On 27 November 2019, the Supreme Court of India, in one of its most landmark judgments, pronounced ‘Right to Clean Air and Water’ as integral to ‘Right to Life’, enshrined in Article 21 of Indian constitution. 

The top court clearly acknowledged in its order that polluted water and air compromise the lifespan of people. Therefore, the state has the obligation to make provisions for clean air and water for its citizens irrespective of their social and economic status. 

India’s commitment to sustainable development goals (SDG) 2030 cannot be achieved if issues related to pollution in urban India are not addressed. SDG goals 3, 6, 7 and 11 can be achieved only if our urban citizens get clean air and water.

According to the 2011 census, one third of the Indian population occupied the urban space, or 7933 towns. This figure is only going to increase in the coming years due to the increasing pace of urbanisation, migration and structural changes in the economy, which is moving away from dependence on agriculture for livelihood. 

Urban India is reporting a higher number of cases for COVID-19 from day one compared to their rural counterparts. In many ways, urban India is more vulnerable to the virus than the rural parts for a number of reasons.

According to the World Air Quality Report 2019 published by IQAir, among the 30 most polluted cities in the world, 21 are from India alone, with Ghaziabad in Uttar Pradesh (bordering Delhi) occupying the first position. Notably, some of these cities have also emerged as COVID-19 hotspots in the country. Herein lies the critical intersection between the pandemic and the right to clean air and water.

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The COVID-19 pandemic and urban hotspots

The top five states that have a significant share of India’s urban population, according to the 2011 Census, are Delhi (97 per cent), Tamil Nadu and Kerala (48 per cent each), Maharashtra (45 per cent) and Gujarat (43 per cent).

By 2036, the urban population in the country is going to increase to 38.6% from 31.8% in 2011, as per report of National Commission on Population, 2019. In a period of two and half decades, India is expected to add another 30.7 crore people, of which 22.4 crores (72.9%) will be in urban areas (ibid). 

The states that will have higher proportion of urban population than the national average in 2036, as per projections, will be Delhi (100.0%), Kerala (92.8%), Tamil Nadu (58.2%), Telangana (55.0%), Gujarat (53.6%), Maharashtra (51.3%), Karnataka (49.3%), Haryana (47.9%), Punjab (45.5%), Andhra Pradesh (42.8%), West Bengal (41.1%) and Uttarakhand (40.6%). These states recorded a degree of urbanisation above the national average of 31.8% as per census 2011 (ibid, pp. 13).

Also read ‘COVID-19 in India: Agrarian and Informal Sectors Under Severe Stress’

If one looks at reported COVID-19 figures – including those who recovered, those who are under treatment and those who had died as of 19 August 2020 – some of these states with higher urban concentration also had a higher number of cases. 

Maharashtra leads the list among the states with 7,80,689 cases, which is 21.5% of total cases in India (36,24,613). It is followed by Tamil Nadu at 4,22,085 (11.6% of national share), Andhra Pradesh at 4,24,767 (11.7%), Karnataka at 3,35,928 (9.3%), Delhi at 173,390 (4.8%), West Bengal at 1,59,785 (4.4%) and Telangana at 1,24,963 (3.4%). 

States with higher urban population than national average both in 2011 and for projected figures in 2036 but a caseload of below one lakh are: Gujarat at 95,155 (2.6% of national share), Kerala at 73,855(2.0%), Haryana at 63,282 (1.7%), Punjab at 52,526 (1.4%) and Uttarakhand at 19235 (0.5%). The figures are as on August 30, 2020.

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Thus, 12 states with greater urban share of urban population, both in 2011 and project figures for 2036, have reported 75.1% of all confirmed cases in the country. States that are predominantly rural, but have cases above one lakh are Uttar Pradesh at 2,25,632 (6.2% of national share), Bihar at 1,35,013 (3.7%), Assam at 1,05,775 (2.9%) and Odisha at 1,03,536 (2.8%).

However, according to the number of tests done per million of population and percentage of positive cases among sample tasted, Uttar Pradesh and Bihar were below the national average, whereas Assam and Odisha were higher than the national average. 

