A new report has revealed that India is home to six of the world’s nine most polluted cities, highlighting the severity of the country’s air quality crisis. The findings, published by Swiss-based air quality database IQAir, analyzed data from 40,000 monitoring stations across 138 countries, identifying India, Chad, Congo, Bangladesh, and Pakistan as having the dirtiest air globally.

The industrial town of Byrnihat in northeastern India was ranked as the most polluted city worldwide, underlining the impact of rapid industrialization and emissions from factories and vehicles.

A Global Crisis: 83% of Cities Fail Air Quality Standards

The report painted a grim picture of global air pollution, revealing that only 17% of cities worldwide meet air quality guidelines set by the World Health Organization (WHO). Experts warned that actual pollution levels could be even worse, as vast regions, particularly in Africa, lack adequate monitoring infrastructure.

Currently, Africa has only one air quality monitoring station for every 3.7 million people, making it difficult to assess the true extent of pollution. However, progress is being made, with 8,954 new monitoring locations and nearly 1,000 additional sensors deployed in the past year to improve air quality tracking.

Despite these advancements, efforts to monitor pollution suffered a setback last week when the US State Department announced it would stop publicly sharing air quality data from its embassies and consulates worldwide. This move could impact the ability of researchers and policymakers to track pollution levels in some of the world’s most affected regions.

Health Risks of Air Pollution: A Silent Killer

Long-term exposure to polluted air is linked to a range of severe health issues, including respiratory diseases, Alzheimer’s, and cancer, according to Fatimah Ahamad, chief scientist at Malaysia-based Sunway Centre for Planetary Health.

The WHO estimates that air pollution causes around 7 million deaths annually, making it one of the leading environmental health threats.

Ahamad emphasized that urgent action is needed to tackle air pollution, pointing out that nearly 99% of the world’s population lives in areas failing to meet recommended air quality standards.

“If you have bad water, you can tell people to wait for a few hours to get clean water. But if you have bad air, you cannot tell people to stop breathing,” she said.

How Cities Are Fighting Back

While the crisis remains severe, some cities have successfully improved air quality through strict regulations and clean energy initiatives.

• Beijing, Seoul, and Rybnik (Poland) have implemented stricter controls on vehicle emissions, power plants, and industrial pollution while promoting public transport and renewable energy.
• In Southeast Asia, the ASEAN agreement on transboundary haze pollution aims to curb pollution from forest fires, though its success has been limited so far.

Air Pollution and Climate Change: A Common Battle

Shweta Narayan, a campaign lead at the Global Climate and Health Alliance, stressed that regions with the worst air pollution are often the same places where large amounts of greenhouse gases are emitted from burning coal, oil, and gas.

“Air pollution and climate change are two sides of the same coin,” Narayan said, adding that reducing fossil fuel use would not only slow global warming but also improve air quality and public health worldwide.

A coalition of 11 EU health ministers is calling for the European Union to integrate funding for critical medicines into its broader defence strategy. The proposal, outlined in an op-ed published on Euronews, urges the inclusion of the upcoming Critical Medicines Act within the EU’s new defence spending framework, citing medicine security as a crucial element of European stability.

The ministers—from Belgium, Czechia, Cyprus, Estonia, Germany, Greece, Latvia, Lithuania, Portugal, Slovenia, and Spain—argue that without a secure supply of essential medicines, Europe’s defence capabilities could be at risk.

A Call for Strategic Investment in Medicine Security

The proposed Critical Medicines Act, set to be unveiled this week by the European Commission, aims to address severe shortages of essential medicines such as antibiotics, insulin, and painkillers. The initiative would focus on medicines that are difficult to source, often relying on a limited number of manufacturers or imports from non-EU countries.

The health ministers advocate for the act to be financed under the EU’s defence budget, allowing it to access part of the €800 billion expected to be mobilized under the Rearm Europe plan. This defence funding package, discussed at last week’s extraordinary EU summit, is designed to ramp up military and security spending across the bloc.

The proposal suggests embedding medicine production investments within a new €150 billion EU defence instrument, which would enable the Commission to borrow from capital markets, issue bonds, and lend to member states.

Parallels with U.S. Defence Strategy

In their op-ed, the ministers drew comparisons to the United States’ Defence Production Act (DPA), which classifies pharmaceutical supply chains as a national security concern. The DPA allows the U.S. government to map supply chains, identify vulnerabilities, and prioritize investments in domestic pharmaceutical production.

The European ministers warn that Europe’s heavy reliance on pharmaceutical imports from Asia—where up to 80% of key medicine ingredients are sourced—poses a serious risk in times of crisis or geopolitical tensions.

“If the supply chain of antibiotics is interrupted in the midst of an escalating conflict, routine surgeries become high-risk procedures, and easily treatable infections could turn fatal,” the ministers wrote. “Foreign actors could exploit this dependency, creating a major security risk for Europe.”

Budget Implications and Political Uncertainty

The push for integrating medicine funding into defence spending comes amid uncertainty over future EU health budgets. The EU4Health programme, launched in response to the COVID-19 pandemic, received €5.3 billion in funding, but recent cuts—including the reallocation of €1 billion to aid Ukraine—have raised concerns over its sustainability.

The European Commission’s next seven-year budget is expected to be tight, and there are indications that dedicated health funding could be merged with other sectors or even eliminated. The proposed defence-linked mechanism, however, could allow increased national health spending by temporarily exempting defence-related expenditures—including medicine security—from EU fiscal limits for four years.

Will the Proposal Gain Political Backing?

It remains uncertain whether the European Commission and Members of the European Parliament (MEPs) will incorporate the ministers’ proposal into legislative talks on the Critical Medicines Act. While some policymakers may welcome a stronger pharmaceutical supply chain as part of Europe’s strategic autonomy, others may be reluctant to blur the lines between health policy and defence spending.

With the legislative proposal expected on Tuesday, the debate over how Europe secures its essential medicines is set to intensify in the coming weeks.