air reflects a ratcheting up of collective ambition to tackle soaring pollution in the IGP-HF zone, with greater understanding of how air pollution intersects with and compounds existing inequalities considered crucial in guiding the development of the most cost-effective and impactful interventions, policies, and plans.

The regional momentum follows a step-change in global recognition of the health impact of climate policies, with health ministers attending the climate talks for the first time last year and the COP Presidency and World Health Organisation issuing a declaration on climate and health.

Image: Delhi Pollution; Wikimedia