The study, titled the Environment Performance Index, also warns that India is staring at a public health crisis if concrete measures are not taken to curb pollution.

“As the dominant source of diseases and disability in our data, countries that score poorly in the 2018 EPI on Air Quality, such as India (Air Quality score of 5.75), China (14.39), and Pakistan (15.69), face a public health crisis that demands urgent attention,” the report said. Modi had rated climate change and environment degradation as one of the top threats that the world faced during his address.

According to the report, the only countries ranked below India are the Democratic Republic of Congo, Bangladesh and Burundi. India has fallen 36 places as compared with the rankings of 2016. “We will not face a public crisis, we are already facing it. Forget the standards prescribed by the World Health Organization, we are struggling to meet the standards prescribed by the government,” said Polash Mukerjee, senior researcher in the air pollution department at the Centre for Science and Environment.

“The report is very robust and comprehensive. If we see the parameters taken into account, India ranks high in all of them. We have had high levels of PM 2.5 and also household fuel consumption on par with sub-Saharan countries. Data provided by the governments of countries has been verified by satellites,” he said, and added that China and Russia have been caught manipulating air quality data in the past.

The study also finds that India has not done enough to tackle air pollution when compared to countries like China.

“Some of the lowest-ranking nations face broader challenges, such as civil unrest, but the low scores for others can be attributed to weak governance,” the report states.