The list of 170 COVID-19 hotspot districts prepared by the Ministry of Home Affairs also corroborated to the above data, as most of these districts have a significant urban population and are prominent hubs for manufacturing or industrial production in the country. 

Red zones are those districts, which alone or together contribute towards 80% of total COVID-19 patients in a given state. All six metro cities – Delhi, Mumbai, Kolkata, Chennai, Hyderabad and Bengaluru – continue to be red zones. Apart from metros, other prominent urban manufacturing and industrial hubs in various states continue to be contributing higher numbers of patients in their respective states.

From Tables 1 and 2, one finds that the top 3 districts in the selected major states have at least one-third of its population living in urban areas.  In the states of Gujarat, Haryana, Karnataka, Kerala, Punjab, Maharashtra, Tamil Nadu, West Bengal, Uttarakhand and Chhattisgarh, the districts reported in the tables contributed to more than 40% of total cumulative cases till August 30, 2020. Similarly, these selected districts contributed to 45%-80% of total deaths in the respective states during the same period.

Also read ‘COVID-19 Adds Fuel to India’s Bonded Labour Crisis’

The major urban centers in these districts also face poor air quality as per various national and international reports over the years. They also face infrastructure issues related to water and sanitation, mostly for weaker sections living in slums in these urban centers.

One can raise an exception to our conclusion as our research and data mix up districts and cities. We are aware most of the above Indian cities and urban centres are districts in themselves, for administrative purpose and metros often spread across more than one district. Though we do not have any revision to the list after 1 May 2020 with us, we tried to look at the confirmed COVID-19 cases in above districts, which are predominantly urban, and the number of deceased and their share in respective states.

In the case of Andhra Pradesh, out of 13 districts, 11 were declared hotspots, which is highest for any state, followed by Tamil Nadu (22 out of 38 districts), Maharashtra and Rajasthan (11 each out of 36 and 33 districts respectively) and Uttar Pradesh (9 out of 75 districts).

We also included some of the districts that were not in the original hotspot district list, but over time emerged as one in their respective states, with the condition that at least one-third of the district population lives in urban areas. 

Table 1: Incidences of COVID-19 infections in Selected Hotspot Districts in the Country in Selected Major States Having Urban Population Higher than the National Average*

States with urban population higher than national average(alphabetical order)Number of confirmed casesNumber of deceasedSelected Districts termed as hotspots(maximum 3 districts having highest reported cases till August 20, 2020)Number of confirmed cases in the district(share in total confirmed cases  reported at state level)Number of deceased in the district(share in total deceased reported at state level)% of urban population in the district(as per 2011 census)  
Andhra Pradesh4247673884Vishakhapattnam36694(8.6%)289(7.4%)47.5
Surat20411 (22.4%)622(20.7%)79.74
Gurugram11818(21.1%)133 (23.1%)68.82
Karnataka3359285589Bengaluru Urban127263(37.9%)1938(34.7%)90.9
Tamil Nadu4220857231Chennai134436(31.9%)2726(37.7%)100.0
West Bengal1597853176Kolkata39713(24.9%)1280(40.3%)100.0
North 24 Parganas33401(20.9%)726(22.9%)57.3
Dehradun3936(17.2 %)128(49.8%)55.5
Uddhamsingh Nagar3703(19.3)22(8.6%)35.6
Source: https://www.covid19india.org/

Among other selected major states that have relatively lower percentages of urban population than the national average but high number of positive cases are – Assam, Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Odisha, Rajasthan and Uttar Pradesh.

We have found the top districts in total number of cases in these states are those which are having higher than 30% of population living in urban areas.

