The development of mega infrastructure projects like Peshawar BRT affects air quality and urban environment more than anything else. From rickshaw drivers to aviation industry, school-going children to visiting tourists, everyone complains about economic losses and health issues of poor air quality in Pakistani cities these days. However, the traditional inertia, our national hallmark, has so far proven stronger than frailties of livelihood and disease. Our countrymen seem contented with haphazard and hyper urbanization of their cities, fast deterioration of physical infrastructure including housing, roads & transport and water supply & sanitation and degradation of environment such as air and water quality. No one is bothered about the poor environmental conditions that cause productivity losses and incur additional health costs to the government and household economies. In recent years, there has been tremendous increase in the incidence of chronic and communicative diseases due to poor water and air quality in cities of Pakistan and other South Asian Countries. The World Health Organization estimates that 3 million people die from ambient outdoor pollution and 1.5 million from indoor air pollution every year, with South and Southeast Asia getting a major share. The government’s response is reactive and superficial as usual. Whereas, some actions and programs on water supply & sanitation in big cities have seen light of the day such as establishment of water purification plants; the urban air quality has been paid little attention to by the relevant agencies such as Environmental Protection, Urban Transport and Health Departments. The authorities must realize that air quality is even more important than water quality. For instance, a normal person drinks two liters of water but breathes 11,000 liters of air every day. A recently published study “CogFX” by the Harvard School of Public Health claims that higher levels of ventilation increases cognitive ability of human brain by 97-288 per cent. On the other hand, the increased levels of substances such as particulate matter cause different respiratory issues in humans, whereas, the higher concentrations of CO2 in the environment creates urban heat island effect and a host of climate related impacts. The scientific community is unanimous in declaring the recurrence of smog conditions at the start of winter every year a symptom of a deeper malaise that requires the correct identification of the causes and effects of man’s interference in nature’s cycle and appropriate action for its cure In the last couple of years, the judicial prodding in Pakistan has pushed the government to take some punitive actions against “dirty'” industries and agricultural practices to control smog conditions and poor air quality in Lahore and some other cities. However, these cosmetic and temporary actions are highly unlikely to improve livability of cities and health and productivity of communities. “The air quality will continue to slide downward in coming years if it is not scientifically monitored and strictly maintained”, says Mr. Sohail Naqvi, Senior Project Officer at WWF Pakistan, working on water and air quality issues.”Currently, some government and privately sponsored air quality monitoring exercises have been started but they are creating more confusion and alarm in the public than awareness and caution due to their contrasting readings on air quality parameters”, he added. A few years ago, the Urban Unit of the Punjab found that air pollution was primarily an urban problem in the province as the rate of urbanization increases. The urban air quality is being deteriorated due to inadequate traffic flow and transport management, use of outdated technology including fuel substitution, non-availability of less polluted fuels and fuel adulteration, non-existence of management tools for effective implementation of laws on emissions and above all absence of transport planning. The Punjab EPD’s data on different ambient air quality parameters shows that NOx and PM2.5 are the major areas of concern in the five largest cities of Punjab where NOx and PM2.5 values hover above 170µg/m3and 250µg/m3respectively against the desired valuesof40µg/m3as per National Environmental Quality Standards. The sectoral emissions inventory of Punjab, just released by Agriculture Department in January this year reveals that the major portion of total air pollutant emissions comes from the transport sector which is responsible for 43 per cent air pollution, followed by 25% from industrial sector and 20% from agriculture sector. However, experts believe that air quality data at city, sector and building levels must be gathered and analyzed on regular basis to initiate adequate response from the concerned departments. The collection and analysis of scientific data is definitely the first step but the ultimate goal of improved air quality and health of urban communities is a distant dream that requires concerted efforts by all stakeholders for its realization. From the current data, it appears that the improvement of roads and transport infrastructure and energy efficiency in building and construction sectors must precede punitive actions against industry and agriculture. The scientific community is unanimous in declaring the recurrence of smog conditions at the start of winter every year a symptom of a deeper malaise that requires the correct identification of the causes and effects of man’s interference in nature’s cycle and appropriate action for its cure. The writer is a freelance contributor