World leaders aren’t doing enough to address pollution at its source, leaving nearly 9 million people each year to die from its effects.

That’s the message delivered on Tuesday by public health experts from the Lancet Commission on Pollution and Health, a high-profile panel of scientific experts. In a new progress update, they report that death and disease rates from pollution are as high as they’ve ever been, causing 1 in 6 deaths worldwide and disproportionately affecting people in the developing world, also sometimes known as the Global South.

“There’s not a whole lot being done about it,” said Rachael Kupka, executive director of the Global Alliance on Health and Pollution and one of the report’s coauthors. She called for coordinated action from world governments and international agencies to mitigate pollution while also addressing other threats such as climate change and biodiversity loss.

The progress update builds on previous data compiled by the Lancet commission, which showed that pollution was responsible for 9 million deaths in 2015. Now, the researchers say that number has remained virtually unchanged. Despite a decrease in deaths from types of pollution associated with extreme poverty — such as household air and water pollution — these modest gains have been more than offset by increased deaths from other forms of pollution such as airborne particulate matter.

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Air pollution is by far the deadliest culprit, causing more than 6.5 million deaths per year, followed by water pollution, lead, and other hazards. Some of the primary sources of air pollution include tiny particles known as PM 2.5, named for their diameter of just 2.5 micrometers — about 30 times smaller than the width of a human hair. These particles, which are produced from wildfires and the burning of fossil fuels, can lodge themselves deep into people’s lungs and cause respiratory, cardiovascular, and neurological damage. According to a 2021 estimate from researchers from the University of Chicago, a failure to meet international guidelines for PM 2.5 exposure takes away roughly 21 billion years of life expectancy every year.

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