Research area: Environmental Governance and Policy

Delhi’s Air Push Needs Delivery to Line up with Intent

Delhi has started treating its air as a year-round problem, not just a winter emergency, and transport emissions, the one source that pollutes just as much in June as in December, are rightly at the centre of that shift. A cluster of new measures, from an ambitious Electric Vehicle Policy to a consolidated Winter Action Plan and a large World Bank-supported clean-air programme, marks a shift from episodic response towards sustained, source-focused action. The direction of travel is right; what it needs now are adjustments that would allow the government to deliver on its goals.

It is winter when Delhi’s air is at its worst, when cold, still air and a low mixing layer trap primary particulate matter emissions near the ground and drive the chemistry that forms secondary particulate matter – the toxic fine particles that condense from gases like nitrogen oxides emitted by vehicles. But summer no longer offers relief. The city has seen high levels of ground-level ozone, a byproduct of heat and sunlight reacting with nitrogen dioxide and volatile organic compounds emissions. Transport feeds both, which is why the only durable cure is cutting its emissions year-round. The sector accounts for 20-25% of Delhi’s fine particles (PM2.5) year-round, unlike dust and crop-residue smoke that are seasonal and transient, and it is also a leading source of nitrogen oxides that drive secondary particle formation12.

The recent measures each aim for a different part of this persistent problem. The Electric Vehicle Policy phases out new petrol- and diesel-powered two- and three-wheelers and backs its mandates with incentives3. The Centre’s Naya Safar scheme replaces ageing trucks and buses that pollute disproportionately relative to their numbers across Delhi, Haryana, Rajasthan and Uttar Pradesh4. The World Bank-supported Clean Air, Healthy Delhi programme funds a seven-year, source-by-source effort.5 At the same time, the Winter Action Plan folds once-scattered and often unpredictable seasonal orders into a single instrument6. Together, these signal genuine intent. Delivering on this intent requires three tweaks and a fourth to track whether these new interventions have directly contributed to improvements in air quality.

First, the deferred mandate to support four-wheelers under the EV policy has presented an opportunity to make the fleet not just cleaner but leaner. Incentives graduated by vehicle weight, footprint, and energy efficiency (kilometres per kilowatt-hour) would steer buyers away from the heavier electric SUVs that shed the most particulates from tyre and road wear7 and take up the most road and parking space in a city short of both. This is worth considering before the mandate is formally declared and electric SUV production is locked in.

Electric car charging station in Begumpet, Hyderabad. Wikimedia

Second, restrictions are more likely to succeed once alternatives are in place. Delhi saw this last July, when denying fuel to end-of-life vehicles was withdrawn within days, undone by public anger and an enforcement system that could not yet read number plates across state lines8; the same unreadiness has just forced Hanoi, Vietnam, to water down a far more ambitious petrol-vehicle ban9. Charging, like the CNG switch two decades ago, is at heart an energy-supply problem, and the fix is to build the supply first — reliable public chargers and a real right and ability to charge at home.

Third, none of these fundamentally change why Delhi runs on so many private vehicles. An electric car occupies the same lane and space as a petrol or diesel car and does nothing for congestion, urban sprawl, asphalt-driven heat islands, or the daily danger to pedestrians. The larger prize remains a network built around buses and the metro, with routes rationalised to feed the metro and cover both under-served peripheries and the short trips it misses. Alongside, the footpaths, shade, lighting, and safe crossings that make walking and waiting bearable must also be built and maintained. The Chief Minister’s Metro Monday is a welcome signal10 but requires the supporting infrastructure designed to aid daily commuters.

A CNG AC Bus at Anand Vihar ISBT. Wikimedia.

