The World Bank's 2025 report 'A Breath of Change' studies air pollution across the Indo-Gangetic Plains and Himalayan Foothills, covering 13 jurisdictions in Bangladesh, Bhutan, India, Nepal and Pakistan. Pollution there causes around 1 million premature deaths a year and costs about 10% of regional GDP annually. PM2.5 levels run 8 to 20 times above WHO guidelines, the worst in the world. The report backs a '35 by 35' target and proposes action through its '4Is' framework: Information, Incentives, Institutions and Infrastructure.