The cost of breathing air

Karachi is not a green city by any stretch of the imagination, unlike some of the other big cities. But even by our twisted standards, there is a strange dejection in the air the moment you enter Korangi or cross Mausamiyat in the afternoon. It’s not because you have to take University Road (whatever patches exist) for the latter, but because the scorching sun directly shines on you, with hardly any trees to protect and just… a lot of dust.

Yet surprisingly, among the major urban centres in the country, Karachi had the lowest average PM2.5 reading of 47.1 micrograms per cubic meter, while Lahore was ahead of the rest at 102.1 g/m³. Such relative performance is absolutely meaningless, though, and should not at all be comforting because all of Pakistan’s major six cities were well above the World Health Organisation-prescribed concentration of 2.5 g/m³. To sum up, even the best performer is 19x beyond the acceptable threshold.

Of course, this is all stale information, and the problem has existed for decades. In fact, Lahore’s pollution concentration was already 33 g/m³ by 1998. At least from an outsider’s perspective, it feels like the whole conversation came into the limelight when our consultants in Islamabad sniffed out new funding opportunities early on. Not long after, the government probably wanted in too, seeing large projects from global development partners, along with the opportunity to make sympathetic and scapegoating statements at the Conference of the Parties (COP).

Does the hyperbole lead to any meaningful change? That depends on how you measure success. If the creation of new policy frameworks or reports qualifies, then we have something to cherish. However, by a relatively stricter barometer of real, on-ground progress in terms of, say, lower emissions, better waste management etc, there is little to show for.

The choice between economic opportunity and respiratory health shouldn’t define a generation’s future, yet for now, it remains Pakistan’s harsh reality

While this is true for climate change at large, where no country seems capable of riding against the wave, air pollution in comparison is a much narrower problem with local solutions. When Beijing decided to tackle its air quality crisis, air quality in northern Chinese cities improved by 35 per cent between 2013 and 2017 through comprehensive action plans. No international treaties or grandiose statements on the nature of global inequality were needed.

In a way, it probably also makes funding more challenging for donors like thinking big while local resources are practically always limited. However, the World Bank’s approval of $300 million for the Punjab Clean Air Program (PCAP) in March represents a landmark event in this regard, which will support the provincial government’s “Smog Mitigation Action Plan (SMAP) in key sectors such as transport, agriculture, industry, energy, and municipal services.

“Key interventions include the investment of 5,000 super seeders to reduce the main issue of the excessive seasonal fog, crop residue burning, the introduction of 600 electric buses to foster a modal shift to public transport, the expansion of regulatory-grade air quality monitoring stations across Punjab, and the enhancement of fuel quality testing through the establishment of two new fuel testing laboratories,” as per the original press release.

Some of the interventions will obviously overlap with the broader fight against climate change. According to the World Bank, a co-benefit of the PCAP’s reduction in PM2.5 is an estimated cut of 35.6m metric tons of carbon dioxide emissions over the next 12 years.

While such interventions are quite needed, the resources, by and large, have to come from locally. China illustrates this example quite well, where the central and provincial governments (of Hebei) committed $2 billion between 2017 and 2019 for combating air pollution. This amount was four times what the World Bank had provided as a loan in 2016.

Here too, the governments — federal, provincial, and if we ever come to that, local — need to play the biggest role in not only creating the awareness for driving behavioural change but also ensuring the carrots and sticks are in place. Plus, it’s not like if they don’t dole out funds for this purpose, there wouldn’t be costs. According to a slightly dated World Bank study, total welfare losses from air pollution in the country are estimated at almost 6pc of the gross domestic product.

Even leaving aside the opportunity costs, there are direct consequences for the lack of action, which are reflected in the health expenditure, which stood at Rs924bn as reported by provincial and central authorities. According to the demographic survey 2020, almost 7.5pc of deaths were attributable to asthma and respiratory diseases, primarily caused by air pollution. While it is hard to pinpoint numbers, a Pakistan Bureau of Statistics dataset shows that at least over 10pc of out-of-pocket expenses happen to be on diseases that are exacerbated by air pollution.

Till then, there would always remain a trade-off between breathing clean air and making a professional career. Don’t hold on to the idea of counting stars in the deep midnight. The choice between economic opportunity and respiratory health shouldn’t define a generation’s future, yet for now, it remains Pakistan’s harsh reality.

The writer is the co-founder of Data Darbar and works for the Karachi School of Business and Leadership

Published in Brackly News, The Business and Finance Weekly, September 22nd, 2025