Finally, none of this can be focused on Delhi alone, or judged only by how much money is allocated or spent. Roughly two-thirds of the city’s fine particles come from beyond its borders11, according to CAQM’s own analysis. Hence, the World Bank programme and Naya Safar matter most for what they do to bring Haryana, Uttar Pradesh, and Rajasthan onto the same path12, and the real test is whether the region acts as a single system. Monitoring, too, must track what these transitions add, not only what they remove — the non-exhaust particles from a heavier electric fleet and the toxic aldehydes from ethanol-blended petrol. It must reward verified results alongside disbursement metrics.

Cleaner air and a more liveable city have never been separate projects: fewer, cleaner and lighter vehicles, improved public transport, and streets built to serve people rather than vehicles result in better air quality while making the city both safer and more desirable to live in. The cause to do both has always existed; what is new is the intent and the instruments, and the work now is to sustain the momentum while improving effectiveness.

Endnotes

  1. S. Guttikunda et al., What Is Polluting Delhi’s Air? A Review from 1990 to 2022, Sustainability 15(5): 4209 (2023). https://www.mdpi.com/2071-1050/15/5/4209 ↩︎
  2. Commission for Air Quality Management, Identification of the Causes for Worsening AQI in Delhi-NCR (January 2026). https://caqm.nic.in/WriteReadData/LINKS/AQI%20Report%20V5%20Final637d7a8a-8dad-44fb-9c8c-8be0dfe42839.pdf ↩︎
  3. Transport Department, Government of NCT of Delhi, Delhi Electric Vehicle Policy, 2026 (30 June 2026). https://transport.delhi.gov.in/sites/default/files/Transport/circulars-orders/delhi_ev_policy_2026-30_0.pdf ↩︎
  4. Press Information Bureau, Cabinet approves Scheme for support to NCRPB for replacement of old trucks and buses in Delhi-NCR (3 June 2026). https://www.pib.gov.in/PressReleasePage.aspx?PRID=2268342&reg=3&lang=1 ↩︎
  5. Delhi govt to launch Rs 8,300-crore ‘Clean Air, Healthy Delhi’ project with help of World Bank, ThePrint (3 July 2026). https://theprint.in/environment/delhi-govt-rs-8300-crore-clean-air-healthy-delhi-project-world-bank/2976914/ ↩︎
  6. Department of Environment and Forests, Government of NCT of Delhi, Directions for Air Pollution Control in Delhi (Notification F. No. 10(39)/ENV/2021) (23 June 2026). Gazette ID: SG-DL-E-01072026-273956. https://egazette.gov.in/(S(kk0xjv3gequbeq0g0yipkr2f))/ViewPDF.aspx ↩︎
  7. A. Karkun, Can EVs Solve India’s Air Pollution Crisis?, Environmentality (9 December 2021). https://web.archive.org/web/20211214105528/https://environmentality.cprindia.org/blog/can-evs-solve-the-air-pollution-crisis ↩︎
  8. Fuel Ban on EOL Vehicles in Delhi and Five NCR Districts Pushed to November 1, The Wire (8 July 2025). https://m.thewire.in/article/environment/fuel-ban-end-of-life-vehicle-pushed-to-november-1 ↩︎
  9. Hanoi Delays Gas-Powered Motorcycle Ban in City Centre, Vietcetera (16 May 2026). https://vietcetera.com/en/hanoi-delays-gas-powered-motorcycle-ban-in-city-centre ↩︎
  10. Rekha Gupta takes Delhi Metro ride under ‘Metro Monday’ campaign, The Pioneer (18 May 2026). https://dailypioneer.com/news/slug-lite/rekha-gupta-takes-delhi-metro-ride-under-metro-monday-campaign?year=2026 ↩︎
  11. Commission for Air Quality Management, Identification of the Causes for Worsening AQI in Delhi-NCR (January 2026), on the share from outside Delhi. https://caqm.nic.in/WriteReadData/LINKS/AQI%20Report%20V5%20Final637d7a8a-8dad-44fb-9c8c-8be0dfe42839.pdf ↩︎
  12. World Bank, India: World Bank Approves Financing for Programs to Promote Clean Air in Haryana and Uttar Pradesh States (10 December 2025). https://www.worldbank.org/en/news/press-release/2025/12/10/india-world-bank-approves-financing-for-programs-to-promote-clean-air-in-haryana-and-uttar-pradesh-states ↩︎

