kathmandu and manila are probably the dirtiest. i’ve been to india but skipped the major cities except bangalore (it was technically a work trip, but i stuck around for several weeks and did some sightseeing). in africa… cairo. in europe… the turkish republic of northern cyprus, if that counts as europe.

worst: federated states of micronesia—no healthcare to speak of. the recommended procedure for anything worse than a head cold is “fly yourself to guam”.

best: taiwan.