The silent pandemic hiding in plain sight is air pollution. No government is willing to regulate it

In early July, I travel to London to meet Rosamund Adoo-Kissi-Debrah, who is fighting for children’s health in London after her daughter Ella died of asthma triggered by air pollution. Rosamund and Ella lived near Catford Bridge by the busy South Circular Road. Ella died in 2013 after suffering from seizures for three years and making 27 visits to the hospital. She was not even 10 years old.

An asthma and air pollution expert in the UK linked her death to spikes in nitrogen dioxide and PM10 particulates that breached legal limits. Five years later, in 2018, with evidence of the health harm of air pollution growing, Rosamund petitioned the attorney general to get a fresh inquest into Ella’s death and have air pollution listed as a reason for death on her death certificate. She got a major boost in 2019 when the UK’s attorney general said that the high court should consider the application and the mayor of London Sadiq Khan backed the call. This makes international headlines.

It is a fellow journalist Beth Gardiner’s article in The Guardian which had alerted me to Ella’s case. I first met Beth in New Delhi in 2015 when she was researching air pollution from ground zero for her book, Choked, which traces the impact of air pollution and the choices that governments and people have made that have caused dramatic impacts in the air we breathe.

The very first thing Rosamund tells me when we meet is that until the age of seven Ella was “a perfectly healthy child” who walked to school every day. In reality, she was inhaling toxic diesel fumes as she did so, and that was what caused damage to her lungs, leading to her death. As we retrace Ella’s path to school, I’m struck by how heavy the traffic is.

Rosamund is wearing a blue-striped shirt and black pants, and as we sit on a bench by the roadside near the location where she is planning to build a memorial park for Ella, I can’t help but think of how Ella died of an asthma attack breathing these very fumes. A few feet away, people are sitting in cafes whose chairs are spilling out onto the pavement. Rosamund is quick to point out to me that there are no monitors close by, thus no way of knowing what the air quality is here.

She tells me that with the recent support from political circles and voices rising in support for her, she is hopeful of getting her daughter’s death certificate to state air pollution as the cause of death. If Ella becomes the first person on this planet to have “toxic air” recorded as the cause of her death, it will have far-reaching implications for human rights and unveil a silent killer.

We talk of her plans to perhaps join local politics. The Green Party is a good option for her as a clean air campaigner. She is also curious about the worldwide fight against air pollution, and I tell her about a recent class action lawsuit that the citizens of Jakarta are planning against their government as well as the petition by toddlers to ban firecrackers in India.

I learn that she also met Dr Arvind Kumar a few months ago. “Pollution is a chemical cause – but people die of diseases,” I remember Dr Kumar saying. “However, pollution is the primary cause. It kills. All ages, all genders.”

That air pollution doesn’t show up as a cause for death on death certificates anywhere is due to a technicality. “If people that died from air pollution were marked with green spots, it would be very easy for everyone to understand. But when people’s lives are shortened by air pollution, they die of the things that people die of anyway: respiratory diseases, heart disease, strokes,” says Dr Gary Fuller, an air pollution scientist and author of The Invisible Killer.

It is also this technicality that leads to it being politicised – in the UK as well, but more so in India. Instead of acknowledging the truth about air pollution affecting people’s longevity, Dr Harsh Vardhan, the incumbent minister for health in 2018, adds to the controversy by saying his benchmark for a medical “emergency” is the Bhopal Gas Tragedy of 1984, once again proving how air pollution – a silent pandemic – can remain hidden in plain sight. The fact that he is an ENT surgeon doctor – politician makes this all the more uncomfortable.

The coronavirus pandemic has reframed the meaning of a public health emergency, but it doesn’t alter the fact that air pollution kills many more than SARS-CoV-2 – just less dramatically. As an environmentalist in Los Angeles has told Beth Gardiner so evocatively, “If you see one person run over in the street, you’ll never forget it but thousands dying from the effects of dirty air will never even faze you.”

Because, with air pollution, like the proverbial frog in the pot of gradually heating water, you die a little bit every day without even understanding what is happening to you.

