Clean-air interventions across South Asia’s Indo-Gangetic Plains and Himalayan Foothills (IGP-HF) could significantly improve public health and economic productivity for nearly one billion people, according to a new World Bank report released on December 15.

The report, A Breath of Change: Solutions for Cleaner Air in the Indo-Gangetic Plains and Himalayan Foothills, warns that air pollution in the region remains one of South Asia’s most severe development challenges. Unhealthy air exposure across the IGP-HF—covering parts of Bangladesh, Bhutan, India, Nepal, and Pakistan—is linked to around one million premature deaths annually, while economic losses are estimated at nearly 10 percent of regional GDP each year.

The World Bank finds that a limited set of coordinated and scalable actions, implemented across multiple sectors and jurisdictions, could substantially reduce pollution, improve health outcomes, and support stronger economic growth.

According to the report, air pollution in the IGP-HF originates from five major sources: households burning solid fuels for cooking and heating; industries using fossil fuels and biomass inefficiently without adequate filtration; inefficient internal combustion vehicles; agricultural practices such as crop residue burning and poor fertilizer and manure management; and the open burning of waste by households and firms.

The report identifies practical solutions that can be rapidly adopted and expanded, including electric cooking, electrification and modernization of industrial boilers, furnaces, and kilns, expansion of non-motorized and electric transport systems, improved crop residue and livestock waste management, and better waste segregation, recycling, and disposal systems.

Clean-air solutions are structured around three mutually reinforcing pillars. The first focuses on abatement measures to reduce emissions at their source across cooking, industry, transport, agriculture, and waste management. The second emphasizes protection measures that strengthen health and education systems to shield children and vulnerable populations during the transition to cleaner air. The third pillar highlights the role of strong institutions, supported by effective regulation, market-based instruments, and regional coordination, to sustain progress over time.

“This report shows that solutions are within reach and offers a practical roadmap for policymakers to implement coordinated, feasible, and evidence-based actions at scale,” said Martin Heger, Senior Environmental Economist at the World Bank. “There are strong financial and economic rationales for South Asian enterprises, households, and farmers to adopt cleaner technologies and practices, and for governments to support them.”

To help governments translate recommendations into action, the report underscores the importance of the “Four I’s”: information to provide reliable data for planning and accountability; incentives to drive behavioral and investment shifts toward cleaner options; institutions to coordinate implementation and ensure compliance; and infrastructure to enable clean energy, transport, waste systems, and modern industrial operations.

“Achieving cleaner air will require sustained financing, strong implementation, and continued collaboration at local, national, and regional levels,” said Ann Jeannette Glauber, World Bank Practice Manager for Environment, South Asia. “By acting together, governments can cut pollution, save millions of lives, and deliver cleaner air for all.”