Strengthening the Scientific Foundations of NCAP: Building a Standardised Framework for Source Apportionment and Emission Inventories

Introduction

India’s first comprehensive action plan for air quality management in cities, the National Clean Air Programme (NCAP), was launched by the Ministry of Environment, Forests, and Climate Change (MoEF&CC) in 2019. The programme initially aimed to achieve a 20–30% reduction in PM10 and PM2.5 concentrations by 2024 across 102 identified cities with an emphasis on PM2.5 due to its significant health impacts. In 2022, the Non-Attainment Cities (NACs) list was revised to include 130 cities. In parallel, PM10 was designated as the pollutant of interest, with its reduction as the metric of progress, due to limitations in PM2.5 baseline data. The programme goal was revised to achieve a 40% reduction in PM10 levels, or attainment of national ambient air quality standards
(NAAQS), by 2025–26 in the NACs.

The 130 NACs were chosen based on an analysis of 2017 manual monitoring data from the National Ambient Air Quality Monitoring Programme (NAMP). Among these, more than 40 cities with over a million residents received air quality performance grants through the 15th Finance Commission’s Million-Plus City Challenge Fund. The remaining cities are supported under the ‘Control of Pollution’ budgetary head of the MoEF&CC. Consequently, cities lacking functional monitoring stations or those that did not fulfil the requirement (cities that exceeded NAAQS for five consecutive years from three monitoring stations) were excluded from the NAC classification. This has resulted in the omission of several other polluted cities (such as Ranchi and Howrah) from the NCAP non-attainment list.

The NCAP vision document also outlined a vision for “comprehensive, multi-scale, and cross-sectoral” action to address not only sources within the remit of the MoEF&CC but also those outside it. It also sought to mainstream air pollution action through existing programmes such as the Smart Cities Mission. Additionally, it aimed to convene sector-specific working groups (such as with the Ministry of Power (MoP) to focus on emissions from thermal power plants and the Ministry of Road Transport and Highways (MoRTH) on vehicular emissions) to promote broader action on pollution mitigation. However, there has been little documented progress on the constitution of these working groups, the development of sectoral action plans, or the integration with other programmes.

Based on NCAP goals, the 130 non-attainment cities prepared city action plans detailing source-specific interventions categorised as short-, medium-, and long-term measures, which the CPCB subsequently approved. These city action plans, meant to be backed by analyses that determine source-specific emissions, form the basis for how cities are supposed to approach air quality action under the NCAP. However, five years into the programme, most cities have yet to complete their source apportionment (SA) or emissions inventory (EI) studies, and their role in determining city-level actions remains unclear. In this brief, we highlight the significance of SA and EI studies as the backbone of effective air quality management, and explain why India needs to strengthen its approach to conducting these studies to integrate them into policy actions.

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Different Paths to Clean Air: Global Insights for India’s Reform Agenda

Summary

India’s air pollution crisis cannot be solved without addressing key structural and institutional constraints, such as reforming our environmental regulatory regime – one that remains under-capacitated, poorly equipped, and under-funded. Previous works have examined their capacities, constraints, and performance in isolation to understand why frontline environmental regulators in India struggle to meet their mandate. Our new issue brief presents a comparative analysis of learnings from diverse air quality regimes and charts a roadmap for building a capable and forward-looking environmental regulatory regime in India.

We study how countries across the Global South and North, such as Brazil, China, Germany, Mexico, Poland, South Korea, and the USA, have built and reformed their air quality regimes, and what India can learn from them to address the challenges ahead. These countries were chosen to be comparable and relevant to India, and the group is therefore a mix of countries with large economies, a history of dealing with high air pollution, and rapid industrialisation coupled with high GDP growth. The varied source profiles, regulatory institutions, history of air pollution policymaking, and differing governance regimes (unitary vs. federal) in these countries also present differing approaches that could inform Indian policymaking on air quality.

