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SouthAsiaDevelopmentMatters StrivingforCleanAir AirPollutionandPublicHealthinSouthAsia StrivingforCleanAir StrivingforCleanAir AirPollutionandPublicHealth inSouthAsia ©2023InternationalBankforReconstructionandDevelopment/TheWorldBank1818HStreetNW,Washington,DC20433 Telephone:202-473-1000;Internet:www.worldbank.orgSomerightsreserved 123426252423 ThisworkisaproductofthestaffofTheWorldBankwithexternalcontributions.Thefindings,interpretations,andconclusionsexpressedinthisworkdonotnecessarilyreflecttheviewsofTheWorldBank,itsBoardofExecu-tiveDirectors,orthegovernmentstheyrepresent.TheWorldBankdoesnotguaranteetheaccuracy,completeness,orcurrencyofthedataincludedinthisworkanddoesnotassumeresponsibilityforanyerrors,omissions,ordiscrepanciesintheinformation,orliabilitywithrespecttotheuseoforfailuretousetheinformation,methods,processes,orconclusionssetforth.Theboundaries,colors,denominations,andotherinformationshownonanymapinthisworkdonotimplyanyjudgmentonthepartofTheWorldBankconcerningthelegalstatusofanyter-ritoryortheendorsementoracceptanceofsuchboundaries. Nothinghereinshallconstituteorbeconstruedorconsideredtobealimitationuponorwaiveroftheprivi-legesandimmunitiesofTheWorldBank,allofwhicharespecificallyreserved. RightsandPermissions ThisworkisavailableundertheCreativeCommonsAttribution3.0IGOlicense(CCBY3.0IGO)http://creativecommons.org/licenses/by/3.0/igo.UndertheCreativeCommonsAttributionlicense,youarefreetocopy,distribute,transmit,andadaptthiswork,includingforcommercialpurposes,underthefollowingconditions: Attribution—Pleasecitetheworkasfollows:WorldBank.2023.StrivingforCleanAir:AirPollutionandPublicHealthinSouthAsia.SouthAsiaDevelopmentMatters.Washington,DC:WorldBank.doi:10.1596/978-1-4648-1831-8.License:CreativeCommonsAttributionCCBY3.0IGO. Translations—Ifyoucreateatranslationofthiswork,pleaseaddthefollowingdisclaimeralongwiththeattri-bution:ThistranslationwasnotcreatedbyTheWorldBankandshouldnotbeconsideredanofficialWorldBanktrans-lation.TheWorldBankshallnotbeliableforanycontentorerrorinthistranslation. Adaptations—Ifyoucreateanadaptationofthiswork,pleaseaddthefollowingdisclaimeralongwiththeattri-bution:ThisisanadaptationofanoriginalworkbyTheWorldBank.ViewsandopinionsexpressedintheadaptationarethesoleresponsibilityoftheauthororauthorsoftheadaptationandarenotendorsedbyTheWorldBank. Third-partycontent—TheWorldBankdoesnotnecessarilyowneachcomponentofthecontentcontainedwithinthework.TheWorldBankthereforedoesnotwarrantthattheuseofanythird-party-ownedindividualcomponentorpartcontainedintheworkwillnotinfringeontherightsofthosethirdparties.Theriskofclaimsresultingfromsuchinfringementrestssolelywithyou.Ifyouwishtore-useacomponentofthework,itisyourresponsibilitytodeterminewhetherpermissionisneededforthatre-useandtoobtainpermissionfromthecopyrightowner.Examplesofcomponentscaninclude,butarenotlimitedto,tables,figures,orimages. AllqueriesonrightsandlicensesshouldbeaddressedtoWorldBankPublications,TheWorldBankGroup,1818HStreetNW,Washington,DC20433,USA;e-mail:pubrights@worldbank.org. ISBN(paper):978-1-4648-1831-8 ISBN(electronic):978-1-4648-1838-7DOI:10.1596/978-1-4648-1831-8 Coverillustration:©ReyesWork.Furtherpermissionrequiredforreuse. Coverdesign:BillPragluski,CriticalStages,LLC. LibraryofCongressControlNumber:2023907856 Contents Forewordxi Acknowledgmentsxiii MainMessagesxv ExecutiveSummaryxvii Abbreviationsxxvii 1Introduction1 Overview1 References4 2AirQualityinSouthAsia:ARegionalPictureofthe SourcesofAirPollution5 Introduction5 KeyFeaturesofAirPollutioninSouthAsia6 ImplicationsforAQMinSouthAsia13 TheImportanceofAirshedManagementforSouthAsia19 Annex2A:ApplicationofGAINSModelinginSouthAsia21 Notes24 References24 3Cost-EffectiveMeasuresforReducingAmbientAirPollutionin SouthAsia27 Introduction27 FourAirQualityManagementApproachesThatGoaboveandbeyondtheCurrentPolicies30 ImplicationsforAQM:TheNeedforAirshedwideAirQualityManagement36 v viSTRIVINGFORCLEANAIR Notes39 References40 4BenefitsofReducedAirPollution41 HealthImpactsofAirPollution41 EconomicBenefitsofReducedAirPollution44 PreventingPrematureMortality45 Annex4A:HealthImpactCalculations53 Annex4B:COVID-19andAirPollutionLink62 Notes63 References63 5ARoadMapforAirshedwideAirQualityManagement69 Introduction69 PhaseI:MoreandBetterMonitoringandImprovedInstitutions75 PhaseII:AdditionalandJointTargetsforCost-EffectiveAbatement78 PhaseIII:MainstreamingAirQualityintheEconomy81 DespiteAmpleOpportunities,SeriousObstaclesRemain84 References84 Boxes 4.1EmpiricalMethodstoEstimatetheEffectsofAirPollutiononHealthOutcomes42 4.2Cost-BenefitAnalysisofPoliciestoReduceAirPollution46 4.3ImprovedCookstovesandCleanerFuelsinIndia48 5.1ExperiencesaroundtheGlobetoImproveAirQuality72 5.2FineParticulateMatterExposureandperCapitaExpendituresinIndia77 5.3SynergiesbetweenAirQualityManagementandClimateChangePolicies83 Figures ES.1ExposureReductionsandCostsofAssociatedEmissionsControlsfortheFour ModeledScenariosintheSouthAsiaRegionin2030xxi 1.1SpatialandSectoralOriginofFineParticulateMatterinAmbientA