The Alarming Rise of India’s Pay-to-Breathe Industry

The mild winter months are always busy for Mumbai-based pulmonologist Revathy K, but these past few months have been especially hectic. In November, a sudden drop in ocean temperatures slowed the winds that normally shift the city’s construction dust, debris, and traffic fumes. The Bandra-Worli Sea Link, a bridge that connects the center of the city to its northern suburbs, disappeared behind a curtain of smog as the city’s air quality dropped to “very poor,” briefly overtaking Delhi, the world’s most polluted city.

“A lot of patients were coming in with a wheeze,” K says, something she usually sees in patients who have asthma or smoking-related disorders.

Within the span of a few months, from November through January, Mumbai doctors reported seeing a rise in chronic and persistent coughs, alongside the annual flu season. “These are patients who’ve never had any allergic symptoms in the past but are now coming in with [symptoms resembling] acute bronchitis,” says K (who, like many Indians, uses an initial as her last name.)

India’s air pollution is a rolling disaster that shows no sign of slowing down. A 2022 report by the Centre for Research on Energy and Clean Air think tank found that “almost the entire population of India” is exposed to air pollution above the guidelines set by the World Health Organization.

In 2019, air pollution killed an estimated 1.6 million Indians.

As attempts to fix the problem at the source fail, a new kind of inequality is taking hold in Indian cities. Facing potentially deadly air quality outside, wealthier Indians are paying to breathe free, creating a booming market for air purifiers that is forecast to grow 35 percent to $597 million by 2027. But in a country already economically divided along caste, gender, and religious lines, where 63 percent of people pay for health care out-of-pocket and the top 10 percent of the population hold 77 percent of the wealth, paying for breathable air isn’t an option for most.

“We are normalizing a world that hardly values nature and natural rights—basic necessities like clean drinking water, fresh and unpolluted air, space to walk for pedestrians is neither part of urban planning nor [do they] concern our collective conscience,” says Suryakant Waghmore, professor of sociology at the Indian Institute of Technology, Bombay. Waghmore says air purifiers purify air for the privileged “while the public is left to decay and degrade.”

As a cold spell swept through Mumbai in January and people donned sweaters and balaclavas to keep warm, a dusty haze hung in the air, occasionally caking onto leaves and piling into mounds on street corners. Roads remained choked with traffic, and the city’s poorer residents resorted to dumpster fires, burning scraps of wood, rubber, and plastic to stay warm.

Timothy Dmello, who spends 12 hours a day outdoors as a paid dog walker, says he started to notice the worsening air pollution as he went up and down the Carter Road promenade, a palm-tree-lined stretch flanked by Bollywood celebrities’ apartments looking out onto the Arabian Sea. He says you can’t see the horizon clearly.

Dmello’s wife is on kidney dialysis; he took a job as a dog walker because the flexible hours meant he could spend more time with her and their 14-year-old daughter. At home, dust from outside builds up, while outside he’s exposed to fumes and particulates. Demello says that sometimes breathing is a problem.

He has seen air purifiers in the hospital, but the cost—cheaper models start at 6,000 rupees ($72)—is out of reach. Like most people he knows, he fell ill with a cough and cold this winter and couldn’t work.

Sixty percent of India’s nearly 1.3 billion people live on less than $3.10 a day, below the World Bank’s median poverty line. Not counting farm workers, 18 percent of the country’s population work outdoors.

Exposure to high levels of ambient PM 2.5 (particulate matter under 2.5 micrometers, which gets stuck in people’s lungs) can cause deadly illnesses such as lung cancer, strokes, and heart disease. Deaths linked to PM 2.5 pollution have more than doubled in the past 20 years, claiming 979,900 lives in 2019. What’s more, according to the World Air Quality Report 2022, air pollution costs India $150 billion a year.

In 2019, when 102 cities in India failed to meet the country’s air pollution standards, the government launched a National Clean Air Programme. Less than five years later, the number of failing cities has grown to 132.