Table 2: Incidences of COVID-19 Infections in Selected Hotspot Districts in the Country in Selected Major States Having Urban Population Lower than the National Average**

States with urban population higher than national average (alphabetical order)Number of confirmed casesNumber of deceasedDistrict with maximum confirmed cases (maximum 3 districts having highest reported cases till August 30, 2020)Number of confirmed cases in the district(share in total confirmed cases  reported at state level)Number of deceased in the district(share in total deceased reported at state level)% of urban population in the district (as per 2011 census)  
Assam105775296Kamrup Metropolitan28125(26.6)66(22.3)82.7
Durg (Has Bhilai Steel City)3070(10.2)33(12.3)38.4
East Singhbhum (Bokaro steel city)6448(16.8)183(44.6%)55.6
Madhya Pradesh 624331374Indore12720(20.4%)389(28.3%)74.1
Uttar Pradesh2304143486Lucknow27428(11.3%)361(8.9%)66.2
Kanpur Nagar14490(6.8%)434(12.3%)65.8
Source: https://www.covid19india.org/ 

Thus, from the above tables, we can see that it is the urban areas in the major states that have a higher share of COVID-19 confirmed cases and deaths in India than rural or semi-urban areas. However recently, the pandemic has started to spread in rural areas near towns, cities and urban agglomerations.

Link between poor air quality and COVID-19

The European Respiratory Society is of the opinion that “Patients with chronic lung and heart conditions caused or worsened by long-term exposure to air pollution are less able to fight off lung infections and more likely to die.”  

The SARS-COV2 virus affects the lung and critical patients need ventilator support to remain alive. Sarah Vogel of Environmental Defence Fund (EDF), suggests ‘air pollution could be responsible for nearly 40 % of lower respiratory tract infections and chronic obstructive pulmonary disease burden and about and another 20 % of coronary heart disease and diabetes burden across the globe.’ 

She points out that the less economically well-off could be exposed to greater air pollution as they are often settled mostly near major ‘pollution hubs’ or ‘downwind’ of it, like refineries, highways, ports and industrial complexes. This is evident in India as well, where slums mostly sprout near the major hubs of manufacturing and transportation. 

A slum in Mumbai | Photo by: Sthitaprajna Jena, Wikimedia Commons

Vogel also stressed on the need for clean mass transit systems, such as cycling and walking, to improve air quality and lung health, as undertaken in Bogota and London.

A recent study by researchers at the T.H. Chan Public School of Health at Harvard University, titled ‘Exposure to Air Pollution and COVID-19 Mortality in the United States’, has statistically concluded that:

“A small increase in long-term exposure to PM2.5 leads to a large increase in COVID-19 death rate, with the magnitude of increase 20 times that is observed for PM2.5 and all-cause mortality. The study results underscore the importance of continuing to enforce existing air pollution regulations to protect human health both during and after the COVID-19 crisis. The data and codes of this study are publicly available to facilitate update of the existing data for examination of the hypothesis in future.” 

The above study was based on air quality data, measured in terms of atmospheric particulate matter that have a diameter of less than 2.5 micrometres (PM2.5), in 3000 counties in the US covering 98% of the population till 4 April 2020.

According to American Lung Association, fine particles of size 2.5 microns in diameter or smaller (PM 2.5) can easily mix into the blood stream through lung tissues and circulate like the oxygen molecules themselves, thereby affecting respiratory system. 

Also read ‘Swachh Survekshan 2020: India’s Annual Cleanliness Survey Fails to Capture Complex Realities’

Quoting Sara De Matteis of Cagliari University, The Guardian reported in March that improving air quality will help to boost survival chances for the most vulnerable in the population, not only from COVID–19 but from other pandemics in future.  

According to the 2019 World Air Quality Report, India is the fifth most polluted country in the world after Bangladesh, Pakistan, Mongolia, and Afghanistan. The yearly average PM 2.5 for India was 58.08 mg/m3 which is much beyond the limit of 10.0 mg/m3 prescribed by the World Health Organisation (WHO).

The same report highlights that out of the 30 most polluted cities in the world, 21 were in India in 2019. Out of these, Ghaziabad in Uttar Pradesh, bordering New Delhi and a major manufacturing and transportation hub, is the most polluted city in the world out of a total of 3000 cities for which the data was collected. The annual average PM 2.5 in Ghaziabad was clocked at 110.2 mg/m3.

