Pakistan’s urban air pollution is among the most severe in the world and it engenders significant damage to human health and the economy,” according to a newly-released report titled ‘Cleaning Pakistan’s Air’.

Released by the World Bank, the report calls upon the government to make urban air quality improvement a priority in the country’s policy agenda, noting that the issue has received little attention despite strong evidence indicating an urgent need to tackle pollution in major cities.

Current industrialisation, urbanisation and motorisation trends suggest that the air quality in Pakistan will only worsen over time unless targeted interventions are made in the short, medium and long term. In addition, the institutional and technical capacity of organisations responsible for air quality management needs to be strengthened, the report says.

Suggesting policy options to address the affects of outdoor air pollution, the report says that air pollution in Pakistan disproportionately affects the health and productivity of the poor, especially for the more than 35 per cent of Pakistanis who live in urban areas.

According to the report, more than 22,600 adult deaths in 2005 were caused in some way by urban air pollution. 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 cases in children under the age of five.

The report expresses concern over data that reveals that the harm caused by air pollution in Pakistan’s urban areas is the highest in South Asia region and exceeds most other high profile causes of mortality and morbidity in the country, including traffic-related accidents.

The report noted a significant expansion of environmental regulatory powers with the passage of Pakistan Environmental Protection Act and the issuance of national environmental policy, but noted that significant implementation gaps still exist. While the laws governing the environment are comparable to those in other South Asian nations, they suffer because of weak implementation and enforcement mechanisms. Neither the organisational structure of Climate Change Division nor that of Pak-EPA has a specific department responsible for air quality management, the report states.

According to the World Bank study, declining government attention to air quality management resulted in a significant paucity of reliable air quality data. The limited data that are available suggest that ambient concentrations of health-damaging particulate matters in Pakistan are on average more than four times above levels recommended in World Health Organisation guidelines.

Comparative risk assessments typically confirm that air pollution generates severe local impacts, particularly on human health. However, attention devoted to local pollution problems has declined rapidly in Pakistan to give precedence to climate change mitigation and other problems that have global impacts.

In the short term the primary emphasis should be on reducing levels of pollutants linked to higher morbidity and mortality from mobile sources. A second level of priority could be given to particulate matter, sulfur oxide and lead emissions from stationary sources. A fourth level of priority could be given to other traditional air pollutants such as carbon monoxide and greenhouse gases.

In the medium term the government should consider adopting measures to reduce the country’s motorisation trend. The number of vehicles in Pakistan has increased from around 2 million to 10.6 million over the last 20 years, the report reveals.

Bus rapid transit can be used to transport increasingly larger volumes of people at moderately higher speeds even in very congested urban areas. While still substantial, the investments needed to develop and operate these systems are significantly lower than those of traditional mass transport systems, such as the underground metros.

Additional policies that are worth assessing in the medium term include traffic control, restricted circulation of private cars during high pollution episodes, urban planning and land use, establishment of high occupancy vehicle lanes, measures to improve traffic flows such as ‘green wave’ coordination of traffic signals, and improvement of infrastructures such as paving of roads.

Climate policies in the transportation sector include improving the efficiency of motorised vehicles and the transportation system; promotion of mass transit; policies to reduce congestion on roads, highways and in urban metropolitan centres; and promotion of non-motorised transport.

The report concludes that Pakistan’s severe urban air pollution problem will need to be tackled through a series of coordinated interventions to strengthen monitoring, build institutional capacity, bolster the regulatory framework and fill existing knowledge gaps.