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Jan Morris, writing in her 1988 book on Hong Kong, describes Victoria Peak, the island's highest point, as a place where "the hills of Guangdong stand blue in the distance ... you see the city itself precipitously below you. The early sun catches the windows of Kowloon across the water." But if you had visited the Peak on Sept. 14, when Hong Kong experienced a record-breaking day of air pollution, you would have seen a view that was little more than a smudge. The skyscrapers could be glimpsed only through a veil of noxious smog, sunlight did not glint from windows and as for the hills of Guangdong—they were left entirely to an onlooker's imagination.

Days like this are becoming increasingly common, with 2004 likely to be Hong Kong's worst year for air pollution since the government began daily measurements in 1995. On August 19, visibility was so bad that eight ships had minor collisions in smoggy Victoria Harbor. The city has already had more than 80 days this year when at least one air-monitoring station registered a "very high" reading, compared with just 53 days in 2003, and the level of tiny, breathable particulates in the air is frequently up to twice the safety standard in the U.S. "We're losing ground," warns Dr. Anthony Hedley, chair of community medicine at the University of Hong Kong, where he studies the effects of air pollution. "I think we're headed into the Dark Ages."

Yet here's the most shocking thing about Hong Kong's pollution: by the standards of most Asian cities, the place is as clean as a whistle. In nearby Guangzhou, fine-particulate levels are up to five times U.S. safety limits. In Beijing, citizens were warned to stay indoors for three days last week as heavy smog blanketed the capital and delayed hundreds of flights; in October, Beijing's local environmental agency declared a "state of emergency" over the failure to meet its air-quality objectives for the year, apparently hoping to shame polluters into cleaning up their acts. Meanwhile, according to a study released by the Calcutta-based Chittaranjan National Cancer Institute, 2 out of 5 residents of New Delhi now suffer from health disorders connected to poor air quality, and in Bombay the air is so thick with pollutants that breathing it is the equivalent of smoking 21/2 packs of cigarettes a day. Acid rain from China has scorched the walls of the Imperial Palace in Tokyo. And a gray cocktail of carbon, sulfur and ash the size of the continental U.S. drifts in a holding pattern 3 km above much of South Asia.

The level of air pollution in Asia isn't just a matter of aesthetics. It's one of life and death. According to the World Health Organization, two-thirds of the 800,000 premature deaths caused by air pollution globally occur in Asia. Long-term exposure to air pollution can raise the risk of pulmonary and heart disease, irritate underlying respiratory conditions and potentially take months or more off a healthy life-span. Days when visitors can't see across Victoria Harbor grab the headlines, but major health problems can be caused over many years by lower pollutant doses. "The average days are the days that are causing the damage," says Hedley. "This is a systematic problem, not an occasional problem."

Westerners with any memory know what Asia is going through. As economies in Europe and North America modernized from 1800 to 1950, they spilled Dickensian levels of muck into the air—until legislation and cleaner technology eventually eradicated most of London's pea-soupers and Los Angeles' smogs. In fact, there are some encouraging signs that Asia may be able to avoid the Western fate of polluting first, cleaning up later. Since the 1970s, Tokyo has drastically improved its air quality, thanks to tough emissions standards and enforcement. In New Delhi, a determined judiciary and committed activists are beginning to turn around what has been one of the world's most polluted cities. In China, some concerned citizens are filing lawsuits to force their government to live up to its often hollow environmental pledges. Environmentalists and policymakers from around the region are meeting in Agra, India, this week at the Better Air Quality workshop to plan the way to a cleaner Asia, but that will only happen if governments are willing to make clean air a priority. "Asia can't develop in a business-as-usual model," says Dr. Bob Watson, the World Bank's chief scientist on climate change. Making Asia's air breathable again will take political will, international cooperation and economic sacrifice—but failure would be a disaster.

It was Hui Ouyang's fear for her seven-year-old son's health that finally made her leave the pollution of Beijing. "An adult can endure it," she says. "But a child cannot." For years, the boy struggled with respiratory ailments that would worsen on days when the air was dark with smoke, dust and car exhaust. Finally, this past January, Hui decided to move to Shanghai, where the air isn't quite as bad. Her son's cough has cleared up, and he can play outside again. "I find it's better for him here," Hui says. "Beijing surely is the worst."

