Conclusions
IAP from solid fuel use is responsible for a large burden of disease among the world's poorest and most vulnerable populations. Inefficient and polluting household energy systems hold back development through resulting ill health, constraints on women's time and income generation, environmental impacts, and other factors. Although there is a trend toward cleaner and more efficient energy with increasing prosperity, little improvement is in prospect for more than 2 billion of the world's poorest people, particularly in South Asia and Sub-Saharan Africa. The number of people relying on traditional biomass is actually expected to increase until 2030.
Although the development of new energy technologies has a part to play in addressing this problem, many effective interventions are already available. The single greatest challenge is to dramatically increase the access of poor households to cleaner and more efficient household energy systems. Much valuable experience has been gained from successful—and unsuccessful—programs in household energy over the past three to four decades. Despite this experience, coherent, evidence-based policy is lacking in most of the countries concerned, where the lessons from experience now need to be implemented. Implementation will require greater awareness of the problem at international and national levels, provision of support for national collaborative action, and a focus on supporting appropriate, mainly market-based interventions.
Better information is crucial to this effort, including stronger evidence of the health effects of IAP exposure; assessment of the social, economic, and environmental benefits of interventions; and indicators to monitor progress. Economic analysis can help bring the case for action into policy, but it needs to be applied at country level and to include a wider range of benefits. Results from analysis at the regional level show that interventions can be cost-effective, particularly improved stoves, as long as these interventions can deliver substantial exposure reductions in practice. This conclusion, as well as its qualification, is important given the expectation that biomass will remain the principal household fuel in many developing countries for more than 20 years. The balance of effort and resources put into promoting cleaner biomass interventions rather than cleaner fuels, or vice-versa, will be an important policy issue for many countries and for the international community (Smith 2002).
With a range of innovative projects and programs under way in a number of countries and regions of the world, now is an important time to focus attention and effort on achieving the health, social, and economic gains that should result from improvements in household energy systems in developing countries.
Notes
1. Particles are typically described according to the aerodynamic diameter, and although the devices used to separate particles of a given size do not yield a very sharp cutoff, this classification is functionally useful because smaller particles are able to penetrate farther into the lungs. Total suspended particles (TSP) include suspended particles of all sizes. Commonly defined smaller particles include PM10 (up to 10 microns diameter); respirable PM (includes all very small particles, about 50 percent of those 4 microns in diameter, and none above 10 microns in diameter); and PM2.5 (up to 2.5 microns in diameter).
2. Not her real name.
