THE mayor of London Sadiq Khan’s recent visit to Pakistan reminded me of the roles that Londoners have played in responding to two environmental crises. These, in turn, have influenced countries’ approaches to environmental infrastructure and regulation around the world. Let me explain.

Water first. John Snow, a Londoner, is known as the father of epidemiology. He was the first to make the connection that water was a carrier of disease. Rather than just being satisfied with treating the symptoms of diarrhoeal disease, he chose to work instead to prevent disease. In the 19th century, tens of thousands of people died in London from cholera, an acute diarrhoeal disease. A particularly bad outbreak in Soho, close to where Snow lived, in August 1854 led to 500 fatalities in the space of 10 days. By tracing each person who was ill, Snow was the first to figure out on Sept 7, 1854, that it was caused by the water source, namely a pump on Broad Street. He persuaded the authorities to remove the handle of the pump and immediately the outbreak was controlled. It was later found that the cause was the mixing of sewage with drinking water. Sadly, it took a while for officials to believe Snow and to act. Ultimately, London (and much of Europe) did update sewer systems, significantly reducing diarrhoeal disease incidence.

Despite remarkable improvements in the proportion of the Pakistani population using an improved water source and an improved sanitation facility, according to the United Nations Development Programme, 27.2 million Pakistanis still do not have access to safe water and 52.7m do not have access to adequate sanitation facilities. It is also telling that only 36 per cent of Pakistanis have access to a safely managed drinking water source, according to 2015 data, despite 55pc piped water coverage. So Pakistani conditions may not be that different from 19th-century London. But you have already been reading a lot about this in Sindh recently.

We need to monitor air quality. This will allow us to determine pollution sources and address them.

Now for the second story. From the 13th century onwards, London suffered from poor air quality, and in the 1940s and ’50s, it became known for its ‘pea soup’ fogs. I am sure the citizens of Lahore and Islamabad know what I am talking about, given the situation last month. In London’s case, the prevalence of coal use in power stations, industries and in homes resulted in air quality that was so bad that it was tough to see. A particularly bad fog, now known as the ‘The Great Smog of London’ took place in mid-December 1952. Official estimates put resulting deaths at over 4,000 and over 100,000 people falling ill due to respiratory illnesses. More recent estimates put the number of dead at 12,000. Even the prime minister at the time, Winston Churchill, dismissed it as a “weather event”. Ultimately, the disaster helped to improve people’s awareness about air quality and health and four years later, the United Kingdom passed its first Clean Air Act. This put in place a number of measures to reduce air pollution and was a milestone with respect to initiating a debate on regulation and public health. Subsequently, more stringent regulations in later acts were enacted.

Today, London still suffers from poor air quality, at 20 µg/m3, which is twice the WHO-recommended average annual level for particulate matter, less than 2.5 microns in size (PM2.5), ie the pollutant that most affects health. Sadiq Khan and his government are actively working to reduce this. Compare this with the annual mean PM2.5 measurements recorded in WHO’s 2016 ambient air pollution database for Peshawar (111 µg/m3), Rawalpindi (107 µg/m3), Karachi (88 µg/m3), Lahore (68 µg/m3) and Islamabad (66 µg/m3), or the 24-hour average PM2.5 reading from the Punjab EPA’s Lahore Gulberg monitor of 78 µg/m3 on Nov 30, 2017.

I have already shared WHO’s estimates for deaths from outdoor and indoor air pollution in Pakistan. At an estimated 155,000 a year, it is a shockingly high and totally unacceptable number. In order to fix this, we need to monitor air quality. This will allow us to determine pollution sources and address them. Monitoring air quality will also help officials to figure out the correct National Environmental Quality Standards (NEQS) or emissions standards imposed on various industries so that the pollution they put into the air does not cause air quality to deteriorate.

Yet it seems that only one province, namely Punjab, has standards for PM2.5, and seems to have a few measurement stations in Lahore. Sindh, despite its huge industrial base, has still not promulgated provincial ambient standards for PM2.5, putting a huge population base at risk. It also seems that emissions standards for some industries are non-existent, such as for PM2.5 emissions from coal power plants. For other industries, the emissions standards do not vary based on the quality of the air shed of the city in which these industries are based. Hence their effect on air quality and citizen’s health may be questionable, making them open to abuse. Further, in cities such as Lahore, which are subject to ‘thermal inversions’, where the air gets trapped due to meteorological effects above the city, measuring air quality comprehensively is crucial as additional emergency measures may be necessary at times to make sure the air quality does not become excessively unhealthy.

Today, we do not have to wait for government air quality monitoring using expensive equipment. Satellites can remotely assess air quality, and relatively cheap air quality monitors, around $200, are also available. I put it as a challenge to all schools, universities, industries and businesses to buy a PM2.5 air quality monitor and link it up to a shared, publicly accessible database for each city, set up by an enterprising Pakistani computer scientist or to existing global air quality websites. This way we will know more about the air we are taking into our bodies, which is as fundamental as the water and the food we consume. It will be an important start to help the government and our fellow citizens eventually tackle this problem.

WHO estimated, using 2004 data, that 22pc of all deaths and illnesses in Pakistan were due to environmental factors. I keep wondering why we cannot learn from London’s experience and prioritise the tackling of air and water quality issues.

The writer is an environmental sustainability and climate expert, and a former Practice Manager of the World Bank’s Environment and Natural Resources Global Practice.

Published in Dawn, December 22nd, 2017