Table 1: Sampling parameters for the 7 countries

We highlight trends and examples relevant to India – how countries set health-based standards, strengthen accountability for action, scale air quality monitoring, and manage airsheds.

Key Learnings

1. Science plays a fundamental role in establishing strict, health-based air quality standards
2. Strong focus on PM2.5 reductions through top-down or bottom-up approaches, depending on country contexts
3. Large increases in monitoring capacity alone may not necessarily yield spatial and temporal representativeness
4. Indian regulators are comparatively resource-poor
5. Airshed-level governance is gaining importance and requires nested governance
6. Accountability is a catalyst for sustained improvements in air quality

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Interplay of Heat and Air Pollution: Unpacking the Science and Policy Blind Spot in India

Environmental challenges are an anticipated consequence of development, and India, as a rapidly growing economy, is no exception. An ever-expanding urban sprawl, growing energy needs, and accelerated land-use transformations have caused a range of environmental issues, some visible, and others, more insidious. Driven by these challenges, Indian cities are quickly transforming into hotspots of multiple, overlapping environmental stressors that are fuelling a public health crisis. Many cities are shrouded in layers of toxic haze in winter, and summer days bring with them an energy-sapping heat. 

However, conversations around these environmental stressors in India have been unconnected –  heat is discussed primarily during the summer, while air pollution gets a focus mostly during the winter – with their interplay largely ignored. While growing evidence has been pointing towards the synergistic effects of exposure to heat and air pollution, the science explaining how heatwaves and air pollution interact – a relationship where one amplifies the impacts of the other – remains largely underexplored. Above all, the link between these two stressors is missing where it matters most: in our policies which are designed largely in silos and are ungrounded in science. As a result of this, public health pays the price. 

The State of Extreme Heat and Air Pollution in India – and Current Policies That Tackle Them

In 2024, 95% of the Earth’s surface temperature was significantly warmer than the 1951–1980 average, with nearly one-third of global land areas experiencing the hottest year on record, according to the Global Temperature Distribution 2024. In the same year, India ranked 5th globally for the worst annual average PM2.5 levels, with 13 out of the world’s top 20 polluted cities located in the country. Cities with over a million residents in India are growing fast, and this urban explosion is one of the most visible and irreversible anthropogenic interventions, fundamentally driving socioeconomic changes, and reshaping our relationship with environmental stressors. According to long-term records of the Indian Meteorological Department (IMD), 2024 was the hottest year in India since 1901. Several studies have pointed towards India’s growing concrete jungles and chaotic urban planning as causative factors behind rising temperatures, contributing to around 60% of warming in Indian cities.

Temperatures above 40°C, the threshold for heat waves, are now routinely breached across major urban cities, and the frequency of these very hot days has been rising over the past decade. While 228 cities in India met the National Ambient Air Quality Standards (NAAQS) for daily PM₂.₅ concentrations (60 µg/m³) in 2024, only 33 met the World Health Organisation (WHO) daily safe guideline (15 µg/m³). 

In response to deteriorating air quality, the Indian government launched the National Clean Air Programme (NCAP) in 2019, flagging 131 cities (non-attainment and Million Plus) with an initial target to reduce particulate matter concentrations by 20–30% by 2024. However, many of these cities have consistently recorded particulate matter levels beyond the annual average safe limits, and the reduction goal has since been revised to 30-40% by 2026, quietly extending the timeline of the target year. 

Meanwhile, Heat Action Plans (HAPs) have been created  in several cities to manage the fall-out from extreme heat events. 