The capital is certainly among the most polluted cities in China, but it has plenty of competition. According to the World Bank, 16 of the 20 most polluted cities globally are in China. China's Ministry of Science and Technology says air pollution kills 50,000 newborn babies a year. With the country's ravenous demand for energy only increasing and its automobile revolution just gearing up, however, China's current air pollution may be only the tip of the smokestack. "The danger in China is that you're getting to the point of no return," says Dr. Elizabeth C. Economy, a fellow at the Council on Foreign Relations and author of The River Runs Black: The Environmental Challenge to China's Future.

Nowhere is that sense of urgency more keenly felt than in Beijing, where in less than four years Olympic athletes must run a marathon through streets where respirable particulate levels average three to four times U.S. safety levels. The capital has already passed some of China's most ambitious environmental measures, spending $8.1 billion on environmental-protection projects from 1998 to 2003. Tighter emission standards took effect this fall, public buses that run on alternative fuel are being used, and the city has promised stricter emissions standards on cars by 2007. Despite these efforts, Beijing's air has become increasingly hazardous to human health. Dr. Seamus Ryan, chairman of family medicine at Beijing United Family Hospital, says he sees a rise in respiratory admissions on particularly polluted days: "When the air gets bad, you see people coming in with coughs and rhinitis."

In China's urban areas, the chief culprit is coal. Cheap and abundant, it supplies 70-80% of the country's energy. Though the government has pledged to use more renewable energy and cleaner fuels like natural gas, the scale of China's power demand means that coal use is still expected to nearly double by 2030. When the country faced a huge energy shortage last year, coal mines and power plants that had been closed for environmental reasons were quickly reopened and sulfur-dioxide emissions soared.

It doesn't help that China has fallen dangerously in love with the automobile. In Guangdong alone the number of cars per household rose 31% last year. China's Ministry of Communications estimates China could have 140 million vehicles on the road by 2020, compared with more than 20 million today. Even if emission controls are enforced, this car boom is an environmentalist's nightmare. "You can do a lot of things right," says Economy, "but the question is whether the scale is simply going to dwarf everything you've tried to accomplish."

Air pollution doesn't respect international boundaries, either, so China's neighbors are saddled with its exports. Hong Kong has long had one of the region's best air-quality-monitoring systems, and it impressively curtailed its own pollutants in the 1990s, not least by shifting its energy mix away from coal toward natural gas and promoting cleaner fuels in taxis. But that progress is being reversed, to the dismay of victims like Lincoln Chan. The Hong Kong native has had asthma since childhood, except for an eight-year reprieve when he lived in the U.S. Now, on polluted days, his lungs act up. "I'm almost like a detector," he says. "I can tell when it's a bad-air day." He's thought about fleeing to a cleaner climate, but his job in construction won't allow it. Now he fears for his three-year-old daughter, Charlotte, who's already begun to have respiratory problems. "I'm really worried about her, but there's not a lot I can do. I'm stuck here."

Hong Kong itself is hardly guiltless. China Light & Power (CLP), which provides the majority of Hong Kong's electricity, burned significantly more coal in 2003-4 to make up for a sharp drop in its supply of natural gas. Although the company last week announced plans to clean up its coal plants and increase its gas capacity, this won't take effect for years; CLP's commercial director, Richard Lancaster, says Hong Kong might not see significant improvement in air quality until 2020. But as much as 80% of the city's air pollution comes from across the border, where the factories and power plants operate with far fewer environmental restraints. Call it "one country, one sky." "Guangdong sends polluted air to us, and we send polluted air to Guangdong," says Alexis Lau, who studies air pollution at the Hong Kong University of Science and Technology. Lau's work shows that emissions on both sides of the border have created a pollutant trap over the delta that circulates air pollution around the region (see graphic). As emissions and urban sprawl increase, the trap becomes tighter, making it harder to clear out the pollution even on windy days.

