Medicosnext
Air pollution has become one of the most pressing public health and environmental challenges in Nepal. The scale of the crisis today extends far beyond environmental degradation—it has emerged as a major threat to economic development, social well-being, and especially child health in Nepal.
According to global estimates, nearly 7 million premature deaths occur annually due to air pollution, and Nepal bears one of the heaviest burdens in South Asia. The country records 222 premature deaths per 100,000 population, among the highest in the region, with approximately 26,000 deaths every year attributed to polluted air. On average, pollution shortens the lifespan of a Nepali citizen by 3.4 years, reflecting the severity of the situation.
Current Situation of Air Pollution in Nepal
Air quality across Nepal, particularly in the Kathmandu Valley and the Tarai, has continued to deteriorate over the past decade. Kathmandu frequently ranks among the world’s most polluted cities and has recently been listed as the 8th most polluted city, with PM2.5 levels reaching 42.4 µg/m³, far exceeding the WHO guideline of 5 µg/m³.
Nearly 98% of Nepal’s population resides in areas where pollution levels surpass safe limits set by the World Health Organization. Seasonal variations further worsen the crisis. Pollution peaks during winter, autumn, and spring, when stagnant cold air, dry soil, and increased emissions combine, while monsoon rains provide only temporary relief.
Health Consequences of Air Pollution
The consequences of air pollution on health are extensive and severe. Air pollution contributes to:
- 75% of COPD cases
- 44% of ischemic heart disease
- 46% of strokes
- 38% of lung cancers
For children, the impacts are even more alarming. Their developing lungs and immune systems make them more vulnerable to pneumonia, asthma, impaired cognitive development, and complications such as low birth weight and preterm birth.
In Nepal, air pollution has evolved into an urgent child health crisis, demanding immediate attention and sustained action.
Causes of Air Pollution in Nepal
Air pollution in Nepal stems from a combination of human activities, rapid urbanization, and geographical features. The major contributing factors include:
1. Residential and Household Emissions
Around 39% of pollution originates from households using traditional cooking fuels. Only 35% of Nepali householdshave access to clean cooking options, making indoor and outdoor household emissions a major source.
2. Vehicular Emissions
Nepal now has more than 3.1 million vehicles, most running on fossil fuels. Older vehicles produce even more air pollution. Road dust contributes significantly to pollution, especially since 84% of roads remain unpaved, causing large amounts of resuspended dust.
3. Brick Kilns and Industries
Nepal hosts about 1,700 brick kilns, heavily concentrated in the Kathmandu Valley. Industrial activity contributes around 13% of the country’s pollution.
4. Agricultural Burning and Forest Fires
Open burning of crops and forest fires—which increased by 76% this year—release massive amounts of smoke, especially during the dry season.
5. Transboundary Air Pollution
Pollution from northern India, particularly during crop-burning seasons, significantly affects the Tarai and Kathmandu Valley.
6. Geographical Factors
Kathmandu’s bowl-shaped topography traps polluted air, preventing dispersion and worsening smog levels.
Policies and Initiatives of Nepal
Recognizing the gravity of the issue, Nepal has introduced several policies and initiatives to control air pollution. The Constitution of Nepal guarantees clean air as a fundamental right, forming the legal foundation for environmental protection.
Clean air is a child survival imperative and a moral obligation; no child should be forced to breathe toxic air from the moment they are born.
Key government initiatives include:
- National Action Plan (2020):
A comprehensive guideline focusing on reducing emissions, improving transport standards, promoting clean energy, and expanding monitoring networks. - Expansion of Air Quality Monitoring Stations:
Real-time data from cities allows better public health advisories and planning. The Department of Environment has provided public access to air quality data from different stations. Kathmandu Metropolitan City also conducts AQ monitoring at multiple locations. - Policies to Promote Electric Vehicles (EVs):
Tax exemptions, charging infrastructure plans, and government EV fleets aim to reduce vehicular pollution. - Industrial Emission Standards:
Regulations for brick kilns and industries are being tightened, although enforcement remains a challenge. - Integration with Climate and Urban Development Programs:
Air quality goals are increasingly linked with climate resilience, green city planning, and public health strategies. - Hospital-Based Surveillance and Early Warning Systems:
Efforts are ongoing to include air-pollution-related illnesses in national health surveillance systems (EWARS).
Despite these policies, effective implementation and enforcement remain the biggest challenges. Coordinated action across ministries, local governments, private sectors, and civil society is essential.
Role and Activities of NEPAS
The Nepal Paediatric Society (NEPAS) plays a crucial role in addressing the child health impacts of air pollution. As children face the highest risks, NEPAS has prioritized environmental health within its advocacy and clinical agendas.
Key contributions of NEPAS include:
- Policy Advocacy:
NEPAS serves as a member of government technical committees, influencing national policies related to child health and environmental protection. - Position Papers and Evidence Generation:
NEPAS develops scientific documents highlighting the health impacts of air pollution on children, guiding policymakers and medical practitioners. - Capacity-Building and Conferences:
The recent national conference theme, “Climate Change and Its Impact on Children,” emphasized the urgent need for pediatric-focused responses. - International Collaboration:
NEPAS works with global bodies such as the Royal College of Paediatrics and Child Health (RCPCH, UK) to strengthen research, training, and advocacy. - Awareness and Community Engagement:
NEPAS mobilizes pediatricians, health workers, and youth to promote clean energy, behavioral change, and community-level air quality advocacy.
Conclusion
Clean air is not merely an environmental concern; it is a child survival imperative, a development priority, and above all, a moral obligation. Nepal’s children are breathing some of the most polluted air in the region, but this reality is neither inevitable nor irreversible.
By uniting science-driven policies, compassionate leadership, and unwavering commitment, Nepal can build a future where every child breathes safely and grows to their fullest potential. The causes of air pollution may be complex and diverse, yet the solutions are firmly within our grasp.
With stronger policies, coordinated national action, and the dedicated work of organizations like NEPAS, Nepal has the power to protect its youngest citizens and secure a cleaner, healthier, and more equitable future for all.
( Dr Ram Hari Chapagain, Dr Bikal Shrestha , Dr Arun Kumar Neupane : All from Nepal Paediatric Society(NEPAS): This article prepared as joint action of NEPAS- RCPCH AQ-MNCH Project)
