A RECENT World Bank study has found that “Pakistan’s urban air pollution is among the most severe in the world” and the worst in South Asia. The damage done to human health and economic productivity is extensive. The details make for grievous reading. They show that some 23,000 deaths are caused annually, directly or indirectly by air pollution alone; hundreds of these deaths are of children. Longer-term health impacts include rising respiratory and cardiovascular illnesses, as well as the greater susceptibility of children to pneumonia and lowered intelligence levels due to lead exposure. The study, published by the World Bank, estimates the economic damage at $1.1bn till 2005. Since then, the impact of air pollution has only grown, as have its human and economic costs.

But there is an upside to be considered. Unlike climate change, air pollution can be reduced very quickly given appropriate action. The most important conclusion of the authors is that institutions make a difference. “[L]arge metropolises with strong institutions have successfully reduced their ambient concentrations to a level that is lower than even those of small Pakistani cities,” say the authors, pointing to “institutional weakness and poor environment governance” as the main reason for the dismal state of air quality in Pakistani cities. Both of these key elements of cleaner and healthier cities — institutions and governance — are within our power to create. All that is required is the will. And therein lies the rub.

Consider, for example, that a thick blanket of smog has been covering the province of Punjab for a growing number of days every winter for more than 15 years now. A number of studies of the smog, done in Pakistan, have claimed that it is caused by the pollutants produced in India’s coal-fired power plants across the border. Specifically, these studies have found heightened levels of sulphates and nitrates in the air in Lahore, which they argue are chemicals produced by the combustion of low quality coal, and an important contributory factor in the smog. Indian scientists have denied this claim, arguing that the smog is a more complex phenomenon and cannot be explained by the presence of a few pollutant chemicals. The World Bank report does not carry any data for the specific chemicals identified by Pakistani researchers. Instead, the report says fine particulate matter is “the most damaging air pollutant in Pakistan”, and identifies its source primarily as vehicular emissions. This may be true, but the report misses an opportunity to settle a controversy by ducking the thornier issues that arise from the most visible and disruptive form of air pollution: the winter smog. However, the authors make an important point by reminding us that a focus on institution building deserves the same priority as infrastructure projects that are being given a lot of attention these days by federal and provincial authorities alike.

Published in Dawn, July 15th, 2014