How does a developed city like Hong Kong avoid being swamped by the air pollution of its developing neighbor? Although Hong Kong and Guangdong swear fealty to the same flag, cross-border cooperation is a delicate matter. In 2002 the two governments completed a regional survey of air quality in the Pearl River Delta and agreed to deep cuts in pollutant levels on both sides by 2010. Those cuts are on a "best endeavor" basis, however, meaning the emissions targets are merely aspirations not enforceable caps. "The best-endeavor basis is just accepting the likelihood of failure," says the University of Hong Kong's Hedley. "If this were an infectious disease, we would not be dealing with it on a best-endeavor basis." Still, the mainland won't be hurried, says Sarah Liao, Hong Kong's Secretary for the Environment, Transport and Works: "China is very conscious of the problem. But working with the mainland, you have to go slower. This is a collaborative work. You can't be seen to be criticizing them."

In the meantime, the problem in Hong Kong is exacerbated by the so-called "canyon effect," whereby polluted air gets trapped between the city's tall buildings. Though Hong Kongers are often typecast as caring only for their pocketbooks, recent polls have shown a ground-swell of environmental concern among these captives of the polluted urban landscape. A survey last month of Hong Kong professionals and managers found that 84% believed the government was not doing enough to protect the environment, and the South China Morning Post, the city's main English-language daily, has campaigned relentlessly for the government to confront the crisis. "As people understand what's going on, they're changing their attitudes," says Edwin Lau, assistant director of the environmental group Friends of the Earth Hong Kong.

The mounting sense among regular people that something must be done has spread to the mainland, too. In the boomtown of Shenzhen, solidly middle-class owners of luxury flats are complaining about the construction of a tunnel that's part of a transport corridor linking the city to Hong Kong's container port. They say an environmental-impact study commissioned by the Shenzhen government radically underestimated the pollutants that will leak out of the tunnel due to traffic. The study said that nitrogen-dioxide emissions would be within national standards, but a study conducted by two of the residents, who are both retired engineers, and verified by independent environmental experts, puts emissions at 20 times the national acceptable levels. At a meeting of the informal group's representatives last month, one resident complained: "My apartment is next to a park, which is why I moved here in the first place. Now the highway will run straight through it." She adds: "Why should Hong Kong have so much better laws than we do when this is a cross-border project?" (TIME's attempts to reach the Shenzhen government for comment were unsuccessful.)

Some of the residents are now starting to raise money to finance lawsuits to stop the project. This would be just the latest in a string of cases brought by ordinary Chinese citizens to force their government to live up to its pollution pledges. Without such pressure from the public, economic concerns inevitably tend to trump environmental considerations. "We understand that China is a poor country that needs to develop economically and that this isn't easy," says Shi Zekang, a retired aviation engineer who co-authored the Shenzhen residents' environmental study. "But I've really started to lose confidence that the government will do the right thing." Others share his skepticism. "Of the laws and regulations on environmental protection, only 10% are being enforced," reckons Wang Canfa, a Beijing-based environmental-law professor who, in 1999, founded the Center for Legal Assistance to Victims of Environmental Pollution. "And people tell me that's an optimistic estimate."

Yet China could surely do better. Although China and Japan are hardly the same, the fear that China will be unable to clean up without stalling economic progress is belied by the example of Japan, which also experienced rapid growth that initially caused serious pollution. In the early 1970s Tokyoites took to the streets in surgical masks to shield themselves from the smog. But today Tokyo has some of Asia's cleanest urban air, thanks in part to stringent efforts that brought down pollution even as the economy thrived. That's partly due to people like Yoshimitsu Ikuta, a 60-year-old inspection chief from Tokyo's Vehicle Pollution Policy Division. Ikuta is a "vehicle G-man," one of 75 officers who test the city's auto fleet each day for polluting diesel vehicles. (The name comes from a popular 1970s TV show about hard-boiled detectives.) Though Tokyo doesn't even have a severe problem with diesel pollution—less than 3% of the diesel vehicles inspected by the G-men over the past year were in noncompliance—Ikuta says he still gets calls from happy Tokyoites thanking him for keeping the air clear: "They say their laundry stays clean after it's been outside to dry. I like to hear people's response to our job."