Delhi, Noida, Gurugram, Greater Noida were other major polluting cities ranking fifth, sixth, seventh and ninth respectively. Delhi is the second biggest COVID-19 hotspot after Mumbai.

Jodhpur (29th), Moradabad (30th), Navi Mumbai (51st), Kolkata (61st), Ahmedabad (69th), Howrah (91st), Chandigarh (111th), Jaipur (120th), Kota (129th), Nagpur (146th), Mumbai (169th), Bhopal (174th), Aurangabad (178th), Visakhapatnam (180th), Ujjain (187th), Jalandhar (221st), Nashik (244th), Hyderabad (249th) and Pune (299th) are other cities and urban centres in India that were listed as the most polluted cities. And as shown in Tables 1 and 2, they also happen to be COVID-19 hotspots. The average air quality of these cities varies between 35.5-77.2 mg/m3, much higher than WHO prescribed limit. 

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One can assert in absence of any rigorous statistical exercise that the two phenomena – prevalence of poor air quality in urban areas or centres in India and prevalence of COVID-19 in these areas or centres – have at least an ‘association’. We cannot assert ‘causation’ between these two phenomena yet, unless we have scientifically drawn observations for the two. 

However, existing research, like the one by Joel Schwartz and Douglas W. Dockery (1992), reports that the risk of dying due to chronic obstructive pulmonary disease (COPD) associated with air particles among the general population is three times higher than all-cause mortality.

Schwartz, in 1994, also found causal association between respiratory conditions as causes of death and cardiovascular deaths occurring in days with high pollution levels in case of London in 1960s and selected cities in the US – Philadelphia, Steubenville, Santa Clara, St. Louis, Utah, Detroit, and eastern Tennessee – in the 1970s and 1980s. 

J Sunyer, in 2001, stressed the need for long-term follow up studies to establish causation between air pollution and COPD. Schwartz also ruled out the effect of seasonal variation on causal association between mortality and airborne particle concentration based on his research on Philadelphia and asserted that airborne particles could affect COPD-related mortality, both in winter (when there is smog in the air) and also warmer months (air is free of smog but not air borne particles). 

Air pollution not only causes COPD, but also contributes to hypertension and diabetes and other comorbidities associated with higher mortality rates for COVID-19 world over. In the Indian context, one observes cities and urban centers with poor air quality also emerging as COVID-19 red zones.

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Safe drinking water and hygiene

Within the above India cities, the situation is particularly grim in urban areas where a large section of population live in slums where both air and water hygiene are compromised. 

Out of them, 65.5 million Indians or 22.5% of the total urban population live in slums. The average household size comes to 5.2 in households living in slums. Most of these slum-dwellers do not have access to basic minimum civic services, such as safe housing, drinking water, access to toilet, drainage of wastewater, solid waste management, internal and approach roads, street lighting, education and health care. 

They are also prone to various water and airborne morbidities compared to other urban dwellers. As urbanisation continues to increase at an accelerated pace, the slum population is only going to increase. For example, Dharavi in Mumbai, the largest slum in the world, reported a higher number of cases of COVID-19 than any part or suburb of Mumbai. 

Dharavi slums, Mumbai | Photo: World Economic Forum, Flickr

The quality of drinking water is also far from safe in most of the cities or urban areas as per the report titled ‘State of Slums In India: A Statistical Compendium, 2013‘, prepared by the Ministry of Housing and Poverty Alleviation. Most of the urban groundwater sources have dangerous levels of mercury, cadmium, arsenic and other hazardous minerals, while surface water sources are polluted by poor drainage systems and lack of waste water management. 

A 2018 research by Indian academics has suggested that both air and water pollution are complementary to each other due to common sources of pollution, like loss of green cover, land reclamation from sea, river and lake beds, discharge of untreated sewage water, unscientific disposal of solid and liquid waste or unplanned construction activities. In 2018, Keshab Das observed in the case of Gujarat that the practice of hygiene and sanitation is desired among slum dwellers mostly in small towns.   

