India is confronting a silent crisis as air pollution takes a devastating toll on public health and economic growth. With 21 of the world’s 30 most polluted cities located in India, toxic air is linked to an estimated 1.67 million premature deaths in 2019—nearly 18% of nationwide fatalities—resulting in a loss of approximately 1.36% of GDP, or about US $36.8 billion.

The burden on healthcare is immense, as respiratory and cardiovascular diseases surge, compelling Indians to miss 1.3 billion workdays in 2019—eroding around US $6 billion in productivity. Additional “presenteeism” reduces performance, costing nearly US $24 billion . Small enterprises and the tourism sector suffer as consumer activity drops by 1.3%, translating into a US $22 billion loss.

Economically, the impact is staggering: air pollution drains about US $95 billion annually—approximately 3% of India’s GDP—affecting labor output, infrastructure, and business revenues.

Worse still, vulnerable states such as Uttar Pradesh, Bihar, and Rajasthan bear the brunt, losing up to 2.15% of state GDP, while Delhi alone sustains an economic loss equivalent to nearly 6% of its GDP.

Experts call for urgent long-term policies and stronger enforcement—beyond temporary fixes like smog towers—to curb pollution, safeguard public health, and protect economic resilience.