For now, it's hard to imagine Beijing or Bombay ever having a work force of G-men. And it's this lack of administrative commitment—not to mention resources—that really foils efforts to control pollution in developing countries. When smog first struck Tokyo in the late 1960s, the city quickly began applying ever stricter emissions standards on cars and power plants—and, more importantly, enforced them. China has surprisingly tight environmental regulations, but the central government's best intentions are often not implemented on a local level. Countries like China and India have access to far more advanced environmental technology than Japan or the U.S. did when they began to attack air pollution, yet the institutional will is often lacking. "The question is enforcement," says Yang Fuqiang, the China representative of the U.S.-based Energy Foundation, a think tank that supports research on sustainable energy. "There's no capacity, and the budget is limited."

China's State Environmental Protection Agency, for instance, has just 300 full-time staff members. (Hong Kong's Environmental Protection Department has more than 1,600 covering a relatively tiny area.) China's local environmental agencies are notoriously weak, and the central government provides just 10% of their budget; the actual authority and most of the funding for pollution protection rests with local political officials who are more likely to be heralded for economic growth than environmental protection. Penalties are so low that it's not uncommon for polluting factories to keep paying fines rather than install expensive cleaning equipment—which helps explain why, by one estimate, just 5-6% of China's factories employ desulphurisation techniques. Even in Beijing, officials have been unable to enforce a two-year-old ban on the burning of coal in the downtown area. "There's no incentive or disincentive to change behavior," says Economy. "It's just easier, faster and cheaper to do it wrong. Then you pay the price later."

Yet even developing cities have proven that it's possible to dramatically improve air quality. For years, New Delhi vied with Mexico City for the title of the world's most polluted metropolis. Dr. Alok Pradhan, a pediatrician at the Kasturba Hospital in old Delhi, recalls that as recently as 2002 the air was so bad at rush hour that when he traveled on his motor scooter his eyes would burn and he'd feel ill. Eventually he had to change his commuting pattern, going home early or staying late to avoid the worst air. At work, he saw a stream of women and children with respiratory problems exacerbated by pollution.

Lately, however, Delhi's air has begun to clear. Plans had been in the works since 1998 to switch the capital's highly polluting diesel buses to cleaner compressed natural gas (CNG), but vehicle owners objected that the new fuel was too expensive. Finally in 2002 India's Supreme Court stepped in and began imposing fines on recalcitrant operators. Today most of Delhi's buses, taxis and auto-rickshaws run on CNG. The Supreme Court has also ordered a switch to unleaded petrol and the closure of polluting industries in the capital. The effects have been dramatic: from 1996 to 2003, sulfur-dioxide levels dropped 63% and respirable suspended particulates—bits of pollution small enough to be deeply inhaled—dropped 30%. Delhi has shown that strong government intervention—backed by environmental activism—can make a difference even in poorer cities. "The air quality is significantly better," says Pradhan, who no longer avoids the rush hour. The change is palpable, especially for those exposed to it every day. "There's still pollution in the air," says Alok Jaiswal, who sells watches on the street, "but my face doesn't turn black and my eyes don't itch."

That may sound like a small victory, but if Asia's developing countries can at least keep a grip on air pollution, even as they grow rapidly, it would be an enormous win. It should certainly help that countries like China and India can use the technology and experience of more developed nations to grow green. "The technology transfer is happening faster, and people are learning from each other faster," says World Bank environmental expert Jitendra Shah. The key will be whether developing countries can bring to bear the political will and economic resources to accomplish that transition. Air pollution is a globalized problem for a globalized world, one that will affect everyone from millionaires on Hong Kong's Peak to slum dwellers in Bombay. "No matter if you are rich or poor, you have to breathe the same air," says Lau of Friends of the Earth. "It's the concern of every citizen. You can see it; you can feel it." In the future, Asians will breathe easier together—or choke in the same way.

• Bryan Walsh | Hong Kong
• Asia's breakneck growth has blackened its skies, endangering everyone’s health