Also read ‘India’s Lax Environmental Clearance Regime is to Blame for the Vizag Gas Leak Incident’

In an April 2020 article for the Economic and Political Weekly, Mohammad Imran Khan and Anu Abraham of Narsee Monjee Institute of Management Studies, based on National Sample Survey Office (NSSO) data on housing and sanitation (76th round) 2018, has shown that 66.08% of rural residents and 45.16 % of urban residents of India live in houses with per capita space that is less than a single room. This makes social distancing within a household to contain the disease or to treat the patient at home impossible for 60% of the population. 

Similarly, according to Khan and Abraham, two out of every five households in urban areas and three out of four in rural areas do not have access to tap water in the house or within their residential premises. Access to exclusive bathrooms and toilets for the household is not available to 40% and 30% of households, respectively, more so in rural areas. Handwashing practices are also found in nearly a quarter of households in the country, comparatively higher for rural areas than urban. 

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Immediate policy issues 

The COVID-19 pandemic has highlighted the shortcomings of urban planning in India, especially with regard to the compromises in air and water pollution. The failure to address these concerns may well be detrimental in containing infections. 

Good quality air is essential to keep respiratory diseases at bay and protect human lungs from infections. Availability of safe drinking water is essential to the human immune system. Post-pandemic urban planning must recognise the availability of both pollution-free air and water as prerequisites for city-dwellers. To this end, a few steps may be taken.

First and foremost, the restoration of green covers, forests and groves in the cities and urban areas must be prioritised and alternatives should be put in place in case a need arises to cut down trees. The existing water bodies in urban centers must be maintained and protected from pollution. For instance, the lakes in Bengaluru, Delhi, Hyderabad and Chennai are on the verge of extinction. Since the virus poses a threat in dense populous areas, the urban centers must have its own regulations to avoid overcrowding.  

Doddanekundi lake, Bengaluru, Karnataka. | Photo: Subhashish Panigrahi, Wikimedia Commons

Second, greener means of public transport should be encouraged rather than private vehicles. India’s traditional cities/urban centers are planned in such a way where the home itself is a place for workshop, business, trade and manufacturing hub. The distance between workplace and residential areas are a major cause of private vehicle ownership and also pollution. So the concept of ‘work place’ and ‘living place’ should be synchronised for occupational or economic activities wherever possible. 

Fourth, decongestion of our urban habitation is quite urgent. The network of stations to collect regular data on quality of air and water in urban areas must be expanded and the data should be made available on a real time basis to planners and academicians to make meaningful policy interventions. 

Fifth, industries and vehicles running on fossil fuels must be encouraged to shift to renewable energy sources. R&D in renewable energy alternatives will play a crucial role in developing necessary technologies to reduce pollution. The financial institutions must be encouraged to finance start-ups, including greener technologies. For example, urban bus and train services, car-pool aggregators, food delivery and e-commerce platforms can switch to electric vehicles. Ahmedabad has already introduced electric buses for mass transport. 

Sixth, affordable housing will go a long way in improving the quality of life for the urban population in India, apart from efficient supply of drinking water and exclusive toilets for each household. Governments at various levels must support affordable housing through budgetary allocations and encourage the private sector to join in by promoting such housing schemes. 

Seventh, slum development programmes must be implemented in a participatory manner by keeping the community need at the centre of the implementation, rather than a one-size-fits-all approach. 

Eight, the National Clean Air Programme (NCAP) launched in 2019 by the government of India must be implemented at war footing to ensure better air quality in Indian urban space. The programme must be executed involving all stakeholders, various arms of the government and areas surrounding the urban centers. Focus must be on the source of pollution, rather than management of the pollutants. 

Ninth, all flagship programmes for urban India – Atal Mission for Rejuvenation and Urban Transformation (AMRUT), Smart Cities Mission, Heritage City Development and Augmentation Yojana (HRIDAY), Pradhan Mantri Awas Yojana-Urban (PMAY-U) and Swachh Bharat Mission (Urban) and various slum development programmes – must focus on improving quality of air, drinking water and sanitation for the inhabitants. 

