Air pollution was responsible for nearly eight million deaths globally in 2023, with the health impacts costing an estimated $8.1 trillion annually, according to the State of Global Air Report 2025. This figure represents approximately six percent of the world’s GDP, as reported by the World Bank.
Dr MarÃa Neira, a former director at the World Health Organisation, highlighted the pervasive nature of air pollution, stating that harmful particles can affect any organ in the body, including the brain. This exposure is linked to cognitive decline and serious diseases such as Parkinson’s, Alzheimer’s, and dementia, as noted in a report by Euronews.
In response to the growing concern over urban air quality, Breathe Cities, a global initiative, is collaborating with 16 cities worldwide to enhance access to air quality data and promote clean air policies. The initiative aims to address the significant health risks associated with air pollution.
For instance, London has successfully reduced deaths linked to toxic air by approximately 40 percent since implementing its Ultra Low Emission Zone (ULEZ) and other clean air initiatives, according to an independent study conducted by Imperial College London.
Conversely, Sofia, Bulgaria, continues to grapple with severe air pollution, primarily from traffic and wood-burning heating. Dr Kostadin Kostadinov from the Medical University of Plovdiv indicated that by 2023, Sofia was among the cities with the highest number of deaths attributable to air pollution.
Dr Neira pointed out that the primary barrier to addressing air pollution is political will rather than technological limitations. She noted resistance from fossil fuel and transport industries as cities strive to transition towards renewable energy and sustainable mobility solutions. The ongoing challenges posed by climate change are expected to exacerbate these issues.
Breathe Cities is now preparing to enter a second phase of its initiative, aiming to extend support to additional communities while building on the progress made in cities like London and Sofia.
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