Remarkably after a yearlong effort by environmental health advocates, air quality has been embedded in the new set of universal development goals for a sustainable future. Since an estimated 60 percent of the global population will live in cities by 2030, which is the deadline of the new goals, outdoor urban air quality is now recognized in three of the 17 Sustainable Development Goals agreed on by the United Nations’ 193 member states on Aug. 2.

Megacities like Delhi and Beijing, which have swapped top-polluted rankings on lists compiled by the World Health Organization, are already challenged. Will these highly polluted cities improve their air quality in 15 years?

Delhi currently has the highest air pollution ranking worldwide, according to WHO’s tabulation. In China, air quality has improved slightly in Beijing, for example, but remains at an unhealthy level even by government standards.

According to news reports, the United States embassy in Delhi said the Air Quality Index value [of] 260 falls regularly in the category of ‘very unhealthy.’ Prakash Jadvekar, the environment minister, recently acknowledged in Parliament that “Foul air is killing up to 80 people a day in Delhi.”

As an example of just how much Delhi’s pollution is affecting the health of its citizens, the chief minister, Arvind Kejrival, recently flew to Bangalore’s Jindal Naturupathy Institute to receive a 12-day treatment for what was continuously played on national television as unabated bronchial asthma. The rest of Delhi’s almost 20 million people do not have that option.

Air quality is easily measured by both ground air monitors and satellite data, with the information provided online and on phone apps. Anyone can get the information directly from an expanding directory of official Air Quality Indexes for cities around the world, with the information updated hourly.

The Sustainable Development Goals (SDGs) will provide a Global Air Quality Framework by using guidelines on what is accepted as safe air and healthy to breathe. The guidelines, set up by WHO, have become a ceiling on air pollution.

This framework will be implemented through three targets: a large reduction in the number of deaths/illnesses from air pollution; a reduction in adverse per capita environmental impact, including air quality of cities; and sound environmental management of chemicals, including a significant reduction of their release to the air. Indicators will come from governments and independent data sources.

Mogens Lykketoft, Denmark’s former speaker of Parliament and the president-elect of the UN General Assembly, views his goal in the latter role as “implementation, particularly the speed of government decision-making in the framework of green development.” Lykketoft plans to also “involve progressive parts of business and capital funds” to emphasize to businesses that “If you want to earn money, this is the future.”

India’s unique challenge in managing its air quality is linked to its devolved democratic form of government, in which opposing political parties are elected to govern at national, state and city levels, leading to political gridlock.

Dr. Randeep Guleria, the head of Pulmonary Medicine at the All India Institute of Medical Sciences, said that while medical experts have held “informal meetings with Delhi government, as yet there is no concrete action plan.”

Anumita Roy Chowdhury, the executive director of research and advocacy for the Center for Science and Environment, a Delhi organization, recalled the optimism of the 1999-2003 first-generation pollution controls, in which the “polluting industry was moved out; coal plants converted to natural gas; the country’s largest public transport system [was] set up; natural gas [was] introduced for cars. As a result, air-pollution levels declined.”

“Since then, there is an explosive increase in motorization — 1,300 new vehicles a day are added to Delhi,” Chowdhury added. “A nationwide policy is urgently needed; air pollution doesn’t follow political boundaries.”

India’s highly respected medical community is also speaking out. Dr. Guleria, the pulmonary specialist, warned that “Chronic obstructive pulmonary disease has been rising by up to 10 percent a year in nonsmokers, including newborns of exposed mothers.”

Data show increases of obstructive pulmonary disease cases to nearly 38,000 in 2014-2015 from about 10,000 cases of respiratory ailments in 2005-2006. “Systemic inflammation also leads to coronary artery disease,” Dr. Guleria said.

Chowdhury said she welcomed the inclusion of nationwide air-quality monitoring in the Indian government’s latest national five-year plan and urged more concrete, coordinated steps to improve air quality.

Beijing: Getting Less “Greyjing”

Beijing, China’s capital, used to represent the epitome of horrific air pollution, but according to Greenpeace, improvements in the city have been made since the government changed direction on coal.

Greenpeace’s review of particulate matter 2.5 concentration levels — a key measure of air quality — in 360 Chinese cities recorded an average 17 percent decline since 2013. Beijing’s particulate matter 2.5 concentration improved more than 13 percent, compared with the first quarter of 2014.

“Countrywide average level is 53.8 [particulate matter] in first half of 2015, still five times higher than WHO [standards] and higher than China’s own standard of 35,” said Dong Liansai of Greenpeace. “But the trend is down.”

AirNow data on @BeijingAir, a US embassy Twitter account, shows the daytime air-quality index still reaching 200, a very unhealthy level.

Policy changes on air quality have also resulted from senior Chinese officials recognizing the health costs of current air pollution levels, which usurp an estimated 6.5 percent of China’s gross domestic product, or approximately $535 billion in 2012.

“Beijing needs to solve the problem of PM 2.5, which is a big problem for us,” said Ming Dengli, the chief of international cooperation at the Beijing Environment Protection Bureau.

Ming cited Beijing’s new legal powers to fine polluters. “Since March 2014, we can set very high fines,” she said. “Before, it was cheaper for industry to pay the fine than to replace pollutants.” Beijing has shut down three of its four coal plants, and the last one is to be shut in 2016.

Each progressive national plan tightens the air-quality/vehicle emissions standards. “Currently, Beijing’s vehicle emissions standards are in China 5 [the government’s emissions control plan],” Ming said, which is equivalent to Euro 5, Europe’s emissions standards plan. “From 2016, China 6 will be closer to [the stricter] US emissions standards.”

Dong of Greenpeace also credited the overall plans’ “powerful motivation” of linking provincial officials’ job performances with target air quality levels for the province, so that moving the polluting industry around the province or reducing the pollutant itself is no longer enough.

Late last year, in a breakthrough agreement, China said it would work with the US and other countries to reduce greenhouse gas emissions through a treaty or other instrument at the climate-change summit meeting to be convened in Paris at the end of 2015.

In another urgent turnaround, China has signed several international cooperation agreements on air quality, including with California, Italy and London. On the Forbes list of the 10 largest solar companies, six are Chinese.

Experts in both Beijing and Delhi are promoting citizens to “Start with yourself, take public transport,” Ming said.

Chowdhury’s appeal to Indians is more fundamental. “The majority of our population is still walking/cycling/using public transport,” she said. “There is still an opportunity for us to protect this baseline of traditional sustainable lifestyle.”