Also read ‘Toxic Smog: The New Normal in South Asia’

For long, our urban centers, the drivers of our economic growth are starved of finance. The Expert Committee on Indian Urban Infrastructure and Services (HPEC) in 2011 had observed that current urban schemes in India were investing less than one-third of required investment in urban infrastructure. 

The municipality’s own revenue, which is less than 1% of the GDP of the country, has recorded steady decline from 2012-13 onwards. Despite increasing availability of funds from the center and respective state governments, their respective shares in GDP are not more than 0.5% for the former and 0.33% for the latter between 2010-11 and 2017-18. The financial condition of smaller urban centers’ municipal councils and Nagar panchayats are worse than their municipal corporation counterparts. 

Out of 18 allotted functions to Urban Local Bodies (ULBs) by respective states governments, less than half of them have any corresponding financial allocations. Therefore, since long, experts have been arguing for diversifying the revenue base of ULBs through municipal bonds, value capture financing (VCF) and credit ratings. 

The state must ensure a part of the fund raised is being used for improving the quality of air, drinking water and sanitation. The smaller towns and urban agglomerations may need more help from respective state governments and centers than large cities and metros, more so in the case of programmes that aim to improve the quality of air, hygiene, sanitation and drinking water. 

The right of every citizen to be entitled to clean air and water must be acknowledged in urban planning. Failing to do so must have a penal provision for executives and planners. Finally, urban health facilities must have a capacity expansion with regard to human resources as well as infrastructure to mitigate emergencies of the kind posed by pandemics. 

The COVID-19 pandemic has offered an opportunity to Indian policymakers to strengthen urban infrastructure for all, especially for  the vulnerable. Without addressing issues related to clean water and air for the urban population, India cannot achieve its commitment to SDG 3.

Views expressed are the author’s own.

Acknowledgments: The author is grateful to Professor Udaya Shankar Mishra, Center for Development Studies (CDS), Trivandrum for his suggestions on an earlier draft. Help from Dr Balakrushna Padhi, Economist, Centre of Excellence in Fiscal Policy and Taxation, Xavier University, Bhubaneswar in revision of the draft is also duly acknowledged.

Notes for Tables

  1. Number of confirmed cases and diseases are till August 30, 2020. 
  2. Column 5; figures in parenthesis are w.r.t. to figures in column 2. 
  3. Column 6; figures in parenthesis are w.r.t. to figures in column 3. 

*Notes for Table 1

  1. For Delhi and Telangana states, district-wise figures are not available. For Telangana, majority of the cases are reported from Hyderabad and nearby areas. Hyderabad is spread across three districts – Hyderabad, Rangareddy and parts of Medachal-Malkajgiri district and Sangareddy district. Most of the COVID-19 cases in Telangana are in Greater Hyderabad Municipal Corporation (GHMC) Areas.
  2. East Godavari, Kurnool, Anantapur and West Godavari districts have higher number of COVID-19 positives than Vishakhapattnam district in the state of Andhra Pradesh as of August 30, 2020. But these districts have less than 30% of population living in urban areas. So these districts are not included in the table. 

**Note for Table 2 

  • Following are districts with higher than 30% of population living in urban areas and also reporting higher number of COVID-19 cases, but not among top 3 districts in respective states: Dibrugarh in Assam; Rajkot and Bhavnagar districts in Gujarat; Ambala, Rewari, Panchkula in Haryana; Belgavi in Karnataka; Kozhikode in Kerala; Amritsar and Bathinda in Punjab; Nashik, Nagpur and Jalgaon in Maharashtra; Sundargarh and Jharsuguda in Odisha; Ajmer and Bikaner in Rajasthan; Madurai in Tamil Nadu; Aligarh, Bareilly, Jhansi, Meerut, Gautam Buddha Nagar and Varanasi in Uttar Pradesh; and South 24 Parganas, Hoogly and Nadia in West Bengal. The above districts are known centers for industry, trade and commerce in the country. 

Featured image (foreground): Dharavi slum, Mumbai | World Economic Forum, Flickr