National and state governments have tried unsuccessfully to address the air quality crisis. In Delhi, the Aam Aadmi Party, which runs the city, tried an “odd-even” scheme in 2016, when the air quality dropped considerably. Private vehicles with registration plates ending in odd numbers could drive on odd dates, and those with even numbers on even dates. Environmentalists say it had minimal impact on air pollution levels. Delhi, as well as nearby Gurugram, which is a major tech hub, have also tried technological solutions. In 2021, the Supreme Court ordered the Delhi government to install two massive, 24-meter-high “smog towers” to filter particulates from the air, while Gurugram has put outdoor air purifiers in place. In February, Mumbai’s civic body, the Brihanmumbai Municipal Corporation, announced plans to install 14 outdoor air purifiers across the city.

However, experts believe these measures are a dead end. “Purifiers don’t work,” says Ronak Sutaria, founder of Respirer Living Sciences, an urban data startup that monitors air pollution. “I think there’s broad consensus amongst the research in the scientific community that purifiers do not solve the problem.”

Outdoor purifiers are a last resort when other methods of controlling pollution have failed, according to Pallav Purohit, a senior research scholar at the International Institute for Applied Systems Analysis in Austria. “It makes sense to use air purifiers only when traditional methods of pollution control are insufficient,” he says. “The shortfall with most outdoor air purification systems is a limited area of coverage, limited efficacy, and high cost.”

Purohit says the purifiers create narrow columns of purified air that only really benefit people who are close to them for an extended period of time.

Following Mumbai’s air quality crisis this winter, critics accused the Maharashtra Pollution Control Board of moving air quality sensors to “cleaner” parts of the city.

Meanwhile, India’s wealthier residents have taken matters into their own hands. Air purifier brands have become a common topic of conversation among middle-class residents. People who can afford to do so move from air-purified homes (where each room often has its own purifier) to air-purified shops and malls, driven in air-purified cars. Brands have enlisted cricket stars and Bollywood celebrities, advertising in English-language newspapers, on social media, and on billboards.

If the combination of advertisements and news coverage is to be believed, breathing air in India’s capital is equivalent to 50 cigarettes a day during Diwali, a Hindu festival where many people burst firecrackers, and 10 cigarettes a day during the winter. For an Indian Independence Day advert, Sharp suggests “Impurities Quit India,” referring to the “Quit India” movement from India’s freedom struggle. News articles meet every spike in poor air quality with air purifier advice: “Delhi air quality turns severe: 5 Air purifiers that will help you breathe clean air,” reads one; “Planning To Buy An Air Purifier Amid Falling AQI? Know the Costs, Other Factors” reads another.

Deekshith Vara Prasad, founder and CEO of Indian-made air purifier AirOK Technologies, says his company’s sales have grown 18 percent since 2018. (AirOK Technologies’ air purifiers are largely used in hospitals and offices.)

Prasad says surging demand has led to substandard products in the market. To work on the air in India’s cities, purifiers need to filter out fine particulate matter, fungus, bacteria, viruses, and toxic gasses like sulfur and nitrous oxides. There are “hundreds” of pollutants, he says. “If I remove two pollutants, I can claim I ‘remove pollutants.’”

The borders of private spaces, like offices and, increasingly, hotels—which sometimes market themselves based on their air purification—are a stark illustration of the unequal access to clean air. Door attendants, valets, bellhops, and security guards working the entrances and exits to these buildings don’t breathe the purified air available to those inside.

Waghmore says this division intersects with India’s social inequalities around status and caste and that air purifiers only consolidate the ideology of “purity” as something that is central to the lives of dominant caste.

Such inequality has severe consequences, as those from disadvantaged castes already face considerable barriers in accessing health care.

Waghmore says the heightened sense of privileged individualism—where the rich have the means to fend for themselves—“has the worst consequences in poor countries, where governments are yet to invest morally and economically in public infrastructure and transport to counter environmental degradation.”

K, who regularly treats those suffering from India’s air pollution inequality, puts it more succinctly. “I don’t think people should live with this,” she say, adding that everyone needs to take demand solutions. “If you don’t get something as basic as fresh air, then what’s the point of living in our country?”

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