Both these policies represent important steps in tackling climate and environmental risks in our cities, yet they do not speak to each other or, for that matter, to India’s own vision for how it views the future of urbanisation. Air pollution control and heat adaptation receive passing mentions in flagship urban renewal and development policies such as the Smart Cities Mission and Atal Mission for Rejuvenation and Urban Transformation (AMRUT), leading to the creation of separate systems or programs for each, instead of a coordinated approach — even though these urban challenges are deeply linked.

The Science Behind How Heat and Air Pollution Interact

The interaction of heat and air pollution manifests most directly through warm nights during hot summers, when high night-time temperatures suppress atmospheric mixing and limit the dispersion of locally generated pollutants. With the increasing frequency and intensity of heatwaves, and a lower focus on managing air pollution during summers, it is critical to dive deeper into this relationship to understand how best to develop policies that address both. While the combined impacts of heatwaves and air pollution are beginning to be understood, the way they interact to amplify their individual impacts through atmospheric chemistry pathways is less studied. This largely happens in two interconnected ways: 

– First, atmospheric conditions with low wind speeds, strong temperature inversions, high surface temperatures, and intense solar radiation worsen particulate matter (PM₂.₅ and PM₁₀) pollution by creating a dome effect that traps the pollutants closer to the surface and reduces vertical mixing of air that aids dispersion. This stagnation reinforces Urban Heat Island (UHI) effects where dense built-up areas and concrete structures absorb and retain heat, slowing night-time cooling.

– Second, high surface temperatures accelerate photochemical reactions involving ozone precursors such as nitrous oxide (NOx) and volatile organic compounds (VOCs), forming ground-level ozone (O3). This interaction adds to the respiratory burden while also intensifying heat stress.

Together, these processes amplify their individual impacts and intensify health risks (figure 1 illustrates this).

Figure 1: Interlinked Mechanism of Heat and Air Pollution

At the same time, the seasonal dynamics of heat-air pollution interactions are equally critical and vary across regions and meteorological conditions in India. In inland regions such as Delhi-NCR and the wider Indo-Gangetic Plain (IGP), winters bring anti-cyclonic conditions and a shrinking planetary boundary layer, with low wind speeds and frequent temperature inversions. This prevents upward dispersion, increasing the surface concentration of certain primary pollutants like PM₂.₅ and NO₂, partially independent of photochemistry. 

By contrast, during summers, high heat and intense solar radiation accelerate photochemical reactions, driving ground level (tropospheric) O3 formation. Coastal regions like Mumbai benefit from sea breezes that enhance dispersion of PM2.5. However, strong sunlight sustains ground level O₃ in summer, often persisting longer into winter than in inland cities due to maritime influences. Although pollution loads are much higher in winters, the intensity of heat and solar radiation in summers acts as a catalyst, amplifying the effects of air pollution.

Dual Stresses on the Human Body

A study of 10 major Indian cities spanning different agro-climatological zones found that air pollution caused more deaths on hot days, with mortality rising by 0.8% on warm days and by 4.6% on extremely hot days for every 10 μg/m³ increase in PM₂.₅. A review of 40 epidemiological studies found that the combined effects from heat and either O3 or PM can harm both respiratory and cardiovascular health. Heat strains our thermoregulatory system and air pollution inflames our cardio-pulmonary system. They act in tandem, creating a compounding health crisis. Human bodies are sensitive to pollution, and its impact increases when coupled with high temperatures, creating a ‘double stress’ that is extremely hazardous. 

A construction worker standing atop a building. Credit: Shantum Singh, Pexels.

The synergistic impacts are far greater than their individual effects. It would be fair to hypothesise that there is still much to learn about the pathophysiology of heat and air pollution. However, evidence shows that co-exposure to heat and air pollution is linked to higher mortality rates. Together, they induce imbalance in physiological processes, especially amongst vulnerable population groups such as the elderly, those with co-morbidities, and young children. The intersectional nature of their synergistic impacts also becomes apparent when considering that persistent exposure to air pollution contributes to deficient lung function among children, women in low-income households are exposed to higher levels of indoor heat and air pollution, and informal workers, such as those in the construction industry or engaged in gig work, suffer the greatest exposure to extreme heat with limited social protection measures. 

