New Delhi: More than 20 lakh deaths in India were attributable to air pollution in 2023, underscoring the need to treat the country’s worsening air quality as a public health emergency rather than solely an environmental concern, according to a new report by the Federation of Indian Chambers of Commerce and Industry (FICCI), a non-profit organisation representing Indian industry and businesses and EY, a global consulting firm.The knowledge paper, “Clean Air, Healthy India”, released on November 5, calls for a health-led approach to tackle air pollution, including explicit targets to reduce fine particulate matter (PM2.5) under the National Clean Air Programme (NCAP), stronger health surveillance and greater access to cleaner alternatives.PM2.5 particles can penetrate deep into the lungs and enter the bloodstream. Prolonged exposure is associated with respiratory illnesses, heart disease, stroke and cognitive impairment, with consequences extending to healthcare expenditure and productivity, the analysis says.“Clean air must be central to India’s healthcare agenda, not treated solely as an environmental objective,” said Dr. Ashutosh Raghuvanshi, chair of FICCI’s Health Services Committee and managing director and CEO of Fortis Healthcare. He called for healthcare institutions to play a greater role in public awareness, tracking pollution-related illnesses and strengthening preparedness.The report argues that India’s clean-air strategy needs to move beyond seasonal interventions and focus on reducing exposure throughout the year.FICCI-EY flags gaps in NCAP, demands PM2.5 targetsThe FICCI-EY paper identifies gaps in the implementation of the National Clean Air Programme, noting that its performance is measured primarily through PM10, while monitoring remains uneven across smaller cities, peri-urban and rural areas.It recommends explicit PM2.5 reduction targets, expanded monitoring networks, source-specific local action plans and stronger coordination between states and cities sharing the same air region.The analysis also proposes 10 interventions to tackle pollution from different sources. These include tighter monitoring of industrial emissions, retrofitting traditional brick kilns to use zig-zag firing, replacing diesel backup generators with battery-hybrid systems, and converting crop residue into fuel and other marketable products.Also read: Delhi’s Smog Problem Cannot Be Solved at a CheckpointFor urban areas, it recommends dust-control systems at large construction sites, intra-city monitoring networks to identify pollution hotspots and smart traffic signals to reduce congestion and vehicle emissions. It also proposes using recovered plastic, industrial residue and construction waste in housing and infrastructure projects.In a statement, Amit Goyal, partner at EY India, said NCAP should measure progress through sustained reductions in people’s exposure to pollution rather than the number of interventions implemented.The report also calls for stronger public-health preparedness, including hospital and school readiness ahead of peak pollution periods, better health surveillance and reliable public advisories.Pollution crisis extends far beyond DelhiThe analysis’ recommendations come amid fresh evidence that hazardous air pollution is widespread across India.A monthly analysis by the Centre for Research on Energy and Clean Air (CREA), released on November 5, found that 261 of the 267 Indian cities with sufficient monitoring data exceeded the World Health Organisation (WHO)’s daily guideline for PM2.5 in October 2026 while 38 cities also breached India’s national daily standard.Uttar Pradesh accounted for the three most polluted cities: Baraut, Khora and Gajraula. The state also had the highest number of cities exceeding the national PM2.5 standard, at 13, followed by Haryana with 11.The national daily PM2.5 standard is 60 micrograms per cubic metre (µg/m³), four times the WHO’s daily guideline of 15 µg/m³.Among five major metropolitan cities assessed by CREA, Delhi was the only one to record a monthly average PM2.5 concentration above the national daily standard, at 69 µg/m³. Mumbai recorded 46, Kolkata 45, while Chennai and Bengaluru recorded 29 each.Also read: Delhi’s Air Quality Index Nears 400, Govt Invokes GRAP III NormsIn a post on social media platform X, Congress leader Jairam Ramesh, cited the CREA findings and called for an urgent overhaul of NCAP. He said the programme needed to move beyond road dust mitigation and address emissions from industry, power generation and residential sources.CREA’s review of recent studies by IIT Delhi and IIT Bombay found that industries were the largest domestic contributor to population-weighted PM2.5 concentrations in India, accounting for 18%, followed by residential sources at 15% and power generation at 13%.An IIT Bombay assessment of 143 cities also found that emissions originating outside city boundaries accounted for an estimated 82–89% of urban PM2.5 concentrations, highlighting the need for coordinated action across cities and states.Ramesh also called for the National Ambient Air Quality Standards (NAAQS), last revised in November 2009, to be updated, particularly the permissible limits for PM2.5.The FICCI-EY report similarly argues that air pollution cannot be tackled through isolated city-level interventions. It calls for coordinated action across government, industry, healthcare institutions and communities, with progress measured by improvements in public health and sustained reductions in pollution exposure.