At some point in the next few days, all private vehicles in Delhi could be banned from the roads. That, at least, is the warning the Supreme Court-appointed Environment Pollution Control Authority has put out, given the steadily deteriorating air quality in the capital. It’s a familiar story, repeated with minor variations every year. Given this, India’s air pollution issue comes off as a peculiarly urban problem. The World Health Organization’s Air Pollution and Child Health: Prescribing Clean Air report released earlier this week underlines the fact that this is not so. As it notes, “the main sources of air pollution may vary from urban to rural areas, but no area is, strictly speaking, safer.”

Analyzing the effects of toxic air on children’s health in 194 countries in 2016, the report found India had almost 61,000 deaths of children under five years due to ambient and household pollution. This is the most deaths globally in this age bracket. In the under 14 bracket, it had over 100,000 deaths. The numbers are partly a function of India’s population size; a handful of other countries have higher mortality rates. But this is only part of the problem. For other children who are exposed to dangerous levels of air pollution in India—which is 98% or so of them—the issue links to a number of long-term physical and mental developmental problems. It is also connected with the country’s shifting epidemiological profile, feeding into the rise of non-communicable diseases such as cardiovascular conditions and cancer. And contrary to popular perception, this is as much or more a rural issue; of the 1.1 million air pollution-related deaths in 2015, 75% were in rural India.

There is, unfortunately, insufficient data and research here. In 2003, the Central Pollution Control Board (CPCB) issued guidelines for ambient air quality monitoring. They differentiated between the types of pollution affecting urban and rural areas. When it comes to the latter, the guidelines focus entirely on indoor air pollution. The use of biomass fuels for indoor cooking, heating and light is a significant problem, true enough; the recent focus on this is to the good. However, every winter, the Indo-Gangetic plains, housing nearly a third of India’s population, are blanketed with a thick layer of ambient pollution. Stubble burning, brick kilns, coal-fired factories and woodfires for heat all contribute. The problem is that of the 600-plus air quality monitoring stations the CPCB set up across the country, there are none in rural areas.

The draft National Clean Air Programme put out earlier this year was an opportunity to plug the gaps. So far, that opportunity has not been realized. The programme aims to expand the monitoring network to include 50 rural areas with at least one monitoring station each. This is a start at best; at least 1,200 are needed to present an accurate spatial picture of rural air quality. The original draft in March also had quantitative emission and sectoral targets. By April, these had been dropped. There is also little detail on how violations of existing emission norms should be addressed. Most crucially, the programme doesn’t envisage any cooperation and coordination across crucial ministries such as health, transport and energy. In effect, what should have been the first comprehensive framework for addressing ambient air pollution across the country seems to have little more in mind than the first step in the process—data collection.

The scenario is, likewise, complicated when it comes to indoor pollution in rural India. The Narendra Modi government’s Pradhan Mantri Ujjwala Yojana, aimed at shifting poor households from biomass to clean liquified petroleum gas (LPG), had the right idea. But it hasn’t quite worked out that way in practice. LPG costs are a major deterrent to adoption and that even in households where LPG is used, fuel stacking—using biomass fuels alongside LPG—is common.

Addressing this will not be easy; the economics of it is just one aspect. Empirical evidence from rural India shows that the energy ladder hypothesis—households move towards modern energy sources as their incomes rise—often doesn’t hold. A number of other factors are in the mix. For example, in Comprehending household cooking energy choice in rural India, V.L. Pandey and A. Chaubal found that the number of educated females between 10 and 50 years of age and the household’s level of education had a positive and significant impact on the probability of using clean cooking fuels in rural India. The size of the household is another factor. Again, education plays a role here; the National Family Health Survey 2015-16 showed that higher education levels lead to later and fewer children.

New Delhi’s status as national capital ensures that it will receive plenty of attention every year come winter. Rural India in the north of the country—the heart of the problem—is not as fortunate. That must change to make a serious dent in the economic and health burden of air pollution.

Should more attention be given to rural India’s air pollution problem? Tell us at [email protected]