Synergistic Impacts, Coordinated Action: Short- and Long-Term Policy Priorities

Heatwaves are now recognised as climate extremes and air pollution as a persistent environmental challenge, but together, they no longer represent a distant risk. Untangling this dual threat requires deeper scientific inquiry into where pollution comes from and why it persists, alongside critical reflection on why policies have struggled to break this cycle.

In 2024, New Delhi crossed 40°C as early as April, with temperatures nearing 46°C in June. That same summer, the 20 hottest cities in India – as recorded by the IMD – were concentrated across Haryana, Uttar Pradesh, and Madhya Pradesh. Following IMD’s heatwave alerts, Delhi rolled out its Heat Action Plan (HAP), as did other cities in the region. Simultaneously, air quality in the region hovered around an index value of 225, falling into the ‘poor’ category and triggering the Graded Response Action Plan (GRAP) under the Commission for Air Quality Management (CAQM).

While both the GRAP and HAP were invoked simultaneously, their implementation occurred independently, reflecting the limited cross-sectoral engagement on these dual environmental stressors. This fragmented response also means that there is little scope to address the amplified risk posed by their co-occurrence. Addressing this policy blind spot is critical for a future that embodies convergent action. 

From an air pollution perspective, that means year-round action that tackles year-round sources such as transport emissions, and not just seasonal sources such as crop residue burning. A recent national-scale study noted that vehicular transport accounts for a staggering 85% of the VOC emissions and 53% of NOx emissions (O3 precursors). The O3 generated from this vehicular pollution is amplified by extreme heat, and contributes to significant health impacts. 

On the heat front, previous studies have highlighted the policy gap with respect to long-term heat resilience in HAPs. Their almost exclusive focus on ameliorating the immediate impacts of heatwaves has meant little attention being paid to addressing the structural issues of crafting heat-resilient cities that reduce the impact of urban heat islands and overall heat exposures. 

A long-term view of these issues requires addressing not just the immediate fall-out of high air pollution and extreme heat, but tackling the systemic, structural issues that drive their synergistic threat. The dual burden of heat and air pollution must be tackled in an integrated approach and not as siloed emergencies. Below, is outlined a series of short-, medium-, and long-term actions to guide this effort:

Short-term actions:

– Strengthen early warning systems: Use local data to map compounding risks. Cities should be able to utilise the high resolution spatiotemporal data from local urban sensors to map out the co-risk zones and power real-time dashboards for targeted measures to be deployed more efficiently.

– Enhance public awareness of co-exposure: Craft an awareness campaign that outlines the compounded risk of simultaneous heat and air pollution is imperative. This can be teamed with existing messaging that is put out by respective agencies for public awareness during periods of poor air quality and extreme heat.

Medium-term actions:

– Integration of GRAP and HAP protocols: There is an urgent need to align the GRAP and HAP within a common framework that addresses climate–health risks in a coordinated manner. This integration should be reinforced by linking related efforts such as the National Clean Air Programme and State Action Plans on Air Quality. At the city level, a unified task force could coordinate implementation across sectors, enabling regional impact assessment and enhancing adaptive capacity. 

– Combined heat-air quality index: India should pilot a composite indicator that integrates temperature, humidity, and air quality metrics into a unified public health risk scale. Similar tools already exist such as the Monterrey Combined Air-Pollution and Heat Risk Index that combines indices featuring additive and multiplicative formulations to evaluate their combined relationship to mortality. Similarly, the Shandong Air-Health Index combines non-optimal temperatures and the effects of air pollution to assess district-level health risks. These models demonstrate the feasibility of developing similar indices for Indian cities. A combined Heat-Air Quality Index could inform early warning systems, trigger timely emergency health responses, and guide risk communication when thresholds are breached.

