‘Need to treat air pollution as public health challenge’

Recent global events have overshadowed the urgent efforts to save our planet.Earlier, nations were working together toward sustainability, green energy, and clean technologies. These efforts included discussions on climate change and improvements in industrial processes, transportation, renewable energy, agriculture, healthcare, and biodiversity.Unfortunately, before comprehensive systems could be established to reduce global warming, powerful nations halted climate funding and turned to economic and military conflicts. The Russia-Ukraine, Israel-Palestine, and US-Israel-Iran wars have caused immense damage.Their impact on the climate is severe, adding to the planet’s fragility. These conflicts have generated carbon emissions greater than the annual output of many countries combined. They have also forced nations to divert resources away from climate action and into defence systems and destructive technologies.In this situation, it seems unreasonable to ask ordinary people to reduce their carbon footprints. Many are already struggling to meet basic needs and survive day to day.World Environment Day is a reminder that to maintain robust health we need to ensure that we live in a holistic environment and take collective measures to maintain it.On this special day, India stands at a critical juncture where the vectors of development, defence, diplomacy, environment and public health stand on the same footing.Amidst increasing pollution from ever growing construction activity, heat emissions from HVAC systems, accelerating emissions from the bourgeoning number of vehicles on road, eroding green covers, and more, we cannot ignore the concern for good quality air.Air pollution, once viewed primarily as an environmental concern, has emerged as one of the most significant threats to human health, shaping disease patterns across age groups and geographies.In many cities, this crisis is measurable and visible to the naked eye. Recent global assessments highlight the scale of the problem. Reports such as the World Air Quality Report show that India remains among the most polluted countries in the world.Many cities consistently rank among the worst-affected urban centres. In 2025, Lucknow was listed among the top 60 most polluted cities globally, with annual PM2.5 levels far above the safety limits set by the World Health Organization.For residents, this means long-term exposure to air that is not only unhealthy but capable of causing permanent damage to vital organs.WHO estimates that air pollution causes nearly 7 million premature deaths worldwide each year. About one-third of these occur in India.The health impacts range from respiratory illnesses and cardiovascular disease to stroke and metabolic disorders. With India’s urban population growing rapidly, the burden is severe.This crisis is tied to unplanned and non-holistic development. Factors such as deforestation, poor dust control, mismanaged urban waste, and rising vehicle numbers, all contribute to worsening air quality. Yet the problem goes unnoticed because its effects are not immediately visible and can seem intangible.One of the clearest indicators of this crisis is the rising prevalence of asthma, especially among children and the elderly. This reflects prolonged exposure to polluted air rather than isolated medical vulnerability.A multi-city study of more than 3,000 adolescents found that in highly polluted environments, asthma prevalence was 21.7% based on symptoms. When measured with spirometry, the rate rose to 29.4%, showing that nearly one in three children had impaired lung function.Children in cleaner cities showed much lower rates, underscoring the direct relationship between air pollution and respiratory disease. The study also documented higher rates of respiratory and allergic symptoms among those exposed to polluted air: over half reported recent cough, nearly one-third experienced breathlessness, and many suffered from allergic rhinitis or eczema.These findings suggest that air pollution is not just causing temporary illness. It is reshaping long-term health by stunting lung growth, increasing lifelong disease risk, and embedding vulnerability early in life.Polluted environments may also trigger metabolic changes that amplify health risks, fueling the epidemic of noncommunicable diseases in India. Living in polluted cities can be equivalent to smoking 20-30 cigarettes a day.Medical evidence with respect to non-smokers turning victims is an ample reduction in life expectancy by 10-12 years.Many people with impaired lung function are undiagnosed and untreated, revealing systemic gaps in health surveillance and access to diagnostic tools. In cities like Lucknow and across Uttar Pradesh, where pollution levels are persistently high, countless individuals may be living with undetected respiratory conditions.Policy responses have often been fragmented, targeting individual sources without addressing the problem. Initiatives such as the National Clean Air Programme have laid a foundation, but their impact is limited.They lack integration with public health systems and place too little emphasis on measurable health outcomes. Even as wars and reversals in climate funding dominate global attention, we must not lose sight of the core issues.What is needed now is a fundamental shift in how air pollution is understood and addressed. It must be treated not only as an environmental challenge but as a central public health priority.This requires a coordinated, multi-sectoral approach that unites urban planning, transport policy, energy systems, and healthcare under one framework. Air quality targets should be directly linked to health indicators, ensuring progress is measured not just in emissions reduced but in lives improved.Public awareness is equally critical.While air quality indices are widely reported, their health implications are not always clear. Bridging this gap is essential to empower communities to take preventive measures and demand stronger action from policymakers.Ultimately, evidence from global reports and local research makes it clear: air pollution is redefining public health in India. If India is to protect the health of its population, especially its young population, clean air must become a non-negotiable priority.When the air we breathe becomes a risk, we pay for each breath with our health and delay in action will be paid for by the future of our coming generations.India must take a lead in tracing and analysing the threats of extreme weather, rising sea levels and all-round environmental disturbances.Globally top leaders must rally around the cause of protecting the environment and view it as a real threat and an existential issue. The human species must learn to respect the limitless power of nature and accept the ultimate truth: ‘While we become extinct, the universe will still continue to exist.’(Writer is the patron of Lung Care Foundation & a former IPS officer)