London already has a mayor who has made clean air a priority. In April 2019, Sadiq Khan introduced tough vehicle emissions standards in central London to help reduce toxic air pollution and protect public health. By doing this, Khan expects to reduce harmful road transport emissions in central London by an estimated 45 per cent in two years. As someone who developed adult-onset asthma shortly before he was elected mayor in 2016, he knows from personal experience that London’s toxic air is damaging people’s health.

The central London Ultra Low Emission Zone (ULEZ) will operate 24 hours a day, seven days a week, 365 days a year. Research by King’s College, London, has found that if these measures had not been implemented, London’s air would not have come into compliance within legal limits for another 193 years. With the new measures, the analysis indicates that London’s air will now reach legal limits in six years. The Environmental Research Group at King’s works closely with the mayor of London as the official air quality monitor.

I wish Delhi chief minister Kejriwal would create such zones, apply “congestion charges” during peak hours, clean and improve public mobility and make private vehicles expensive instead of just imposing the ineffective odd-even road rationing scheme his government lapses into every time winter AQI goes off the charts. Internalising costs of pollution reduction measures has been shown to improve polluting behaviour.

When I’m sitting with Rosamund, I can’t help noticing that this part of London looks crummier than central London where I’ve just come from after meeting Beth. Even without measuring, I know the pollution levels will be higher. But Khan has also addressed this inequity while pushing his ULEZ plan, saying it will help the poorest Londoners most.

London is Beth’s adopted city from where she has travelled to China, the US, Poland and Germany for a more global overview for her book. Talking to someone who has looked at air pollution through the same lens as me is energising and helps me understand some issues from another angle. I tell her how counter-intuitive I find Delhi’s odd-even road rationing scheme. “National governments encourage car sales to increase GDP growth and profits. But they leave it to local authorities to keep those cars off the roads,” I complain.

Jing’s words that pollution smells of money have begun haunting me. I tell her how terribly skewed subsidies in India are, something I’ve recently learnt from a transportation researcher. Car owners are the most highly subsidised, when they should actually be paying parking and congestion charges. “The government is indirectly subsidising car owners instead of making ownership expensive and public transport cheaper – which is the only way to drive behavioural change,” I tell her. “In India, we have roughly 30,000 buses for the entire country’s population, while the city of Beijing alone has 25,000.”

Beth has her own learnings and grouses to share. The main one being that despite being caught, car manufacturers are still selling vehicles whose nitrogen dioxide emissions are many times over the legal limit. She feels strongly that they must be penalised for cheating. We discuss the Volkswagen cheating scandal that exposed rampant rule breaking and bending across the industry. Insisting that manufacturers make cleaner cars would be far more effective than policing where those cars can go, she says. London’s ULEZs are good measures to begin with, and the best that a local government can do, but only the national government can enforce any radical change, she will write in an article.

We agree that electric mobility, especially when electricity is generated by clean, renewable energy, is one of the quickest solutions. In India, this would entail that everything from public buses to the highly polluting two-wheelers runs on electricity generated by clean energy. But what the world really needs is fewer cars altogether. “It’s [fewer cars for mobility] a goal that’s reachable if we reorganise the places we live to be denser, more pedestrian and bicycle-friendly and have public transportation and ride-sharing that is convenient and affordable,” Beth tells me.

But no one is willing to pay the higher costs of clean air – even though its benefits are so clear. After this meeting, I catch the connecting train that will take me to Catford Bridge and Rosamund.

The same day, after I leave Rosamund, I also communicate with Simon Birkett, a clean air campaigner who sends me a copy of the Clean Air (Human Rights) Bill, a private member’s bill that has been tabled in the UK Parliament to establish the right to breathe clean air, and requires the public authorities to achieve and maintain clean air and set and review limits for pollutants, as well as greatly enhances the powers of environmental agencies.

I find myself wishing that we had something similar in India. But pollution is a topic that has not entered the echelons of our Parliament as of yet.

Excerpted with permission from Breathing Here Is Injurious to Your Health, Jyoti Pande Lavakare, Hachette India.