Long-term actions:

– Urban greening & cooling infrastructures: Expanding urban greenery can significantly reduce the intensity of urban heat island effects. Global case studies have shown that increasing tree canopy cover by 10% can lower surface temperatures by 0.5–1.5°C in urban areas. By moderating local temperatures, such interventions can also help in reducing peak O₃ formation and manage the experience of extreme heat.

– Thermal comfort through indoor cooling systems: Promoting well-ventilated and centralised indoor cooling systems, combined with energy-efficient technologies that have low global warming potential (GWP), could enhance thermal comfort while reducing greenhouse gas emissions (e.g., CO₂, HFCs) and air pollutants (e.g., NOₓ, SO₂, PM) from power generation.

– Focus on blue-green infrastructure that promotes thermal comfort: Land-use plans that integrate parks, urban forests and water bodies can help cool cities through shading and evapotranspiration, acting as heat sinks. A study in Ahmedabad found that a large park combined with reflective north–south roads reduced local temperatures by 0.17 – 0.33°C. Roads oriented along the north–south axis receive less cumulative solar exposure, absorbing and retaining less heat – a cost-effective strategy to mitigate the urban heat island effect.  This, in turn, can indirectly curb ground-level O₃ formation and aid in the limited removal of air pollutants. 

– Cross-cutting institutional readiness: Urban planning/city planning departments are a key nodule to systematic redesigning of urban zones. Coordinating with the departments of pollution, health, water, labour, and disaster management collaboratively would be more urban resilient. Training of local authorities and professionals involved in respective departments should be well-equipped with Standard Operating Procedures (SOPs) for timely response.

These recommendations, if implemented in an integrative and sustained manner, can build the momentum needed for collective action towards heat-air pollution challenges.

Air Pollution: Public Health Impacts and Policy Measures

Introduction

Air pollution and its impact on human health represent a slow and ongoing public health emergency. The detrimental effects of air pollution span from respiratory and cardiovascular diseases to adverse pregnancy outcomes and developmental problems in children and contribute to premature mortality across the developed and developing world. Air pollution, including microscopic PM and gaseous pollutants, can harm lung function and affect the cardiovascular system by causing oxidative stress, inflammation, altered heart rhythms, and disruptions in blood pressure. PM2.5 (PM smaller than 2.5 microns) can also penetrate deep into the lungs and bloodstream, affecting multiple organs and systems (Izzotti et al. 2022). The International Agency for Research on Cancer (IARC) has classed PM2.5 as a cause of lung cancers, building on evidence showcasing the carcinogenic effects of both vehicular diesel pollution and coal-burning emissions (Balakrishnan et al. 2015).

The 2019 India sub-national burden of disease study estimated that exposure to ambient and household air pollution contributed to 1.67 million deaths and 53.5 million disability-adjusted life years (DALYs) lost, amounting to 17.8% of total deaths and 11.5% of total DALYs, respectively. The economic loss associated with this exposure was estimated at $36.8 billion or 1.36% of GDP (A. Pandey et al. 2020). More recent results using similar approaches indicate an increase in air pollution’s burden of death to over 2.1 million deaths annually in India (State of Global Air 2024). Death rates from various sources of air pollution have changed substantially since 1990, with death rates from ambient PM2.5 increasing by 115.3% and that from household air pollution (primarily from traditional biomass-burning cookstoves) declining by 64.2%.

While the declines in household air pollution impacts are heartening, the increases in death rates from ambient air pollution are only likely to increase in the coming years, with India rapidly urbanising and industrialising. Many of the world’s most polluted cities in the world are in India, several of them tier-2 and 3 cities (IQ Air 2023). Combined with the growing evidence base on air pollution’s health impacts and the need to capitalise on its demographic dividend, there is a greater urgency than ever to tackle the all-pervasive challenge of air pollution.
 

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