The Lancet Commission on 21st Century Global Threats to Health has identified 17 catastrophic threats facing humanity, spanning health, social and economic conditions, environmental change, technology and conflict. Several of these pose significant concerns for India, particularly air pollution, with the report warning that the cost of tackling high pollution levels in the country could be political rather than economic because of the link between elevated fine particulate matter (PM2.5) levels and agricultural practices that the government may be reluctant to regulate.“We have not quantified the economic impact of the regulation required to reduce PM2.5. In some cases, such as India, the cost might be political rather than economic, as high PM2.5 levels are related to agricultural practices, which the government is reluctant to regulate,” the report said.The 17 threats include air pollution, antimicrobial resistance, childhood malnutrition, climate change, conventional conflict, declining development assistance for health, high alcohol use, high blood pressure, income inequality, low educational attainment, naturally occurring pandemics, obesity, poor mental health, smoking, unhealthy ageing, nuclear conflict and the malicious use of AI.The commission warned that if current trends continued, these threats could collectively account for tens of billions of years of lost healthy life. “While the scale varies by threat and region, every country faces significant risks. Within each country, the health harms will also be distributed unequally, with people in resource-limited settings and marginalised communities bearing the greatest burden, compounded by existing inequalities,” the report said.The report also highlighted the potential health benefits of limiting global warming. Keeping the rise in global temperatures to around 1.8°C, instead of allowing it to reach 4.4°C, could prevent 1.89 billion years of healthy life from being lost to causes such as extreme heat and air pollution. Without sharp cuts in emissions, these losses would continue to accumulate beyond 2100 and increasingly intensify other threats, including migration, in ways not yet reflected in the estimates, the commission said.Commission co-chair Prof Christopher JL Murray, Director of the Institute for Health Metrics and Evaluation at the University of Washington, said, “The striking finding is not only the scale of these threats, but that humanity still has the agency to act. Across all 17 catastrophic threats, the decisions made by leaders today will shape the health and well-being of the next generation. But delaying action will only serve to shift and increase the costs into the future.”“The estimates highlight how much health loss could be avoided in each area. Some are already imposing substantial health burdens today, while others carry a real danger if they materialize. Crucially, all 17 threats are interconnected, which is why they must be addressed together, not in isolation,” added Murray.