Air pollution needs a Covid-like response: Dr Soumya Swaminathan

The former World Health Organisation (WHO) chief scientist says India's response to toxic air remains 'too little, too late', warning that children exposed to high pollution levels may never grow into healthy adults.

In Short

• ICMR estimates link air pollution to nearly two million annual deaths
• Emerging research connects polluted air with dementia, Parkinson's and diabetes
• Reactive restrictions disproportionately burden daily-wage workers and poorer families during winter

The post-Diwali pollution spike has once again pushed Delhi and several other Indian cities into hazardous air quality levels, bringing back familiar concerns about respiratory illnesses, hospital admissions and the health risks of prolonged exposure. But the consequences of India's pollution crisis could extend far beyond the immediate coughing, breathlessness and worsening asthma episodes.

Warning that the country is underestimating the scale of the health threat, Dr Soumya Swaminathan, former chief scientist at the World Health Organization (WHO), says air pollution must be treated as a public health emergency rather than an annual environmental problem.

She believes India needs the kind of coordinated, high-level government response it mounted during Covid-19, backed by substantial funding, clear accountability and a long-term action plan.

In an interview with India Today Digital, Dr Swaminathan described the current approach as "too little, too late", cautioning that the damage is already beginning at pollution levels that many people may consider relatively safe.

Her biggest concern, however, is the impact on children, including those who are exposed to polluted air even before they are born. "These kids are not going to grow up to be very healthy adults. This is the sad, sad reality," she warned.

DAMAGE BEGINS EARLY

Dr Swaminathan says air pollution is among the biggest risk factors for health today, with an impact extending well beyond the lungs. Citing estimates from the Indian Council of Medical Research (ICMR), she pointed to approximately two million deaths in India every year linked to air pollution.

Unlike smoking, another major health risk that individuals can choose to avoid, exposure to polluted air is largely beyond an individual's control. Hundreds of millions of Indians are breathing it, often throughout the year.

While the Indo-Gangetic plains face particularly high pollution levels, she cautioned against treating this as a Delhi-NCR problem. Cities in other parts of the country, including Assam, have also featured among India's most polluted locations.

What worries her most is the exposure of pregnant women, unborn babies and young children. Children breathe faster than adults, their organs are still developing and their proximity to the ground exposes them to pollutants that can be present in higher concentrations closer to the surface.

The consequences could be long-lasting. Pollution can interfere with the development of children's bodies, brains and cognitive functions, with some effects potentially becoming clearer only decades later.

Emerging research is also pointing towards links between air pollution and neurodegenerative conditions such as dementia and Parkinson's disease, besides metabolic disorders such as diabetes. Swaminathan believes pollution could add to India's already substantial diabetes burden.

She also flagged concerns about lung cancer, pointing to the growing number of cases among non-smokers. Recounting conversations with thoracic surgeons, she said they have reported seeing blackened lungs even in teenagers undergoing surgery.

BEYOND EMERGENCY CURBS

Dr Swaminathan says the government's response continues to be largely reactive, with restrictions such as the Graded Response Action Plan (GRAP) kicking in when pollution reaches dangerous levels.

While such measures are necessary, she pointed out that their burden often falls disproportionately on daily-wage workers and poorer families. Children from low-income households may be kept indoors when schools shut, but without access to air purifiers, they continue breathing polluted air at home.

She called for a science-based, 10-year national action plan targeting the major sources of pollution, rather than relying on short-term restrictions during winter.

Transport emissions, industrial pollution, waste burning and the continued use of biomass for cooking need sustained attention. She advocated expanding public transport, making cities more pedestrian- and cycle-friendly, introducing more electric buses and trucks, and strictly enforcing existing industrial pollution norms.

She also highlighted the continuing dependence on wood, charcoal and cow dung for cooking in rural households across North India. While the Ujjwala scheme has expanded LPG connections, affordability of refills remains a barrier for many families.

Making clean cooking fuel affordable, she said, would reduce indoor pollution while also lowering emissions that contribute to outdoor air pollution. It would particularly benefit women and children, who bear a disproportionate share of household exposure.

Another critical shift, according to Dr Swaminathan, is to focus on PM2.5 rather than relying predominantly on PM10, which is largely associated with dust. Fine particulate matter, along with pollutants such as ozone and nitrogen oxides, needs greater attention.

She also called for updating India's national ambient air quality standards, which have not been revised in more than a decade, and developing a roadmap to gradually bring them closer to WHO recommendations.

A COVID-LIKE RESPONSE

One of the biggest obstacles, Dr Swaminathan believes, is the absence of a consolidated picture of how pollution is affecting people's health.

Hospital admissions, outpatient visits, intensive care admissions and deaths are recorded across different institutions and government departments. Bringing this information together could help authorities identify pollution-related health spikes, vulnerable populations and the areas requiring urgent intervention.

She proposed a national climate and health data platform that brings together health records, air pollution measurements and meteorological information. Such a system could help policymakers identify hotspots and decide where resources should be directed.

She also pointed to government analysis suggesting that the imposition of GRAP Stage IV restrictions over a few days could save 3,000-4,000 lives. This, she said, demonstrates the potentially immediate consequences of reducing exposure to severe pollution.

But the larger response cannot depend on emergency restrictions alone.

Drawing a parallel with India's COVID-19 response, Dr Swaminathan said the country needs leadership at the highest level, with different ministries and state governments working together, dedicated financing and clearly assigned responsibilities.

"The same sort of urgency should be brought to air pollution," she said, arguing that the issue must transcend political differences because it is fundamentally about public health.

She also proposed setting up an environmental health regulatory agency to address the growing health threats arising from environmental exposures.

Her message to policymakers is that India already has enough scientific evidence to identify the sources of pollution and the interventions needed to tackle them. What is missing is the political will to translate that knowledge into sustained action.

- Ends