India's economy is growing at a blistering pace, and while that is increasing welfare for millions, it's also raising some alarming public health red flags.
Respiratory pediatrician S.K. Kabra has busy Saturdays. His outpatient waiting area at this New Delhi hospital teems with parents whose children complain of breathing difficulties.
Kabra says poor air quality is a key component in a grim U.N. statistic: 13 percent of Indian children under five years of age, who are hospitalized for respiratory infections, die.
"Pollution increases the morbidity, increases the frequency, increases the severity. If a mother and a baby are exposed to some pollutant, that will increase respective morbidity," noted Kabra.
A recent U.S. study using satellite data gave India the lowest air quality rating in the world, citing concentrations of particulates five times higher than those deemed safe for human health.
For poor and rural Indians, a significant danger comes from cooking with wood and other biomass. But the fastest-growing source of dangerous pollution is actually related to India's increasing wealth.
Anumita Roychowdhury is an executive director at the Delhi-based Center for Science and Environment. She speaks of a "toxic spiral" with the growing number of vehicles on India's streets.
"Imagine a city with more than 5.6 million vehicles, adding nearly 1,200 to 1,300 vehicles a day," said Roychowdhury. "The pace of the problem is growing faster than our ability to deal with it."
Roychowdhury says diesel fuel subsidies for freight and agriculture are being misused by private car owners who buy diesel vehicles for savings at the fuel pump.
"Now your diesel emissions, which are several times more carcinogenic, because of the subsidized fuel, their numbers are galloping today and adding to the toxic risk in our cities," Roychowdhury explained.
Akshay Mani, a specialist in sustainable transportation with the consultancy Embarq India, calls for taxing vehicles more to reflect their environmental cost.
"Then you can also find solutions of how you use that money," said Mani. "You put it into a fund and use that fund to improve public transport and use it to create a more equitable system where you are taxing people who are driving while you're using that money to actually provide good public transport for other sections of society."
While the subway system here in New Delhi has won praise for its efficiency, Mani says, a lingering problem is the so-called "last mile" to the traveler's door.
"How do you provide with the right kind of coverage given that public transport can't reach all parts of the city? How do you make sure all parts of city are accessible to public transport? Because you have these feeder systems in place which can then make those stations accessible to all corners of the city," Mani added.
Some hope a humble mainstay of Indian transportation may play a key role in reducing traffic and clearing the skies. Newer autorickshaws run on low-emission natural gas. Entrepreneurs hope new dispatch networks will attract passengers to quickly summon rides with just a phone call or text message.