The president, according to reports, has been racked with a cough for the past month, which might not surprise residents of the capital Jakarta where air quality is among the worst in the world and where Jokowi was told by a court that he must clean it up.

“He has been coughing for almost four weeks and said he has never felt this way,” Indonesia’s Minister of Tourism and Creative Economy Sandiaga Uno said after a cabinet meeting in Jakarta this week.

Doctors were diagnosing the cause of the president’s cough, Uno said, adding that it might be related to worsening air quality, which Jokowi has asked to be tackled “within a week”.

The cough and Uno’s remarks came as air quality in Indonesia’s capital has steadily plummeted in recent weeks, leading Swiss air quality technology company, IQAir, to release data that showed Jakarta had the worst air pollution in the world.

Even before that newly-released data, studies have consistently found Jakarta to be one of the most polluted places in the world due to a confluence of factors which include vehicle exhaust emissions, construction projects, the burning of biomass and other fuels, including coal, and the release of aerosols.

Part of the air pollution problem in Jakarta is also caused by factories and industry in surrounding areas which emit a putrid smog that wafts across the capital.

If the president’s cough has indeed been caused by air pollution, critics are likely to say it is the consequence of his own inaction.

Jokowi lost a landmark “citizen lawsuit” in 2021 that was filed by 32 plaintiffs in response to the deteriorating air quality in the capital.

Three judges presiding over the case – in which Widodo and three ministers and three provincial governors were named as defendants – found that they bore responsibility for Jakarta’s air pollution. The governors of neighbouring West Java and Banten provinces had failed in their duty to regulate pollution in their areas, which had affected the capital, the judges ruled.

The defendants had “committed an unlawful act by neglecting to take measures to control air pollution in Jakarta”, the judges said at the time, ordering the president and his officials to improve air quality in the capital and also revise government regulations on air pollution.

Then-governor of Jakarta Anies Baswedan said that he would not appeal the verdict and that his administration was “ready to carry out the court’s decision to improve the air quality in Jakarta”.

Jokowi and his ministers appealed the verdict, only to lose again in 2022, before appealing again in 2023. That final verdict is still pending.

“It’s very sad, isn’t it, that the government just started moving and looking busy after the President coughed for a month?” said Elisa Sutanudjaja, one of the plaintiffs in the “citizen lawsuit”.

“They have been in denial for two years and continue to appeal every time they lose in court,” said Sutanudjaja, who first started to be concerned about pollution in the capital when she became pregnant.

Sutanudjaja told Al Jazeera that she was unmoved by the sudden flurry of activity around air quality at the cabinet meeting on Monday, noting that the citizens’ case to stop air pollution had gone on for years because of government appeals.

“How many people got sick and died because of pollution during those two years of denial?” she asked.

Indonesia’s Ministry of Health acknowledged that there are 600,000 residents of Jakarta living with upper respiratory infections as of August this year, Bondan Andriyanu, a climate and energy campaigner for Greenpeace Indonesia, told Al Jazeera.

“This is an emergency and needs to be handled urgently,” Andriyanu said of the air pollution crisis.

“It shouldn’t need to go viral online and only then does it get handled.”

As part of the cabinet meeting on Monday, Jokowi reportedly instructed his ministers to create more green spaces in the city and encourage offices to implement hybrid working conditions, which are considered half measures that have angered activists and plaintiffs involved in the citizen lawsuit.

“I’m annoyed to see that the central government can only shift the responsibility to the residents and hope residents use public transportation, even though the public transportation system is very bad,” Sutanudjaja said.

“They also seem to ignore the existence of industries and power plants and only blame the people for the pollution,” she said.

On Wednesday, the eve of Indonesia’s Independence Day on August 17, the Jakarta Clean Air Initiative Coalition, a group made up of the plaintiffs and other clean-air advocates, protested in the capital over the pollution.

“On the 78th anniversary of independence, I feel that the independence of the Indonesian people has been taken away by state administrators who should have been able to solve the air pollution problem,” said Istu Prayogi, a plaintiff in the citizens lawsuit who lived in Jakarta during the 1990s and has been diagnosed with spots in his lungs.

While critics say the government has failed to implement practical, anti-pollution solutions in Jakarta, there is now a mammoth plan to move Indonesia’s capital to a new, smog-free location some 1,200 km (745 miles) away in East Kalimantan, the eastern portion of the island of Borneo.

The plan was first unveiled the day before Indonesia’s 74th Independence Day in 2019, during Jokowi’s annual address to the nation, and has long been touted as the solution to Jakarta’s myriad problems which, in addition to the choking air, includes traffic jams, overcrowding and unregulated groundwater extraction which is causing the capital city to sink.

According to the plan, which is projected to cost more than $32bn, 1.5 million of Jakarta’s 11 million residents will relocate to the lush jungles of Borneo, where the air will be crisper and no one is racked by coughs brought on by pollution.

Sutanudjaja, the plaintiff in the citizen lawsuit, said she was sceptical, calling the plan to move the capital “an excuse”.

“They are just moving the problem,” she said.