A NEWLY published report by the Lancet Commission has identified pollution as the biggest environmental cause of disease and premature death in the world. The report claims that almost 22 per cent of premature deaths in Pakistan are attributable to pollution — and this comes to about 300,000 deaths annually. This is more than the deaths caused by road accidents in the country, or three times the combined toll of tuberculosis, malaria and AIDS. These are stunning findings and have caused a global stir.

A 2014 World Bank study, in a similar vein, pointed out that more than 22,600 deaths per year are directly or indirectly attributable to ambient air pollution in Pakistan. “Outdoor air pollution alone causes more than 80,000 hospital admissions per year, nearly 8,000 cases of chronic bronchitis and almost five million cases of lower respiratory” problems among children under five.

The urban air pollution levels in Pakistan are amongst the world’s highest, and intensely damaging for human health and quality of life. Pakistan is the most urbanised country in the South Asian region and the direct and indirect costs to our urban, peri-urban and rural standard of life are accelerating. This is degrading our environment, and eroding our economic growth rate. The pollution in low-middle-income countries like Pakistan is estimated to cost 2pc of GDP and almost 7pc of health spending.

The urban air pollution levels in Pakistan are amongst the world’s highest.

To make things worse, most of this cost is borne by the poor. Marginalised groups, particularly women, children and the elderly, get disproportionately affected. Yet, the commission’s economic analysis does not include the information about the cost of environmental damage caused by pollution, nor does it fully address the challenges and opportunities offered by climate change to address the root causes of pollution.

Despite adverse effects on human health, the pollution issue has traditionally been ignored by the policymaking community in Pakistan. National and provincial assemblies have not enacted any significant legislation to curtail pollution. The manifestos and platforms of political parties are silent about air pollution, industrial emissions, use of chemicals, or technology or fuel import standards. The ambient air quality or industrial emissions standards are inadequate, fragmented and poorly enforced. The capacity of environment protection departments in the provinces has evaporated over the years despite the 18th Amendment that devolved greater environmental responsibilities to them. Their budgets are negligible and enforcement capacities questionable.

Pakistan has the highest greenhouse gas emissions intensity in South Asia — more than India. We emit more GHG emissions per unit of GDP than any other country in the South Asian region. This structural inefficiency adds to the cost of doing business as well as to the national health bill.

Worse, Pakistan’s overall trends indicate a steady increase in emissions per unit of economic output over the past few decades. This is expected to further accelerate owing to rapid increase in population, the growing number of mega and intermediate cities, inadequate public transportation and the absence of mass transit systems, heavy reliance on fossil fuels and recent investments in coal-fired power plants. According to the Nationally Determined Contributions (NDCs) document that the federal government submitted to UNFCC Secretariat in 2015, the emissions are projected to more than double during the next decade. If the present trajectory of business as usual (BAU) continues, Pakistan, according to the NDC, will need $40 billion to offset these increases.

Add to this the institutional complexity and their standard practice of working in silos. The regulatory agencies and research groups that focus on agendas for environmental health and pollution control operate in two distinct domains. Key sources of pollution-health nexus — air, water, soil, industry and chemicals — are regulated by different national and provincial agencies. This often results in competing policies, interests and fragmented understanding of the full scale of pollution and its share in the national burden of disease. The Lancet Commission report has provided a unique opportunity to our national, provincial and city governments to give deeper thought to how best to change this state of affairs.

Going forward, our commitment to Agenda 2030, also known as the Sustainable Development Goals (SDGs), provides a window of opportunity to curtail pollution over the next 15 years. Robust and long-term programmes to protect the health and lives of people through national pollution-control programmes are needed at the federal and provincial levels. The prime minister needs to set up an inter-ministerial commission to design and deliver Pakistan’s pollution management programme. A series of targeted, well-integrated interventions should reach out to millions of Pakistanis through pollution-monitoring networks in the provinces, a consolidated regulatory framework for pollution control and using command-and-control measures that include ambient air standards, emissions standards and technology standards. For this to happen, the government must:

a) link air quality to health indicators by focusing on reducing pollutants linked to higher morbidity and mortality, particularly fine particulate matter, sulphur dioxide and lead content that are several times higher than WHO air quality guidelines; and b) link with cleaner production by focusing in particular on such industries as cement, fertiliser, sugar, steel and power plants, and on brick kilns, plastic moulding, and other waste-burning industries.

Curtailing pollution is essential for meeting the following SDGs: SDG-1 (poverty alleviation), SDG-3 (improving health), SDG-6 (access to clean water and sanitation), SDG-10 (promoting social justice), SDG-11 (building sustainable cities and communities), SDG-13 (climate change) and SDG-14 and 15 (protecting land and water). Their successful implementation will help curtail pollution that disproportionately kills the poor and vulnerable. Pollution control can benefit greatly from efforts to decarbonise economic development and mainstream renewable energy to slow the pace of climate change in Pakistan.

The writer is CEO of LEAD Pakistan, an Islamabad-based think tank specialising in environment and development issues.

Published in Dawn, October 28th, 2017