Pakistan has been named the world's most polluted country in a new global air quality report, with India ranking sixth, underscoring an environmental crisis that affects hundreds of millions of people across South Asia who share the same toxic air regardless of cricket rivalries.
Cricket rivalries aside, Pakistan and India share the same toxic air. When Fatima Ahmed visited Karachi for a month, she remained "constantly sick with flu, cough, chest congestion, irritated sinus and mouth palate and sometimes fever," she wrote on social media. Her question resonates across the border: "How do you live?"
The answer, for the roughly 500 million people living in Pakistan and northern India's most polluted regions, is that they often don't have a choice. A billion people aren't a statistic - they're a billion stories, and many of those stories now involve chronic respiratory illness, shortened lifespans, and children who have never seen a clear blue sky.
According to the pollution data, Loni in Ghaziabad, India, ranks as the world's most polluted city. The designation offers little comfort to residents of either country. Air pollution recognizes no borders - the same weather patterns, crop burning, industrial emissions, and vehicle exhaust that choke cities in Pakistan also suffocate Indian metros.
"The air quality index in Lahore and Delhi routinely exceeds 400 during winter months - that's hazardous, the kind of air where health officials tell you not to go outside," says Dr. Saima Wazed, a public health researcher at the Regional Air Quality Network. "But people have to go outside. They have to work, send children to school, live their lives."
Both countries have implemented measures to combat air pollution, from odd-even vehicle schemes to temporary construction bans and crop residue burning restrictions. But enforcement remains weak, and the fundamental drivers - rapid industrialization, insufficient public transportation, reliance on coal and other dirty fuels, and agricultural practices - persist.

