[Answered] Evaluate the potential of the National Clean Air Programme (NCAP) to deliver significant public health benefits. What policy and institutional tweaks are essential for its effective implementation?

Introduction

Air pollution causes 1.67 million deaths annually in India (Lancet, 2020) and is the second leading risk factor for disease burden. The NCAP (2019) holds transformative potential for health-centric environmental governance.

Potential of NCAP in Delivering Public Health Benefits

1. Direct Health Co-benefits: IIT-Delhi & Climate Trends (2025): A 30% cut in pollution reduces incidence of heart disease, diabetes, anaemia, low birth weight. WHO studies link PM2.5 to COPD, stroke, lung cancer, making NCAP a preventive healthcare strategy.
2. Reduced Mortality & Morbidity: Lancet Planetary Health (2021): Failure to meet WHO air standards caused 1.5 million deaths in India. NCAP’s 40% PM reduction target by 2026 could save thousands of lives annually.
3. Economic Productivity Gains: World Bank (2019): Air pollution cost India 1.36% of GDP. Cleaner air reduces healthcare costs and improves labour productivity, adding an estimated $95 billion annually (NITI Aayog, 2022).
4. Climate & Environmental Synergy: Tackling PM also reduces black carbon, aligning with India’s Paris Agreement NDCs and enhancing climate resilience. Cleaner cities improve urban liveability indices, supporting SDG 3 (Health) and SDG 11 (Sustainable Cities).

Challenges Undermining NCAP Effectiveness

1. Limited Geographical Coverage: Focuses on 131 cities, ignoring rural and peri-urban regions where biomass burning and crop residue contribute heavily.
2. Institutional Weakness: SPCBs (State Pollution Control Boards) lack manpower, autonomy, and monitoring capacity. Monitoring stations often placed in low-density areas, missing urban hotspots.
3. Policy-Implementation Gap: Funds underutilised, Delhi NCR smog episodes reveal lack of interstate coordination. Absence of strong enforcement despite NCAP’s aspirational targets.
4. Fragmented Jurisdiction: Air pollution is transboundary, but cities are left to their own devices. Example: Punjab-Haryana crop burning impacts Delhi, but NCAP lacks a federal coordination framework.
5. Weak Public Health Integration: Pollution rarely linked with disease surveillance or healthcare planning. No structured framework for public health advisories during high AQI episodes.

Essential Policy and Institutional Tweaks

1. Expand Coverage Beyond Cities: Include rural areas with crop burning, brick kilns, and biomass fuel usage. Adopt airshed management approach (like California Air Resources Board).
2. Strengthen Monitoring Infrastructure: Install high-density real-time monitors in industrial and traffic-heavy zones. Promote open-source AQI data platforms for public awareness.
3. Inter-State and Inter-Agency Coordination: Establish Regional Clean Air Authorities (modeled on CAQM in Delhi-NCR). Ensure synergy between MoHFW, MoEFCC, MoRTH, and state governments.
4. Mainstream Health in Air Policy: Integrate NCAP with National Health Mission. Link ICMR disease registries with air quality data for targeted interventions.
5. Capacity Building & Funding: Increase budgetary allocation, ensure timely fund utilisation by ULBs. Strengthen SPCBs with trained staff, technology, and accountability mechanisms.
6. Behavioural & Technological Shifts: Promote EV adoption, renewable energy, LPG/PNG transition. Launch community awareness campaigns, replicating the success of Swachh Bharat Abhiyan.

Conclusion

Health is central to human capability. For NCAP to succeed, India must adopt health-centric air governance, regional coordination, and institutional accountability to ensure clean air as a public good.