Air pollution claimed approximately eight million lives worldwide in 2023, according to the State of Global Air 2025 report. The World Bank estimated the annual health-related cost of air pollution at around US$8.1 trillion, equivalent to nearly 6% of global gross domestic product (GDP).
Maria Neira, a former World Health Organisation (WHO) official, warned that air pollution affects more than just the respiratory system. Pollutant particles can reach various organs, including the brain, and have been linked to cognitive decline and neurological conditions such as Parkinson’s disease, Alzheimer’s disease and dementia.
Cities around the world are stepping up efforts to reduce air pollution and improve public health. The Breathe Cities initiative is working with 16 cities to expand air-quality monitoring and support the implementation of environmental policies aimed at reducing emissions and exposure to harmful pollutants.
In London, deaths associated with air pollution have fallen by approximately 40% since the introduction of the Ultra Low Emission Zone (ULEZ) and other measures, according to an independent study by Imperial College London. The findings highlight the potential impact of targeted urban policies on reducing the health burden of air pollution.
In Bulgaria’s capital, Sofia, transport and wood-burning heating are among the main sources of air pollution. Authorities have introduced a low-emission zone, but its implementation is currently limited to three months a year. This has prompted calls for the measure to become permanent to strengthen efforts to improve air quality.
Neira argued that the main challenge in tackling air pollution is no longer technological but political, pointing to the need for stronger policy decisions and sustained action. Meanwhile, the Breathe Cities initiative is preparing to expand its work to additional cities and communities, as efforts to address the global health impact of air pollution continue.
