Kathmandu, Nepal

A city of medieval palaces and temples, Kathmandu, Nepal lies in a bowl-shaped valley along an ancient trade route linking India and Tibet. The largest metropolitan city in Nepal, it serves as the centre for history, art, culture, education, health care and economy. The city is growing rapidly, with an estimated three–fold increase between 1990 and 2015, from 400 000 to 1 200 000 people.

In recent years, air pollution in Nepal has become a serious environmental and public health risk, with pollution levels 4.9 times higher than recommended by the WHO. Deteriorating air quality in Kathmandu is putting hundreds of thousands of Nepalese at risk of several health problems. In fact, the WHO has consistently found air pollution to be the leading risk factor for death and disability in Nepal.

The air quality of the city has been a major public health problem causing air pollution-related morbidity and mortality, placing an economic burden on the country due to loss of productivity and over-utilization of health system resources. Until recently, there were no air quality monitoring stations in place, which was a major obstacle to mitigation of existing air pollution in the country. There has also been a lack of health impact assessment data to estimate the health and economic burden of air pollution as well as of the sectoral measures needed to tackle this environmental challenge.

In response, the Government of Nepal, through its Department of Environment, has established three monitoring sites; two in Kathmandu valley and one in Dhulikhel, and plans to set up a network of air quality monitoring sites throughout the country. As the first South-East Asian city to pilot the Urban Health Initiative – launched with strong political support – lessons learned in Kathmandu will serve as an example and open the door to air pollution and health mitigation projects in other major South-East Asian cities facing air pollution problems. Plans are underway to build the capacity of key stakeholders and perform joint multisector data analysis.