Stringent Emission Control Policies Can Provide Large Improvements in Air Quality and Public Health in India.

Exposure to high concentrations of ambient fine particulate matter (PM) is a leading risk factor for public health in India causing a large burden of disease. Business-as-usual economic and industrial growth in India is predicted to increase emissions, worsen air quality, and increase the associated disease burden in future decades. Here we use a high-resolution online-coupled model to estimate the impacts of different air pollution control pathways on ambient PM concentrations and human health in India. We find that with no change in emissions, the disease burden from exposure to ambient PM in 2050 will increase by 75% relative to 2015, due to population aging and growth increasing the number of people susceptible to air pollution. We estimate that the International Energy Agencies New Policy Scenario (NPS) and Clean Air Scenario (CAS) in 2050 can reduce ambient PM concentrations below 2015 levels by 9% and 68%, respectively, offsetting 61,000 and 610,000 premature mortalities a year, which is 9% and 91% of the projected increase in premature mortalities due to population growth and aging. Throughout India, the CAS stands out as the most effective scenario to reduce ambient PM concentrations and the associated disease burden, reducing the 2050 mortality rate per 100,000 below 2015 control levels by 15%. However, even under such stringent emission control policies, population growth and aging results in premature mortality estimates from exposure to particulate air pollution to increase by 7% compared to 2015, highlighting the challenge facing efforts to improve public health in India.