Putting health at the center of air pollution control policy
Photo used for illustrative purposes only.
Jhe deteriorating winter air quality in northern India has once again drawn public attention to the harmful effects of air pollution on our health. The effects of exposure to bad air are felt in all organs of the body, and most deeply by vulnerable people in society – children, the elderly, pregnant women and people with pre-existing health conditions. In India, in 2019, 17.8% of all deaths and 11.5% of respiratory, cardiovascular and other diseases are attributable to high pollution exposure ( The Lancet). This public health emergency has prompted calls for health to be placed at the center of air pollution policymaking.
Screaming in his absence
The primacy of protecting public health — the raison d’être of environmental legislation — is clearly articulated in the statement of purposes and rationales of India’s major environmental laws. Yet if we examine the makeup of our environmental regulators, expert panels, and decision-making entities that define and translate these laws into air pollution policy, health expertise is conspicuous by its absence. Driven by a combination of the isolated nature of policymaking and insufficient understanding of health among decision makers, air pollution policy is created and implemented in a vacuum. There is little knowledge of the effect it has on society.
So what would it mean for India to put health at the center of air quality governance and policy-making? So far, India’s air pollution policy has at best treated health as one of many equally relevant facets in decision-making. He must transcend that. Health must become a feature and eventually a function of air pollution control policy.
Treating health as a facet of air pollution policy has occasionally meant giving a health voice a seat at the table. However, even a review of the most recently formed institution, the Commission for Air Quality Management, reveals a lack of health representation. Recent papers published by the Center for Policy Research also reveal that health sector representatives make up less than 5% of members of State Pollution Control Boards. How can their work as frontline air pollution regulators be effective or more responsive to health needs if health doesn’t even feature in important policy discussions?
Lessons to be learned
What does it mean to make health part of air pollution control policy? Health and epidemiological evidence will guide our determination to achieve substantial health benefits from air quality objectives. The only effort so far in India, which has seen air pollution through this lens, is the Air Pollution Steering Committee of the Ministry of Health, which has taken a exposure to politics. It did this by prioritizing interventions that did the most to reduce exposure and, therefore, provide health benefits. It also highlighted local and global epidemiological evidence on the harmful effects of air pollution and defined policy measures aligned with this science (for example, focusing on smoke from household stoves).
As India revises its Ambient Air Quality Standards (NAAQS), it would do well to learn from this groundbreaking effort. The NAAQS review has remained a largely opaque process over the years, and putting health first in such a process would mean that the standards would be determined not only by local conditions, but also by the impact of exposure. on vulnerable populations.
Avoid the status quo
The final step would require radically rethinking the way we design politics from the ground up. Behind every source that contributes significantly to air pollution, there is a history of parochial, sectoral and isolated policymaking. Whether it’s stubble burning (a byproduct of thoughtless water conservation laws) or emissions from thermal power plants (where tougher standards have been delayed for more than five years), decisions are taken without any consideration of their potential second and third order effects, in particular on health.
Here again, there are lessons to be learned from the steering committee of the Ministry of Health. The committee brought together experts from a variety of disciplines and sectors, including epidemiology, environment, energy, transportation, public policy and economics, to develop a prescription that would focus primarily on health benefits . Indeed, such an approach that highlights the explicit health benefits of specific sustainable and effective interventions is necessary to prevent the repudiation of basic science that ensures the proliferation of untested ad hoc technological solutions such as anti-tower towers. smog. This kind of thinking would also lead us to accelerate climate and air quality actions that control emissions from the sectors that cause the greatest health burden.
We are at a crossroads in our fight against air pollution. The contemporary approach to tackling this problem has been tried for decades and proven ineffective. The choice is now up to us whether we want to focus science and health on what will likely be a long road to solving this problem, or continue down the same path that got us to this smog status quo.