6th November 2023 Editorial

Introduction

  • World Cities Day, celebrated on October 31, focuses on the theme “Financing Sustainable Urban Future for All.”
  • This theme underscores the importance of channeling finances in the right direction to rectify flawed urbanization, making cities more liveable and safer.
  • Air pollution is a significant threat, diminishing life expectancy by over 10%.
  • The Energy Policy Institute at Chicago (EPIC) reported that 39 of the 50 most polluted cities globally are in India, resulting in an average loss of 5.3 years of life expectancy, reaching 11.9 years for residents of Delhi.
  • This emphasizes the urgent need for policy changes to ensure better and healthier urban futures.

 

Pollution’s Impact on Health

  • Air pollution leads to a range of health issues, including burning eyes, respiratory problems, cardiovascular diseases, and asthma.
  • Recent reports have labeled air pollution in Mumbai as “Death by Breath,” reflecting unsatisfactory Air Quality Index levels.
  • While the problem was initially associated with the Indo-Gangetic plains, coastal cities in India are also witnessing deteriorating air quality.

 

The Role of ‘Grey’ Infrastructure

  • The exacerbation of pollution in Indian cities can be attributed to urban development strategies that prioritize real estate development, road expansion, and unrestricted vehicular use, thus crowding out space for pedestrians.
  • Factors like road dust, concrete batching, polluting industries, and vehicular emissions also contribute. Motorized transport alone accounts for 60% of urban pollution.

 

  • The growth in India’s automobile market, expected to reach $160 billion by 2027, highlights the need for rethinking urban development.

 

Challenges during Winter

  • During North Indian winters, crop residue burning, particularly in Haryana and Punjab, exacerbates smog and particulate matter, but this is only a seasonal component of the issue.

 

  • The expansion of construction activities in Indian cities contributes to approximately 10% of air pollution, especially in the National Capital Region.

 

The Need for a Paradigm Shift

  • City residents often lack a participatory role in urbanization and need to become active stakeholders.
  • Shifting focus to public transport, secure pedestrian paths, and bicycle lanes, along with regulating construction activities, is essential.
  • Investment in public transportation, including adding 10 lakh buses to meet urban mobility demands, must be prioritized.
  • Controlling private vehicular movement through congestion taxes and alternate-day driving based on license plate numbers can reduce traffic congestion and pollution.
  • Public figures, including city leaders and state chief ministers, should promote public transport.

 

Environmental Protection and Afforestation

  • Protecting urban commons, such as water bodies, urban forests, and parks, is crucial to maintain green spaces within cities.
  • Current urban development strategies, often involving land use changes and open space allocation to real estate developers, threaten urban ecology and exacerbate pollution.
  • Meaningful afforestation within cities is necessary, rather than planting trees far from urban areas.

 

Strengthening Governance

Empowering citizens through governance structures is essential. Pollution guides and standard operating procedures should be readily available and integrated into urban life.

Public health advisories should be supported by the medical fraternity. Initiatives such as the Graded Response Action Plan (GRAP) should be implemented in cities to combat air pollution.

 

Conclusion

Air pollution is a grave threat to public health, particularly affecting marginalized communities. Financing sustainable urban futures for all is vital to mitigate the adverse effects of flawed urbanization.

Shifting to public transportation, regulating construction activities, protecting urban green spaces, and strengthening governance are crucial steps to combat pollution and ensure healthier lives for all city residents.

Introduction:

The Delhi Declaration, issued during India’s G20 presidency, encompasses a commitment to enhance the global health architecture.

This commitment aims to build more resilient, equitable, sustainable, and inclusive health systems.

The key aspects of the declaration include implementing the One Health approach, strengthening pandemic preparedness, and reinforcing existing infectious disease surveillance systems.

 

Tackling Antimicrobial Resistance (AMR):

One significant aspect of the agreement is the prioritization of addressing Antimicrobial Resistance (AMR).

This is to be achieved through research and development (R&D), infection prevention and control, and antimicrobial stewardship efforts within National Action Plans (NAPs).

The agreement also emphasizes the need for equitable access to safe, effective, and affordable vaccines, therapeutics, diagnostics, and medical countermeasures, particularly in Low- and Middle-Income Countries (LMICs), Least Developed Countries, and Small Island Developing States.

 

AMR Impact:

A 2021 report by Lancet revealed that 4.95 million deaths worldwide were associated with bacterial AMR, with 1.27 million deaths directly attributed to it.

These figures are comparable to diseases like HIV and malaria.

High death rates in Sub-Saharan Africa and South Asia highlight the susceptibility to AMR in these regions.

Rising AMR levels not only endanger public health but also pose risks to other medical procedures such as cancer treatment and organ transplants.

 

Global and Local Strategies for Implementation:

  • For the Delhi Declaration’s intent to be realized, a combination of global and local efforts is crucial.

 

  • At the global level, G20 countries should collaborate with developing nations to establish regional AMR action plans.

 

  • International funding mechanisms for AMR R&D should be championed, and patent reforms should be promoted to foster innovation and affordability in new antibiotics.

 

  • Dialogue among developing countries to explore models like the Medicines Patent Pool can be beneficial.

 

  • At the local level, countries must prioritize the implementation of their NAPs. India, for instance, developed a comprehensive NAP on AMR in 2017 but struggled with sub-optimal implementation due to leadership and resource challenges.

 

  • The focus should be on surveillance, research, and inter-sectoral collaboration between human, animal, plant health, and the environment.

 

  • Expanding the monitoring networks to gain a better understanding of the extent of the AMR problem is essential.

 

  • Additionally, government initiatives, such as Free Diagnostic Services and Kayakalp, need to be harnessed to strengthen AMR containment efforts.

 

  • Promoting responsible behavior among citizens, involving academia, and engaging civil society organizations (CSOs) are crucial aspects of tackling AMR.

 

Conclusion:

Antimicrobial Resistance represents a global health threat with an annual death toll comparable to Covid-19.

The Delhi Declaration highlights the need for concerted global and local efforts. Nations, including India, must prioritize AMR containment through comprehensive NAPs, expanding surveillance networks, and promoting responsible behavior among citizens.

Collaboration among nations and support from academia and CSOs are essential in addressing this critical issue.

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